Recoveries

Overview

The Employment and Assistance Act and the Employment and Assistance for Persons with Disabilities Act authorize the ministry to recover debts and certain types of assistance issued to or on behalf of clients.

Assistance issued while awaiting income from another agency may be recovered through an assignment or consent to deduct future income from the other agency.

 Debt may be incurred in any of the following circumstances:

  • assistance is issued where there is no eligibility (overpayments)
  • repayable supplements are issued
  • repayable hardship assistance is issued

The ministry records and notifies clients of debt in any of the following ways:

  • notification of overpayment
  • a promise to repay agreement
  • a repayment agreement

The ministry recovers debt in any of the following ways:

  • voluntary payments from current or former recipients of assistance
  • applying a repayment amount to assistance issued to clients
  • a deduction for an offence overpayment
  • collection action
  • court action

Employment and Assistance Workers and Investigative Officers must fully explain the procedures that are authorized under the Employment and Assistance Act and the Employment and Assistance for Persons with Disabilities Act in specific situations for recovering assistance.

Policy

Effective: December 5, 2005

Section 28 of the Employment and Assistance Act and section 19 of the Employment and Assistance for Persons with Disabilities Act permit the ministry to recover client debts to the ministry without a formal agreement, either by way of deduction from future assistance, collection action or through court action.  Based on the principles of administrative fairness, the ministry’s policy is to make efforts to inform clients when they have a debt to the ministry and the particulars of the debt before taking any action to recover the debt.

Effective: April 16, 2004

Debt owed to the ministry remains with the original case and must not be transferred from one case to another when clients have changed family units or cases or are no longer in a dependency or spousal relationship.

Effective: August 1, 2015

The ministry may recover amounts paid to or on behalf of clients for any of the following:

  • assistance while awaiting payment of income from other agencies
  • assistance that they were not eligible to receive (overpayments)
  • repayable supplements, for example, security deposit supplement, utility security deposit supplement, co-op housing share purchase supplement, replacement of lost family bonus supplement, repayable warrant supplement due to hardship, repayable warrant transportation supplement [see Related Links – Security Deposits, Utility Security Deposits, Co-op Share Purchase Supplement, Family Bonus Supplement, Warrants]
  • repayable hardship assistance

For information on recovering repayable hardship assistance, see Related Links – Eligibility for Hardship Assistance – Procedures – Table:  Hierarchy of Hardship Categories.

Effective: August 1, 2015

The ministry may recover assistance paid to a client through any of the following documents or processes: 

  • assignment or consent to deduct a client’s future funds from another agency
  • repayment agreement – recovery of repayable benefits by deduction from ongoing assistance
  • a promise to repay – recovery of repayable benefits at a future date
  • overpayment notification – recovery of overpaid benefits by deduction from ongoing assistance
  • collection action – action taken by government and non-government agencies to recover amounts owed by individuals who are no longer in receipt of assistance
  • litigation or prosecution
  • deduction for offence overpayments

Effective: September 1, 2015

A signed assignment or consent to deduct form authorizes a transfer of funds that are payable to a client from another agency directly to the ministry.  Assignments and consents to deduct prevent duplication of payments to a client for the same period of time by enabling the province to recover assistance that is issued to a client while he or she is awaiting retroactive income from the other agency.  By accepting the assignment or consent to deduct from the client, the agency accepts the ministry’s claim to the money referred to in the document and transfers the amount that is payable to the client directly to the province (that is, either the amount of assistance issued for the same time period or the other agency’s payment, whichever is the lesser).

To assign or consent to deduct future income, it must first be clearly established that funds may be forthcoming from another agency in the future.  When a client or dependant is potentially eligible for future income from another agency, an assignment or consent to deduct form must be completed prior to issuing assistance. The assignment or consent to deduct must be signed by the person awaiting the income.

All of the following are examples of anticipated income from other agencies for which assignments or consents to deduct are taken:

  • Canada Pension Plan benefits (CPP Retirement Pension, CPP Disability Benefits, CPP Child of Disabled Contributor Benefits and Survivor Benefits)
  • Employment Insurance benefits
  • Veterans Affairs Canada benefits
  • Workers’ Compensation Board payments (WorkSafeBC)

[For more information on taking assignments or consents for specific types of income, see Related Links – Pursuing Income.]

Assignment of Employment Insurance (EI) Benefit

The objective of the EI Assignment of Benefits (AOB) program is to eliminate dual payments of hardship assistance and EI benefits.

