CLAIMS HANDBOOK - Department of Human Services

(If customer has a valid SSN)
BENEFIT RECOVERY (CLAIMS) HANDBOOK
ALL procedures must be entered the same day
1. Change AU member’s status from SE to OR.
2. Change another AU member’s status to SE.
3. Take the above procedures through DONE.
4. Deny OR using reason 512 (ongoing and historically for the months you want
individual disqualified- you will have to go back 1 month prior to the first month the
individual will be disqualified because when you add-a-person the individual will be added
for the first month with a reason “337” and will not be disqualified that month) – go through
DONE.
5. Do Add-A-Person for OR, changing individual’s citizenship to a citizen code – go
through O, P, Q.
6. Change the status of the AU members previously changed in steps 1 and 2, back to
the original status – go through DONE.
7. Impose disqualification on DEM3.
8. Enter disqualification into DRS unless the customer does not have a social security
number.
9. DO NOT change the codes back to the original non-citizenship codes until the entire
period of disqualification has been served by the AU member. Changing the codes
prematurely will affect the budgeting and the customer will receive erroneous
benefits.
To correct erroneous disqualification data on STAT:
1. Access STAT screen – change SA to PN.
2. Remove the reason code.
3. Shorten the penalty period by changing the end date to a date prior to the first day
of the penalty period.
4. Access DEM3 and correct the counter #.
5. Access MISC and enter “Y” under cal. elig.
6. Go through DONE.
To remove a disqualification from SUCCESS at the end of the disqualification period:
1. Access STAT Screen during final month of DQ period – Change SA to PN
2. Remove the reason code.. The penalty end date should be last day of the current
month
3. Access DEM3. Verify that the effective date is correct or delete data
4. Go through DONE
Rev December ‘10 45