Title: CalWIN Benefit Recovery Functionality (Overpayments

DSS AD Identifier: Admin AD 12-100 Page 1 of 28 Implementation Date: 4/2/2012 Revised Date:

DEPARTMENT OF SOCIAL SERVICES

ADMINISTRATIVE DIRECTIVE

County of Santa Barbara

Title: CalWIN Benefit Recovery Functionality (Overpayments)

Implementation Date: 1/6/12

Revised Date: 4/2/12

Number: ADMIN AD 12-100

DEPARTMENT WIDE IMPACT:

AOP Support Reviewed: Incorporate into business processes

APS/CWS Reviewed: No known impact

CalFresh Reviewed: Incorporate into business processes

CalWIN Reviewed: Incorporate into business processes

CalWORKs Reviewed: Incorporate into business processes

Document Imaging Reviewed: Incorporate into business processes

Fiscal Reviewed: Incorporate into business processes

Foster Care Reviewed: No known impact

General Relief Reviewed: Incorporate into business processes

Hearings/Collections/IEVS Reviewed: Incorporate into business processes

IHSS Reviewed: No known impact

Medi-Cal Reviewed: No known impact

Staff Development Reviewed: Incorporate into business processes

Stockroom Reviewed: No known impact

Systems Reviewed: No known impact

FILING INSTRUCTIONS: Administrative (Multiple Programs) – Benefit Recovery and IEVS. Obsoletes the following documents:

Admin AD 06-23, Admin AD 06-27, Admin AD 06-28, Admin AD 06-29 and How-To 05. The following documents have been deemed obsolete by CalWIN Releases: How-To 39, How-To 111, How-To 142, and How-To 153. BSC Workflow 3.32 has been updated to incorporate most updated information.

PROGRAM ANALYST REFERENCE:

CalWIN Procedural Help and Benefit Recovery Survival Guide


Background This Administrative Directive (AD) focuses on CalWIN functionality for Overpayments (OP’s) in the CalWORKS, CalFresh, General Relief and Foster Care programs. The Benefit Recovery (BV) subsystem in CalWIN maintains information on overpayments and underpayments. It allows staff to take case actions based on program specific regulations and policies. Staff can record repayment agreements, process Interim Assistance Program (IAP) repayments and GA/GR loans and make a discrepancy referral (i.e. fraud referral functionality not used in Santa Barbara County). The BV subsystem also allows users to create non-system determined claims (manual claims) when needed. Staff should direct program regulations questions to their respective program Department Business Specialist (DBS). This AD is combining several ADs and How-To’s so all information is centrally accessible in one document. Also included in this AD are the following enhancements to the BV windows that were included in Release 28 on November 14, 2011:

A Recovery Case # column to the Display Claim Recovery Detail window, Claim Recovery tab. This Case ID will be for the case from which the recoupment was withheld. The Case ID will not display when the Recovery Type is labeled as New Claim, as that transaction records the creation of the claim.

A Claim Reasons tab to the Display Claim Recovery Detail window where all of the NOA reasons associated with the claim will be displayed.

The following two columns will be added to the Display Claim Summary, Display Claim Summary by Case, and Display Claim Summary by Liable Party/Individual windows:

o NSDC Indicator: to show whether a claim originated as a Non-System Determined Claim (NSDC). If the claim is NSDC, a “Y” will be displayed in this column. If the claim is system-generated, the column will be blank. [All converted claims will have a blank NSDC indicator].

o Prior Claim #: to display the previous claim number for regrouped claims. If the claim did not result from a regrouping action, the prior claim # will remain blank. The Prior Claim ID would always be the last claim number that was regrouped to create new claim[s].

On the Search/View for Client Correspondence in Print Queue window, add the Reference Type and Reference # (Claim ID) associated with the NOA so that users can easily identify each claim.

CalWIN Functionality Key processes supported by Benefit Recovery include:

Initiate the Benefit Recovery process – CalWIN automatically initiates the Benefit Recovery process when users enter a change in Data Collection for a prior or current month, when timely ten-day notice is not available.

Establish an overpayment/underpayment – CalWIN determines the overpayment or underpayment for users as follows:

1. When users authorize an overpayment, a claim is established against the responsible persons.

2. Before issuing a supplemental payment, the Benefit Recovery subsystem checks to see if there are any outstanding or current overpayments to offset.

3. When users authorize a Medi-Cal overstated SOC, CalWIN will reduce future months SOC or send a reimbursement letter to the provider, according to the client’s choice.