According to an agreement between the ministry and Service Canada, the ministry will be reimbursed for the issued Awaiting EI Benefits hardship category through direct deductions from clients’ EI benefits when there is:

  • EI entitlement for the same week for which hardship assistance was paid, and
  • consent from the applicant obtained in writing prior to the payment of hardship assistance.  Applicants provide their consent by signing an EI Assignment of Benefits (AOB) form (HR2528) each time they receive hardship Awaiting EI Benefits. [see Related Links – Awaiting EI Benefits]  The EI AOB identifies the amount of hardship assistance issued weekly (weekly assignment) and minimum weekly living allowance (MWLA). The weekly assignment is calculated by dividing the amount of hardship assistance issued by the number of Sundays within the assignment period.  The MWLA is calculated by dividing the maximum monthly amount of income or disability assistance for the specific family unit by 4.33.  The weekly assignment and MWLA are rounded down to the nearest dollar.

MWLA applies every week of the assignment period.  This ensures Service Canada deducts only the portion of clients’ EI weekly benefits that exceeds the MWLA to reimburse the ministry for the hardship provided to clients eligible for EI.

Once the completed EI AOB is received by Service Canada, the ministry cannot adjust amounts already determined on the EI AOB.

In situations where the client’s EI entitlement is close to the hardship assistance amount, it is important to issue only the minimum amount of hardship in order to decrease the repayable amount.

If a client requires additional hardship assistance while awaiting EI, another EI AOB must be completed.  This additional amount will be added to the existing assignment amount. [For more information, see Related Links – Awaiting EI Benefits]

Pending Insurance Claims and Civil Litigation Awards

The settlement of insurance claims (for example, from the Insurance Corporation of BC) and other civil litigation involving compensation can be a lengthy process where the outcome cannot be predicted.  The ministry does not recover assistance paid to a client while he or she is awaiting insurance claims and other civil litigation decisions.  When a client indicates that he or she is pending an insurance claim decision or other civil litigation matter that potentially involves financial compensation, Employment and Assistance Workers must periodically request a written update of the status of the claim or litigation to ensure the client is still eligible for assistance.

If a person receives a financial settlement while they are a recipient of assistance, and fails to report receipt of the settlement, an overpayment due to client error occurs if assistance is issued when the client is not eligible to receive it.  [For more information, see Policy – Overpayments.]

Effective: July 29, 2013

Repayment agreements on open cases are an agreement between the ministry and a client, where the person acknowledges the debt and agrees to begin to repay the debt immediately by deduction from his or her monthly assistance cheque.  The amount of the repayment and the monthly repayment amount are included in the agreement.  The minimum amount allowed for the monthly repayment is shown in Rate Table – Monthly Repayment Amounts.  [see Rate Tables]

In the case of a couple, both the key player and spouse must sign a repayment agreement. However, if circumstances beyond the control of either recipient prevent both from signing the form, one signature from either the key player or spouse is sufficient to complete the repayment agreement.

Repayment agreements are used to recover debt owed to the ministry in any of the following situations:

  • a client becomes eligible for income assistance or disability assistance after hardship assistance that is repayable under the EA Regulation or the EAPWD Regulation has been issued [For more information on recovering hardship assistance that is repayable, see Related Links – Eligibility for Hardship Assistance.]
  • a supplement that is repayable under the EA Regulation or EAPWD Regulation is being issued.  All of the following are examples of repayable supplements:
  • replacement of lost family bonus supplement cheque
  • co-op housing share purchase supplement
  • security deposit supplement
  • utility security deposit supplement
  • repayable warrant supplement due to hardship
  • repayable warrant transportation supplement

[For more information on recovery of these supplements, see Related Links – Family Bonus Supplement, Co-op Share Purchase Supplement, Security Deposits and Utility Security Deposit, Warrants.]

Repayment agreements should not be taken for overpayments or non-repayable supplements [see Overpayments].

Effective: July 29, 2013

A promise to repay is a contract between the ministry and a client, where the client acknowledges the debt and agrees to pay that debt at a later date. 

In the case of a couple, both the key player and spouse must sign a promise to repay. However, if circumstances beyond the control of either recipient prevent both from signing the form, one signature from either the key player or spouse is sufficient to complete the promise to repay.

No deduction amount is included, as no repayment schedule has actually been set up. 

The ministry uses a promise to repay agreement to recover debt owed to the ministry in either of the following situations:

  • hardship assistance that is repayable under the EA or EAPWD Regulation is being issued [For more information on recovering repayable hardship, see Related Links – Eligibility for Hardship Assistance.]
  • a reconsideration or an appeal supplement is being issued while awaiting the outcome of the reconsideration or appeal [For more information on recovering reconsideration or appeal supplements, see Related Links – Reconsideration and Appeal.]

