Calculating Underpayments 430-05-90-20

(Revised 11/01/04 ML2941)

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If a household was eligible but received an incorrect benefit, an underpayment is calculated only for those months the household participated. After correcting the loss for future months the worker must calculate the underpayment as follows:

  1. If a household’s application was denied in error, the month the underpayment initially occurred is the month of application.
  2. If a household filed a timely recertification and it was denied in error, the month of underpayment is the month following the expiration of the household’s certification period.
  3. If an eligible household’s application was delayed by the worker, the month of underpayment is the month of application.
  4. If a household’s benefits were terminated in error, the month of underpayment is the first month benefits were not received.

 

In each instance above, if the case has been closed since the incorrect denial or closure, the case must be reverted to open.  If the case has been reopened since the incorrect denial or closure, benefits must be manually calculated using actual month circumstances and an underpayment must be added and authorized for each month the household is eligible for a benefit.  

 

An underpayment is calculated for each month beginning with the first month incorrect benefits were issued to:

 

In cases where there is insufficient information to determine eligibility, the worker must advise the household of what information is needed to determine eligibility. The F813 - Request for Information on a Closed Case must be sent requesting actual month circumstances for each benefit month there is insufficient information to determine eligibility.  For each month the household cannot provide the necessary information to determine eligibility, the household is ineligible.

 

Exception:

If expenses are not provided the expense is not allowed in determining the underpayment.  

 

For the months the household was eligible, the worker must calculate the benefit the household should have received. If the household received a smaller benefit than it was eligible to receive, the difference between the actual and correct benefits equals the underpayment.

 

When a household is entitled to underpayments for a period of time in which the certification would have expired, an application form must be completed. The worker must be able to establish eligibility and benefit level for each month using actual verified circumstances. The application form would be registered as a recertification the month the original certification period expired.