Calculating the Amount of Claims 430-05-80-30

(Revised 01/01/04 ML2893)

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Verifications needed to complete the claim must be obtained by using Notice F814 – Required Verification – allowing the household 10 days to provide the information. The worker must only request verification of new information that they become aware of.

 

Exception:

Quarterly wage matches through IEVS. If needed verifications cannot be obtained from the individual using the appropriate IEVS verification notice, the quarterly wage must be prorated over the quarter and a claim established. The IEVS verification notices advise the household of the source of the information and also provide the household an opportunity to provide verification of the information received if it differs from the IEVS data.

 

If the case is closed and the household fails or refuses to respond to the request, the worker must document in the case file that there is an outstanding claim issue. If the household applies at a later date, the household must cooperate by providing the information necessary to calculate the claim. If the household continues to fail or refuse to provide the information, the application must be denied.

 

If the case is an ongoing Food Stamp case and the household fails or refuses to respond to the request, the worker must send the F401. The case will close at the end of the advance notice period. The worker must document in the case file that there is an outstanding claim issue. If the household reapplies at a later date, the household must cooperate by providing the information necessary to calculate the claim. If the household continues to fail or refuse to provide the information the application must be denied.

 

If the household responds and indicates they need assistance in obtaining the information, the worker must attempt to obtain the information from the appropriate source. If the appropriate source fails to respond and provide the needed verification, the worker must complete the claim based on the best information provided by the household. The worker must document the attempt to verify income and the income used.

 

In determining the amount of a claim in all instances, the worker must apply 10-10-10.

• The household has 10-days to report.
• The worker has 10 days to act.
• In all instances 10-days must be allowed for the 10-day advance notice.

 

Actual circumstances must be reviewed for each month. It may appear that there is an overissuance for one month but no claim established due to 10-10-10.

 

When completing a claim for income that was used incorrectly, not reported or reported incorrectly actual income must be used.

 

Example:

A household reports and verifies the earnings of two individuals. At a later date the worker discovers that a third household member has been working for several months. When calculating the claim, the verified earnings of the two individuals remain unchanged. Actual verified income of the third individual is used in establishing the claim.

 

When a household fails to report or to timely report earned income, the earned income deduction is not allowed when establishing the overissuance. The Earned Income Penalty Violation Code (PV) is entered on the EAIN screen for only the earned income not reported or not reported in a timely manner.

 

When completing a claim for expenses, only the incorrect expenses are changed. All other expenses remain unchanged unless there is other information reported timely.

 

Example:

The standard utility allowance was allowed in error. The household also has rent and child care expenses. When completing the claim, the standard utility allowance is removed and the rent and child care expenses remain unchanged, unless there is other information reported timely.

 

If an underpayment would result instead of a claim and the household failed to report or report timely, benefits are not restored.

 

If a worker failed to act on a timely reported change, the first month overissued is the first month the worker would have made the change based on 10-10-10.

 

If a 10-day advance notice would have been required for the month the claim is being established (individual did not report timely or worker did not act timely), it is assumed, for the purpose of calculating the claim, that the 10-day advance notice period would have expired without the household requesting a fair hearing.

 

The amount of an overissuance is the difference between the amount of entitlement and the amount received.

 

Trafficking Claims

Claims from trafficking related offenses will be the amount of the trafficked benefits as determined by:

• the individual’s admission;
• adjudication; or
• the documentation that forms the basis for the trafficking determination.