Determine the overpayment recovery method – CalWIN determines the overpayment recovery method according to repayment agreements and/or program rules and regulations.

Track overpayments – CalWIN tracks the recovery of the overpayment through adjustments, payments or grant reduction.


Override overpayment/underpayment information – When an overpayment or underpayment has been established, users, as an authorized user, may override the recovery or supplemental payment amounts

Offset process- CalWIN allows users to identify when an underpayment should offset an overpayment. Eight different processes of BV functionality are outlined in this AD. They are:

1. Automatic Processing of Overpayments

2. Reviewing Overpayment History

3. Adjusting Overpayment Claims when Re-Opening a Closed Program

4. Processing Repayments on Overpayment Claims

5. Processing Overpayments and Underpayments on Closed Cases

6. Adjusting an Existing Claim (IEVS Staff Only)

7. Create a Non-System Determined Claim

8. Processing Overpayment which Occurred Prior to CalWIN Conversion Additional information on BV functionality can be viewed in CalWIN Procedural Help under Benefit Recovery.


1. Automatic Processing of Overpayments CalWIN contains much of the functionality to process overpayment claims by generating the necessary correspondence, calculation claim amount and repayment amounts. After staff has made all appropriate changes in CalWIN, they should run EDBC. Note: If EDBC is run in overnight batch, and results in an overpayment, CalWIN will not authorize benefits. The following alert will be generated: “Case cannot be authorized in Batch because of overpayment(s). Please Authorize the case online.” The CalWIN report MRT020R, Caseload Exceptions can also be used to identify cases that have exceptioned out of the batch process due to the creation of an overpayment. The Capture Discrepancy Information window will display months for which benefits have already been authorized. It also displays for future month after ten-day cutoff. It will not display if all the programs in the case are pending. It is important to mark months with a “Y” in the Evaluate Benefit Discrepancy field when the benefit amount needs to be re-evaluated. EDBC will re-determine eligibility and benefits for the prior and current months, and determine if an underpayment or overpayment exists. For more information on this window please refer to Capture Discrepancy Information Overview in CalWIN Procedural Help.

NOTE: CalWIN will not create new claims for Admin Overpayments which are less that $35.00 however it will create Overpayments for IHE Overpayments which are less than $35.00. Workers should allow the generation, notification and collection of these claims through CalWIN.


After entries have been made and saved, close the window to allow EDBC to run. Users can review the discrepancy information on the Display Benefit Discrepancy window in Wrap Up.

In Wrap-up the Display Benefit Discrepancy window will display months that were re-evaluated and if an over or under payment exists. Months that have an overpayment will need further review by clicking on the [Claim Detail] button.

If you don’t view the Claim Detail window the following error message will be received:

After reviewing the Claim Detail tab the Liable Individual tab needs to be reviewed.

e Liable Individual tab needs to be selected and reviewed prior to closing the dow. If this step is not done the following error message is received:


the of a liable

rocess identifies liable

individual if

t be found

rpayment discharged in

A) – The

AP – Each recipient is a liable

e individual is the

t the time of the OP are liable

individual is the

dividual is the payee or Adoptive

alth Care Services (DHCS) for investigation.

CalWIN identifies the liable individuals, according to regulation and policy, at the same time that an overpayment is established. Staff should review and update the liable individuals when necessary based on program regulations. Following authorization, staff can add liable individuals to claim or change the recovery statusindividual to inactive, if necessary.

The Benefit Recovery pindividuals as follows:

CalWORKs and KinGAP – The liable individual is the case payee. Anyone included and aided in the case during the discrepancy period can be considered a liable the case payee:

Canno

Dies

Has the ove

bankruptcy

Is no longer on aid

Refugee Cash Assistance (RCliable individual is the case payee.

GR and Iindividual.

Welfare to Work – The liablWelfare to Work participant.

CalFresh – All adults age 18 or older and the case payee aindividuals.

Foster Care – The liable payee/Foster Care provider.

Adoption Assistance Program (AAP) – The liable inParent.

Medi-Cal – Liable individuals are not identified for Medi-Cal understated SOC (overpayment). Staff will need to use shelf stock to send Medi-Cal understated SOC information to the Department of He


ndow. These

usehold

son hich

verpayment NOA is generated.

