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 EISEligibility Information System benefit determination screen and then press the ENTER key to exit out of the FSADFood Stamps Allotment Determination screen. For APAAdult Public Assistance, the caseworker must calculate the overpayment manually. When submitting claims for APAAdult Public Assistance overpayment, the caseworker must complete the GEN 95Report of Claim Determination form and the APA 5APA 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 95Report of Claim Determination form, APA 5APA Claims Budget Worksheet worksheet for APAAdult Public Assistance overpayment, FSADFood Stamps Allotment Determination and/or TAPDTemporary Assistance Payment Determination screenshots into ILINX and emails them to the Claims Unit.

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

Caseworker:

1. Complete GEN 95Report of Claim Determination form.
2. Capture the FSADFood Stamps Allotment Determination screen before and after overpayment using Snipping tool.
3. If APAAdult Public Assistance overpayment, include APA 5APA 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 95Report 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 95Report of Claim Determination and APA 5APA Claims Budget Worksheet)
      2. EISEligibility Information System Screen pertaining to Over/Underpayments (FSADFood Stamps Allotment Determination screenshots)
5. In Content Store, select case files (doc types of Report of Claims Determination and EISEligibility 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 EISEligibility Information System payment screen or manual budgets reflecting the overpayment or underpayment determination to the Report of Claim Determination e-Form (GEN 95Report of Claim Determination), and submit them to the Benefit Issuance and Recovery Unit in Juneau.

Note:

When submitting a GEN 95Report of Claim Determination for a SNAPSupplemental Nutrition Assistance Program overpayment, print the FSADFood 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 95Report of Claim Determination submission to the Benefit Issuance and Recovery Unit in Juneau.

Although unintentional household error claims for SNAPSupplemental Nutrition Assistance Program are limited to 12 months prior to the date of discovery, unintentional household error and agency error claims for APAAdult Public Assistance and ATAPAlaska 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.