10-144 C.M.R. ch. 301, § 600-FS 666-10 - Restoration of Lost Benefits

GENERAL RULE - Do not restore benefits more than twelve (12) months prior to the month the agency becomes aware of the underpayment or is notified of the reversal.

When an underpayment is identified, take action to restore benefits when:

- the underpayment was caused by the agency;

- a disqualification for intentional program violation is reversed, or special instructions state that a household is entitled to a restoration of lost benefits.

A household is entitled to restored benefits, even if it is not currently receiving FS.

Installments may be made to restore lost benefits. An accounting system for documenting entitlement to restored benefits and for recording the balance must be maintained.

A fair hearing may be requested when the client is dissatisfied.

In order to restore benefits determine the time period to be covered in the restoration.

1. Regardless of the time period of lost benefits, restoration cannot cover more than a twelve (12) month period. Restoration may be made:

- back to the date of application when erroneously denied.

- back to the first month that benefits were not received when benefits were erroneously terminated.

- for the months the household was underpaid.

The difference between what the household received and what it should have received equals the amount to be restored.

2. Establish eligibility for each month's benefit separately.

3. Subtract any amount owed the agency due to any previously established claim for overpayment, regardless of cause of overpayment.

4. If the household's membership has changed, restore the benefits to the household containing the majority of the household members at the time the error occurred. If this cannot be determined, restore benefits to the person who was the head of household at the time of the error.

Notes

10-144 C.M.R. ch. 301, § 600-FS 666-10