Next the [Reasons] button needs to be selected on Display Benefit Discrepancywindow so the user can select the reason for the data change on the Capture Reasons for Change wichanges can include:

Change in income

Change in resources

Change in hocomposition

When users enter a reason for the change, the reason will populate to the appropriate NOA. It is important that the correct reais selected since this determines wo

Once users have reviewed the overpayment/underpayment information, users can authorize claims, upplemental payments, and Medi-Cal understated/overstated SOC through the Authorization process.

e print mode to “Batch”. If

and CalWIN is taking the appropriate actions on the case for eginning and processing the repayment.

rrespondence in Print Queue window.

s After the case has been authorized the worker should review Client Correspondence. CalWIN automatically generates all correspondences for a new overpayment as detailed by program regulations. The worker will need to Search/View for Client Correspondence in the Print Queue and set thyou do not change the print mode the client will NOT receive the correspondence. Important: With this business process the Eligibility Worker will be responsible for ensuring the correct correspondence is going out to the clientb Pending correspondence can also be searched by the claim number on the Search/View Client Co


should not be collected (i.e. Liable individual no longer part of the household) the claim

, refer the OP to Welfare Fraud. If the case closes before the OP is aid in full (PIF), there is no need to refer case to the IEVS unit. The IEVS unit receives a monthly OP Report

119 where they receive this information.

The IEVS Unit does not need to be notified when claims are collected on an open case. However, if there is a reason why the claim should be put in “Suspended” status. Workers will need to contact the IVES Supervisor to make a status change to the claim. If the OP is due to a Non-Admin error between $250.00 and $949.00, refer the OP to the IEVS unit. If the OP is due to a Non-Admin error over $950.00p

Overpayments/Underpayments

When CalWIN determines that an underpayment exists for a prior month, and the user has indicated that it can be used as an underpayment offset, Benefit Recovery looks for outstanding overpayments and uses the underpayment to offset the existing overpayments according to the recoupment hierarchy. CalWIN will not use underpayments for current and future months to offset overpayments. If there are no outstanding overpayments or a balance remains from the offset process, Benefit Recovery computes a supplemental

or Medi-Cal, it can be indicated whether or not there has been benefit usage, ether the SOC amount met, and hether to refer the understated SOC discrepancy to DHCS.

intains a history of the offset and identifies the recovery type as Offset.

payment for the client.

Fw

CalWIN ma

CalWIN follows specific program rules to perform offsets. In general, those rules include:

Cash programs – If the payee of the underpayment is a liable individual on an outstanding overpayment, CalWIN will offset the underpayment against the overpayment.

CalFresh – If the payee of the underpayment is a liable individual on an Inadvertent Household Error or Intentional Program Violation OP, CalWIN will offset the underpayment against the OP.

Medi-Cal – There is no offsetting of overstated SOC against understated SOC in Medi-Cal. Users can use SOC (according to the client’s choice):

bursement to the client

one of the following two methods to resolve a Medi-Cal overstated

Reduce a future month(s) SOC

Send a provider letter requesting reim

Underpayment/Supplement Exceptions

CalWIN will not automatically offset all underpayments/supplements. There is logic within the application that nefit or not. T e logic within the

confirms if the client should be receiving this beCalWIN application:

he table below depicts th

When an underp overpayment is ayment/determined (and there is an ex

Will an offset occur? isting active

claim): For current or future month benefit No For Past month Yes* For CalFresh Admin claims No


not be offset regardless of the logic in the table shown on the previous page.

Note – On the Capture Discrepancy Information window there is a field titled “Underpayment Offset [Y/N].” If this field is ‘N’, then the underpayment/supplement will

Track Return of Repayment Agreement

Repayment Agreements are sent to all inactive cases/programs and to active CalFresh, Welfare to Work, and Foster Care cases. CalWIN tracks the return of the repayment agreement and automatically initiates the appropriate Benefit Recovery action if the agreement is not returned within the required time frame depending on program regulations.

CalWIN uses the following rules to track the return of the repayment agreement:

CalFresh – Responsible individuals have 30 days to return the repayment agreement. If the repayment agre iated. ement is not returned within this timeframe, automatic grant recoupment will be init

CalFresh recoupment is processed for the following error types (in priority order):

Error

Intentional Program Violation

Inadvertent Household

Administrative Error

Welfare to Work – The responsible individual must return the repayment agreement within 10 days. If the repayment agreement is not returned within this timeframe, grant recoupment will be initiated.

