Special Assistance SA-3300 Administration of checks and payments

VII. UNDERPAYMENTS FOR ONGOING RECIPIENTS

A. Reasons for Underpayment

An underpayment occurs when the recipient receives a payment less than he/she is eligible to receive due to:

1. Error in applying program regulations, or

2. Error in computing the payment, or

3. Error in processing, or

4. Recipient fails to report a change in situation timely.

B. Reimbursing Underpayments

Promptly reimburse the recipient for all county and State responsible underpayments when:

1. The case continues to be active; or

2. The recipient reapplies for assistance and is found to be eligible; or

3. The case would have been active if the error had not occurred.

NOTE: Do not authorize assistance or adjust payments for more than 12 months prior to the month the underpayment is discovered. Follow instructions in the EIS User's Manual.

C. Computing an Underpayment

1. Verify all changes according to the appropriate SA Manual section.

2. Determine incorrect payment period. The overpayment/underpayment period includes the month when a change should have been made effective until the month the change is made effective.

3. Determine eligibility for the error period as it would have been done had the error not occurred.

4. Compute income as instructed in SA-3210, Income. Follow all regulations, including notice requirements.

5. Calculate net overpayment and net underpayment when overpayments and underpayments occur during the same period.

6. Determine the difference between net overpayment and net underpayment.

a. If the difference results in an underpayment, refer to VII.D.

b. If the difference results in an overpayment, refer to VIII.C.

Note: Do not count the adjusted payment as income or as a resource.

EXAMPLE OF UNDERPAYMENT:

Mr. Jones is an SA facility resident. His only monthly income is RSDI and SA. Social Security realizes that they have overpaid Mr. Jones $500.00 RSDI in the past. To recoup overpayments, SSA reduced his ongoing RSDI check by $10.00/month effective April and continuing until the $500.00 is recouped. Mr. Jones reported to the IMC on May 5 that he was not receiving enough money each month for his cost of care. The IMC verifies with Social Security that RSDI payments were reduced effective April. The IMC issues a $10.00 supplement for April and a $10.00 supplement for May. The ongoing case is corrected effective June to reflect decreased RSDI and increased SA payment.

D. Issuing a supplemental SA payment

To correct an underpayment, complete a DMA-5022, Retroactive Eligibility screen according to the procedures in EIS Section 3104.