CLAIMS HANDBOOK - Department of Human Services

BENEFIT RECOVERY (CLAIMS) HANDBOOK
Statute of Limitations:
• IPV claims are established no more than 6 years prior to the date of referral to OPIC.
• AE and IHE claims are completed for no more than 12 months prior to the date originally
established in SUCCESS or 12 months prior to the date returned by OPIC via
disposition letter.
• Underpayments are restored for the month the error is discovered and the 12 months
prior, only.
COMPROMISE – WRITE OFF
A customer may request that their non fraud claim balance be reduced or in extreme cases
eliminated if the balance cannot be reasonably be paid within 3 years of the original
establishment date, and need or hardship is demonstrated. The portion of the debt that is
written off will remain available for payment via underpayment offset after the agreed to
balance is paid in full but the claim will show $0 balance in SUCCESS and the written off
portion will never be considered delinquent. A monthly payment must be negotiated, and all
agreed to payments must be received in a timely manner until the agreed to balance is paid
in full or the compromise agreement will be voided. A Compromise Repayment Agreement
must be signed. If grant reduction payments are originally negotiated and the case later
closes, payments must continue manually until the claim balance is $0.
If the customer is currently receiving benefits, demonstration of need is met, and the claim
may be reduced to an amount that can be paid in full within 3 years of the establishment
date using the customer’s monthly recoupment amount as the negotiated monthly
repayment amount.
Hardship is determined on a case by case basis by examining the customer’s income and
expenses as well as other household circumstances that may hinder payment.
A claim compromise is determined using the Compromise Worksheet which captures the
case status, income and expenses. Clients are to receive written notification of the
compromise request decision (approvals / denials).
To compromise a balance in SUCCESS:
On RMEN H – select claim (Y). Enter the compromise amt (total amount that the customer
is expected to pay including any payments already posted) and compromise reason O.
Document NARR. Include reason for compromise, negotiated monthly payment, and # of
months to be paid.
Track payments monthly and remove compromise in SUCCESS if monthly payments are
missed and the claim becomes delinquent.
Rev December ‘10 15