Foster Care and AAP – The time frame for return of the repayment agreement is 90 days. If the repayment agreement is not returned within this timeframe, Foster Care will be referred to collections.

GA/GR –A repayment agreement is not sent when the case is active. Grant recoupment is initiated with appropriate timely notice.

CalWORKs, KinGAP, and RCA – A repayment agreement is not sent when the case is active. Grant recoupment is initiated with appropriate timely notice for KinGAP and RCA. Grant recoupment will start in the next QR cycle for CalWORKs. Priority order for cash grant recoupment is:

Intentional Program Violation

Client Error

Administrative Error

Note: The repayment agreement allows the clients the option to repay by Lump Sum. For CalFresh overpayments the client can repay by lump sum for the entire or partial amount of the overpayment by coming


repayments please refer to Processing Repayments on Overpayment Claims

in to the office and using their EBT card and/or cash payment. Clients can also repay their Cash Aid overpayments by a lump sum repayment of cash or from their EBT card. For more information on how to record a repayment agreement please refer to Record a Repayment Agreement in CalWIN Procedural Help. For information on processing ontained in this document.

c


2. Reviewing Overpayment History From the CalWIN Navigator select the Benefit Issuance and Recovery subsystem. Expand Benefit Recovery, select Display Claim Summary by Case, input the case number and click [OPEN].

Overpayment history can also be accessed by selecting Display Claim Summary (need claim number) or Display Claim Summary by Liable Party/Individual (need name).

The Display Claim Summary by Case window displays a list of claims for the case, including prior claim number (number of claim from which this claim was regrouped). CalWIN regroups claims by closing the existing claim for that time period and recreates new claims based on grouping methodology. If there are no changes to the discovery date, error type or amount owing, the claim remains the same. If any of the three factors varies, the claim will be regrouped.

The NSDC Indicator column will be marked as a “Y” if the claim is non-system generated and will be blank if the claim is system generated. The Display Claim Recovery Detail window displays liable individual, claim recovery, claim status details and claim reasons of the overpayment. Liable individuals are listed along with their collection status.


The Recovery Case # column identifies which case the recoupment was taken from. Recoupments may be taken from cases other than the case the claim originated from. This happens when case members from the overpaid case go on to other cases and are deemed liable individuals for the original claim.

Claim Status

Description Effect of Status Change

Pending A claim is in a "pending" status prior to benefit authorization.

Open A claim is in an "open" status when it is authorized but before recoupment notices have been generated. A Food Stamp claim remains in an open status until the Repayment Notice has been returned or the thirty-day period has passed.

Active A claim is in an “active” status when recoupment notices have been generated and either the claim is being recouped or recoupment will start the first of the following quarter.

Suspended A claim in a “suspended” status is basically on hold. Recoupment does not occur in this status.

All payments are left as they were when the status was changed.

Cancelled A claim is in a “cancelled” status when the claim was established erroneously and the status is adjusted by the user.

All payments are reassigned to other claims for the same program type. If no other claims exist, the funds are returned to the client as a NSDI.

Terminated A claim is in a “terminated” status when the claim is ended by the user. Unlike a cancelled claim, this claim was valid and collectible.

All payments are kept. Collection ceases.

Closed A claim in a “closed” status has been collected in full or has been adjusted to a zero

balance.

The table to the left describes the different types of status that can be displayed on the Claim Status tab below.


The overpayment reasons that were selected for the overpayment are displayed on this tab.

For assistance in viewing history in the Benefit Recovery subsystem by other search methods please refer to View Benefit Discrepancy History in CalWIN Procedural Help.


3. Adjusting Overpayments Claims when Re-Opening a Closed Program While a program is in a closed status it is possible that the client may have submitted payments toward the balance of their overpayments which have not been updated in CalWIN. If a client reapplies and a closed CalWORKS, CalFresh or General Relief program is re-opened, the EW must contact the IEVS unit to find out the current balance of the overpayment. This action needs to take place before a case is granted or denied. If the claims are not present in CalWIN because they may have not converted from CDS, the IEVS worker will enter a Non-System Determined Claim following instructions above ‘Processing Overpayment which occurred prior to CalWIN Conversion’. The IEVS worker will also make sure that all payments processed on the claim since the case closed which have not been posted in CalWIN will be posted in CalWIN so that the claim balances match in CalWIN. NOTE: The EW is responsible for contacting IEVS anytime a closed case is re-opened so that IEVS may verify that all OP claims and their balances are accurate in CalWIN. IEVS staff will validate that all active and open claims associated with the case are in CalWIN and will verify that the balances are correct and process any repayment adjustments as necessary.


