607-3 CLAIMS
Claims are established against households receiving more food stamps than they are entitled to receive. Whether the overissuance was caused by agency error, inadvertent household error (client misunderstanding or failure to report) or intentional program violation (client fraud), collection must be attempted as outlined in this section.
All adult household members are jointly and individually liable for the value of any overissuance of food stamps to the household.
Agreement to repay, or payment of, the overissuance shall not relieve a household of civil or criminal liability, or from collection of the overpaid food stamps under any other applicable provision of law. Nor does it relieve a household from payment of any additional amounts due from other overpayments identified later.
For each food stamp overissuance discovered, the caseworker is responsible for providing the Claims Unit in Juneau with a completed Report of Claim Determination (GEN 95). See MS 607-3D for list of overpayments that do not require a claim.
The Claims Unit is responsible for establishing the claim on EIS , sending the appropriate demand letters, and taking necessary actions to collect the claim. The Claims Unit determines when a claim should be changed, pended or terminated.
607-3 A. INTENTIONAL PROGRAM VIOLATION ( IPV ): FRAUD
Claims are identified as intentional program violations if the household member is convicted in a court, is judged to have committed fraud in an administrative disqualification hearing, or signs a waiver of the right to a disqualification hearing. See MS 608-2 on Administrative Disqualification Hearings.
Intentional program violations shall consist of having intentionally:
Made a false or misleading statement, or misrepresented, concealed or withheld facts; or,
Committed any act that constitutes a violation of the Food Stamp Act, the Food Stamp Program Regulations, or any state statute for the purpose of using, presenting, transferring, acquiring, receiving, possessing or trafficking of food stamp benefits.
The following are considered to be intentional program violations:
A false or misleading statement is made to the state agency either verbally or in writing to obtain or attempt to obtain food stamp benefits to which the household is not entitled.
Information is concealed, misrepresented, or withheld to obtain or attempt to obtain food stamp benefits to which the household is not entitled.
Failure to report changes in household circumstances as required to obtain food stamp benefits to which the household is not entitled.
Replacement of food stamp benefits already received is requested.
Food stamp benefits are used to buy items that are not eligible, such as alcohol or cigarettes.
Improperly obtained food stamp benefits are used or possessed.
Food stamp benefits are sold or traded.
607-3 B. INADVERTENT HOUSEHOLD ERROR ( IHE ): CLIENT ERROR
Client error, also referred to as inadvertent household error, includes, but is not limited to:
Client failure to report that was not done knowingly, willfully, or with deceitful intent to defraud, including:
Failure to provide the agency with correct or complete information.
Failure to report at all.
Failure to report changes timely.
Failure to report changes correctly.
The household was eligible for fewer food stamp benefits or ineligible pending a fair hearing decision, but received continued benefits and the hearing decision was rendered against the household.
The household received benefits on a quarterly or semiannual basis and was overpaid due to a reportable change in household circumstances.
Claims considered agency errors include:
The agency failed to take timely action on a reported change.
The agency assigned an incorrect allotment.
The agency issued duplicate food stamp benefits in error that the household transacted.
The agency computed income, expenses, deductions, or allotment incorrectly.
The household continued to receive food stamp benefits after the certification period expired.
The agency failed to effect an allotment change due to an ATAP grant change.
The agency made any other error that resulted in incorrect food stamp benefits issued.
607-3 D. OVERPAYMENTS THAT DO NOT REQUIRE CLAIMS
An overpayment claim is not done when:
An unanticipated change in income or household circumstances occurs after the benefit is already issued. There is no claim for benefits issued prior to the effective date of the change. See MS 604-3D for policy on effective date of change. Subsequent months may be incorrect and require a claim.
Example:
A household has no income. Its application is approved and benefits are issued on May 4. On May 15, one of the members obtains employment and receives his first paycheck on May 22. Regardless of whether or not the household member reported receipt of this income, benefits could not have been adjusted for May and no loss to the program has occurred. A claim determination is not completed for May.
A household is allowed a deduction for an expense and the household never pays the expense. Food stamp rules allow deductions when the expense is incurred, regardless of when or if it is paid. See MS 602-4.
The agency fails to ensure the household:
Signed the application; or,
Provided or applied for a social security number.
The agency-caused overpayment claim amount is $125 or less and the household is not currently receiving food stamps. When determining if the claim amount is $125 or less, use the total of the overpayment amounts for all the months in the claim determination.
Exceptions:
All overpayment claims, regardless of amount or type (i.e., agency-caused or client-caused), are established when the household is currently receiving food stamp benefits.
All overpayment claims, regardless of amount or type (i.e., agency-caused or client-caused), are established when the overpayment is discovered through a Quality Assessment review.
607-3E. ESTABLISHING AN OVERPAYMENT CLAIM
When information is received indicating a household may have received too many food stamps:
Ensure the household's current food stamp budget reflects correct information to avoid further incorrect benefits.
Obtain written verification of any questionable issues.
Inadvertent household error and agency error claims are calculated back no more than 12 months prior to the month of discovery. Intentional program violation claims are calculated back to the month the fraudulent act occurred, but no more than six years from the date the overissuance was discovered. When the claim is due to IPV or an error at application, the claim is effective with the first month food stamps were incorrectly issued. When the overpayment is caused by a change during the certification period, it is effective with the allotment which should have been changed had the client and agency acted correctly. Allow for adverse action notice and time required for the issuance to take effect.
Cancelled benefits are not included in the claim.
Calculate what should have been issued and compare this amount to the amount issued. Refer to MS 607-1. If no difference, no claim exists.
If the household is eligible for restored benefits and has an outstanding claim balance, the restored benefit amount must be applied as payment to the claim. See MS 607-2.
Exception:
Initial month allotments shall not be reduced to offset a claim even if the allotment is paid retroactively. See MS 600-2, for definitions of initial month and initial benefit.
Evaluate the claim for possible fraud.
If fraud is involved, a fraud referral report form is completed and submitted to the DPA Fraud Control Unit.
If no fraud is involved, a claim determination form is completed and submitted to the Claims Unit.
Note:
Do not submit both a claim determination form and a fraud referral form.
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