Establishing Claims 430-05-80-20

(Revised 07/01/18 ML3528)

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All claims must be established before the last day of the quarter following the quarter in which the overpayment or trafficking incident was discovered. The date of discovery is defined as the date the worker first suspects a household:

1. received more benefits than it was entitled to; or

2. may have misused their benefits.

 

Exception:

Corrective action as a result of a Quality Control review must be completed within 30 days of receiving the Quality Control finding.

 

The date and the source of discovery must be recorded on the OVCA screen.  The source of discovery codes are:

AG - Agency

IV - IEVS

QC - Quality Control

OS - Other Source

If the claim has not been established by the last day of the quarter following the quarter the overpayment or trafficking occurred, the claim must still be established for up to twelve months prior to the date of discovery. The claim would not be considered timely, but is valid.

 

EXCEPTION:

If an IPV was committed, the claim must be re-calculated back to the month the IPV first occurred. The worker must establish a claim for any over issuance for a maximum of six years.