4. Processing Repayments on Overpayment Claims AOP staff will find out what method the client has chosen for the repayment (cash, check or EBT). If the client is making the repayment from their EBT account reception will contact the current eligibility worker or the last known eligibility worker for closed cases. For any other repayment method Reception will contact the IEVS unit. Repayment From EBT

If the client is requesting to make a repayment from the EBT account the receptionist will notify the current eligibility worker (or the last known EW for closed cases). The EW must complete the W-153, EBT Lump Sum Repayment Request, when a client is requesting a repayment from their EBT account. When complete the EW will send the W-153 to Input staff for processing. The W-156 is no longer required in this process. Input staff will process EBT repayments in CalWIN upon receiving the W-153. CalWIN will send the transaction to EBT via the interface and indicate that the transaction was successful. Input staff will print a receipt for the client and mail if necessary. Input staff will sign and date the W-153 and send a copy to the EW and a copy to the IEVS unit. To record a repayment in CalWIN, Input staff will: Enter the repayment that has been received in CalWIN by following the steps below:

a) From the CalWIN Navigator select the

Benefit Issuance and Recovery subsystem. Expand Benefit Recovery, select Display Claim Summary by Case, input the case number and click [OPEN].

b) Highlight the claim on the Display

Claim Summary by Case window and click on the [Record Repayment] button.


c) The Record Repayment Detail window will appear. Complete the following: Repayment Type – Repayment Repayment Method – EBT Amount – The amount received Enter the “Allocated Amount in the

‘Allocated Details’ group box (this should be the same as the repayment amount received.)

Note: All claims for program will display in Balance Details. Verify that the claim the repayment is to be made on is selected/highlighted.

Dollar amount should be the same in both fields

d) Save the window. The following

message box will pop-up. Verify the dollar amount and repayment method and click “Yes” to proceed with transaction.

e) CalWIN will transmit the repayment request to the EBT system and you should receive a message if the

transaction was successful.

f) The [Print Receipt] button is enabled and may be used to enter the details for a receipt as shown below.


g) When the [Print Receipt] button is clicked the Print Receipt Information window opens so the client’s name can be entered. The client’s address can also be entered when the [Address] button is clicked. This information populates on the receipt printed from CalWIN.

h) Save and close all windows. In order to verify that the transaction has been processed in CalWIN, Input staff should go to Interface Activities in the CalWIN Navigator and expand EBT Data. Highlight Inquire on History Data from EBT then click open. Enter the Case #, Account Type, Start Date, and click the [Search] button. In the Search Results group box you will see the Repayment and amount reflected. Repayment Other Than EBT If the client needs to make a repayment on anything other than EBT, reception staff should notify the IEVS unit. IEVS worker will accept repayments in the form of cash, check or money order. They will enter the repayment information into CalWIN and print a receipt for the client and mail if necessary. The IEVS Worker will enter the repayment information in CalWIN. Enter the repayment that has been received in CalWIN: a) From the CalWIN Navigator select the

Benefit Issuance and Recovery subsystem. Expand Benefit Recovery, select Display Claim Summary by Case, input the case number and click [OPEN].


b) Highlight the claim on the Display

Claim Summary by Case window and click on the [Record Repayment] button.

c) The Record Repayment Detail

window will appear. Select the following: Repayment Type: “Repayment” Repayment Method: Type of

repayment received. (if “Check” is selected you will need to complete check details.)

Amount: The amount received. Enter the “Allocated Amount” in the

‘Allocated Details’ group box (this should be the same as the repayment amount received).

Note: All claims for program will display in Balance Details. Verify that the claim the repayment is to be made on is selected/highlighted.

d) Save the window.

e) The [Print Receipt] button is

enabled and may be used to enter the details for a receipt if necessary.


f) When the [Print Receipt] button is clicked the client’s name and address can be entered which populate to the receipt printed from CalWIN.

g) Close all windows. NOTE: It’s important that staff involved in the repayment process provide detailed case comments.


