111-1          DETERMINING THE AMOUNT OF A PROGRAM LOSS

The caseworker calculates the amount of the overpayment according to program policy.  Rework each error month through the appropriate EIS Eligibility Information System benefit determination screen and then press the ENTER key to exit out of the FSAD Food Stamps Allotment Determination screen.  For APA Adult Public Assistance, the caseworker must calculate the overpayment manually. When submitting claims for APA Adult Public Assistance overpayment, the caseworker must complete the GEN 95 Report of Claim Determination form and the APA 5 APA Claims Budget Worksheet worksheet. The amount of an overpayment is determined by subtracting what should have been issued from what was actually issued for each error month. The supervisor, case reviewer, or lead worker uploads the GEN 95 Report of Claim Determination form, APA 5 APA Claims Budget Worksheet worksheet for APA Adult Public Assistance overpayment, FSAD Food Stamps Allotment Determination and/or TAPD Temporary Assistance Payment Determination screenshots into ILINX and emails them to the Claims Unit.

Follow the procedures to submit claims (GEN 95 Report of Claim Determination):

Caseworker:

1. Complete GEN 95 Report of Claim Determination form.

2. Capture the FSAD Food Stamps Allotment Determination screen before and after overpayment using Snipping tool.

3. If APA Adult Public Assistance overpayment, include APA 5 APA Claims Budget Worksheet form.

4. Send form and screenshots to leadership.

5. Write on subject line: "GEN 95 for Review and Upload."

Leadership:

1. Review GEN 95 Report of Claim Determination form for accuracy.

2. If corrections needed, send back to caseworker, who will correct and resend.

3. If correct, upload into ILINX via Capture.

4. Complete submission through Capture tab, Classification Queue and Work Queue.

1. Use the following Classification DOC Types:

1. Report of Claim Determination (GEN 95 Report of Claim Determination and APA 5 APA Claims Budget Worksheet)

2. EIS Eligibility Information System Screen pertaining to Over/Underpayments (FSAD Food Stamps Allotment Determination screenshots)

5. In Content Store, select case files (doc types of Report of Claims Determination and EIS Eligibility Information System Screens pertaining to Over/Underpayment) for client.

6. Select email as attachment (can include multiple attachments).

7. Email to the Claim Unit at DPAClaims@alaska.gov.

Attach copies of the EIS Eligibility Information System payment screen or manual budgets reflecting the overpayment or underpayment determination to the Report of Claim Determination e-Form (GEN 95 Report of Claim Determination), and submit them to the Benefit Issuance and Recovery Unit in Juneau.  

Note:

When submitting a GEN 95 Report of Claim Determination for a SNAP Supplemental Nutrition Assistance Program overpayment, print the FSAD Food Stamps Allotment Determination screens for each month, before and after corrections are made to the case. One printout will show the benefit that was issued and another one will show the overpayment that has been calculated.

Include all screen shots with the GEN 95 Report of Claim Determination submission to the Benefit Issuance and Recovery Unit in Juneau.

Although unintentional household error claims for SNAP Supplemental Nutrition Assistance Program are limited to 12 months prior to the date of discovery, unintentional household error and agency error claims for APA Adult Public Assistance and ATAP Alaska Temporary Assistance Program cases do not have a limit to how far back a claim can be established. Claims should be established beginning the date the error originally occurred. The same time frames apply to underpayments.

Note:  

A program loss occurs for benefits issued pending the fair hearing decision when the hearing decision supports the agency’s action.