CLAIMS HANDBOOK - Department of Human Services
CLAIMS HANDBOOK - Department of Human Services
CLAIMS HANDBOOK - Department of Human Services
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BENEFIT RECOVERY (<strong>CLAIMS</strong>) <strong>HANDBOOK</strong><br />
CLAIM FILES<br />
The claim file is a legal, fiscal file verifying a debt and must contain sufficient<br />
documentation and information to support the debt.<br />
Underpayments and invalidated overpayments do not require a claim file.<br />
Valid claims must have a file that is identified by the AU number and head <strong>of</strong> household,<br />
the claim sequence number and type, the date <strong>of</strong> establishment and the date <strong>of</strong> pay<strong>of</strong>f or<br />
termination. The file should be marked for purging when the debt is paid in full or<br />
terminated.<br />
Counties may elect to use one folder for each AU with multiple claims, separated by<br />
sequence. The claim file may either be located inside the active case record or filed in a<br />
central location. Claim files for inactive cases must be maintained centrally.<br />
The AE/IHE claim file must contain:<br />
• Identification <strong>of</strong> all liable adults in the AU for the overpayment months<br />
• SSN and DOB for all liable adults in the AU<br />
• Verification to support the debt<br />
• Pro<strong>of</strong> that the AU received benefits to which it was not entitled<br />
• A budget for each month <strong>of</strong> overpayment<br />
• Screen print <strong>of</strong> claims documentation<br />
• Pro<strong>of</strong> <strong>of</strong> initial notice <strong>of</strong> claim to the AU<br />
• Repayment agreement if available<br />
The IPV Claim file must contain:<br />
• Form 5667 and OPIC disposition packet containing supporting documents, including<br />
liability documentation.<br />
• Court Order / Consent Agreement / Hearing Decision / WDH<br />
• DRS Screen Print (FS only)<br />
• DEM3 screen print for all programs where customer is active receiving benefits<br />
All claim files must contain:<br />
• Pro<strong>of</strong> <strong>of</strong> review and credit <strong>of</strong> expunged benefits<br />
• Returned correspondence<br />
• Copy <strong>of</strong> receipt for manual payments and pro<strong>of</strong> <strong>of</strong> posting<br />
Claim files are purged 3 years after date <strong>of</strong> closure unless there has not been a fiscal audit<br />
since the closure date. Maintenance <strong>of</strong> the OFI program file is not required to support the<br />
debt.<br />
When an established claim is later found established in error and payments have been<br />
posted, the payments must be returned to the AU in the same form as received. The claim<br />
is terminated after the payments are returned to the AU. These claims cannot be<br />
invalidated (IE).<br />
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