5. Processing Overpayments and Underpayments on Closed Cases There may be times when staff needs to make changes on a case after a program has been discontinued. If the changes made could potentially restore the eligibility of the case (Example: Client completes RRR within 30 days of discontinuance), the worker will need to process the changes and then rescind the case to Run EDBC and authorize. When EDBC is run CalWIN will automatically calculate all overpayments and underpayments and process them according to program regulations. If the changes will not restore eligibility but could create an Overpayment or Underpayment, the worker will make the changes to the case and should have their Lead worker or Supervisor, who have security access, Run EDBC to see if the specified changes impact benefits. If an underpayment is identified, the worker will complete an NSDI request to issue the underpayment supplement to the client. If an overpayment is identified, the worker will follow instructions on section 1 of this AD ‘Automatic Processing of Overpayments’. Note: If the changes impact the Medi-Cal Share of Cost for the period please submit a W-442 to Input staff to process the changes on MEDS.


6. Adjusting an Existing Claim (IEVS Staff Only) Claim balances can be adjusted as allowed by regulation, policy and security access. When an overpayment is forgiven, the process stops all overpayment recovery and closes the claim. If the claim was referred to collections, the information will be sent to our county’s collection system (CUBS) via the interface. This process is not intended for repayments. a.) From the Benefit Issuance and

Recovery subsystem on the Navigator, expand Benefit Recovery. Highlight the Display Claim Summary by Case window, enter the case number and click [Open].

b.) Highlight the claim that needs

to be adjusted and click the [Adjustment] button.


c.) For the Adjustment Type, select

Revision Upward if the claim amount is a higher amount. Select Revision Downward if CalWIN has a higher amount.

d.) Select the adjustment date of

today, and select the applicable reason.

e.) If multiple claims are displaying

in the Balance Details box, highlight the claim that needs to be adjusted. Click the [Add] button to add it to the other column.


f.) Click in the Adjustment field. Enter the amount to be adjusted. If you selected revision downward, CalWIN will subtract this amount from the claim. If you selected Revision Upward, CalWIN will add this amount to the claim. Save and close the window.

g.) The new balance will now

show.


Original claim amount of $118 had an adjustment amount of $68 applied leaving a new balance of $50


7. Create a Non-System Determined Claim (NSDC) (IEVS Staff) Manually created claims are done under certain circumstances such as:

An overpayment discovered for months preceding conversion to CalWIN

A claim on an Inter County Transfer

A claim can not be automatically generated in CalWIN IEVS staff is authorized to enter NSDC when necessary in CalWIN. The following steps are to be followed: a) From the Benefit Issuance and Recovery

subsystem on the Navigator, expand Benefit Recovery. Highlight the Display non System Determined Claim Summary window. Enter the case number and click [Open].

b) Select the program the claim is being

created for and click [Search]. Verify that any rows found are not the claim you are creating to avoid duplicates. Click the Add icon to add a new claim.


c) On the Discepancy Info tab, enter the start and end date of the claim. Select the program. Select the appropriate error type and discovery date. Enter the appropriate discovery source and discrenpany reason. Now click on the Monthly Details tab.

d) Enter the benefit issued and the correct

benefit. Enter the benefit usage and the O/P amount. If the correct benefit was $0, enter it in the field, even though it appears to be there already.

Note: If the claim is for Employment Services, Payment Type will be enabled.

Now click the Liable Individual tab.

e) Select the appropriate liable individuals

and the individual collection status of active. If you need to add additional individuals, click the Add icon. If a Foster Care provider needs to be added as the liable party, click the Liable Party tab. Put checkmarks in the demand notices and repayment agreement boxes.

Click the Claim Details tab.


f) Select the appropriate reason for manual claim. If the claim is on an ICT case, complete the information in the Originating County group box.

g) Click [Authorize] and the

‘Authorization was successful’ message should be received.

If a program needs to be added for a NSDC, IEVS staff should continue to follow How-To #167 Add Program for Non-System Determined Claim.


8. Processing Overpayment which occurred prior to CalWIN Conversion Santa Barbara County converted to CalWIN in March 2006. Although we should rarely have OP’s that occurred before that time period, staff should follow the steps below if they come across this situation. When an OP is identified and the EW determines that it includes months prior to CalWIN conversion, the EW will send the information for those months to the IEVS unit via a W229. Once the IEVS unit receives the information, they will manually calculate the OP for the Non-CalWIN months. IEVS staff would complete a Non-System Determined Claim (NSDC) in CalWIN. IEVS staff would only be responsible for the OP before CalWIN conversion. EW staff would be responsible for OP’s that occurred after implementing CalWIN.

Documents

Title: CalWIN Benefit Recovery Functionality (Overpayments