[For Promise to Repay – Benefit while Awaiting Reconsideration/Appeal Decision (HR2737) form, see Forms and Letters.]

Effective: January 19, 2015

Overpayments of income assistance, disability assistance, hardship assistance or supplements may result from either of the following:

  • ministry (administrative) error
  • client error (intentional or unintentional)

Amount of Overpayment

When calculating an overpayment due to undeclared income or other circumstances, the total amount of the overpayment is the amount of assistance received by the family unit which exceeds the amount they would have received if they had reported the income or other circumstance.  Failure to report does not necessarily result in the family unit being found ineligible for the entire amount of assistance issued for the assistance month. 

When calculating an overpayment, the following amounts are not included as assistance received in the calculation of an overpayment:

  • repayable supplements (for example, a security deposit), as a repayment for the supplement has already been added to the case
  • repayable hardship assistance (for example, hardship issued for assets in excess) because a repayment for the hardship assistance has already been added to the case  
  • amounts deducted from assistance due to a sanction

When calculating an overpayment, the following amounts are included as assistance received in the calculation of the overpayment:

  • non-repayable supplements (such as diet or crisis supplements)
  • non-repayable hardship assistance (such as hardship for missing SIN)
  • amounts deducted from assistance for repayment of debt

The amount calculated as an overpayment for a benefit month must never exceed the amount of assistance issued for the benefit month.

Overpayment due to undeclared asset

When calculating an overpayment due to an undeclared asset which is in excess of the allowable asset limit, the amount of the overpayment is the lesser of:

  • the maximum value of the asset during the overpayment period, or
  • the amount of assistance received during the overpayment period

The overpayment period is the time period in which the asset exceeded the allowable asset level. [see case example in Procedures]

Overpayment due to undeclared earnings

When calculating an overpayment due to undeclared earnings, the overpayment is determined after applying any earnings exemptions that the client was eligible for at the time the earnings were received. Clients do not lose their eligibility for earnings exemptions if they do not declare their earnings. [For more information on earnings exemptions, see Related Links – Income Treatment and Exemptions]

Overpayment due to undeclared marriage-like relationship

When calculating an overpayment due to a marriage-like relationship, staff are to use the definitions of “dependent” and “spouse” in the Acts which were in effect at the time the overpayment occurred. The current definitions of “dependent” and “spouse” in the EA Act and EAPWD Act came into effect on July 1, 2006. These definitions cannot be used to calculate an overpayment for a period before July 1, 2006. [see Related Links – Family Composition – Policy]

Ministry Error and Client Error Overpayments

Overpayments may occur due to client error, ministry error, or both, and may be intentional or unintentional. Whether due to ministry or client error, all overpayments must be reviewed, recorded, and tracked. All overpayments must be calculated in accordance with regulation and policy and by following procedures.  The completed overpayment must be recorded on an approved overpayment chart.  All documents to support the overpayment must be copied and attached to the overpayment chart and Overpayment Notification Form (HR3092 or HR3092A) and placed on the client’s case. 

Ministry error overpayments occur in situations where the client accurately and completely reports all income, assets, and circumstances, and the ministry makes an error in data entry or applies policy or regulation incorrectly, and as a result the client receives more assistance than they are eligible to receive.

Client error overpayments occur in situations where the client does not accurately and completely report all income, assets, and circumstances, and as a result they receive more assistance than they are eligible to receive.

Determining whether an overpayment is due to ministry or client error has no effect on the establishment of the debt. All overpayments of assistance are a debt that the client is liable to repay. The determination of client or ministry error relates to:
 

  • the decision to impose a sanction (a sanction is not applied when the overpayment is due to ministry error)
  • the decision to refer a case to Prevention and Loss Management Services (PLMS) for review

Referring Overpayments to Prevention and Loss Management Services (PLMS)

Employment and Assistance Workers (EAWs) calculate and recover ministry error overpayments involving any amount. EAWs do not refer ministry error overpayments to PLMS unless the case is closed.

Client error overpayments must be referred to PLMS if any of the following circumstances apply:
 

  • the estimated overpayment amount is greater than three months’ assistance for the family unit
  • the client has previous client error overpayments
  • there is an open Investigation associated with the case
  • the overpayment arose from duplicate assistance (collecting on more than one case or under more than one name), identity theft, or an alleged spousal or dependency relationship

Investigative Officers (IOs) calculate and recover client error overpayments referred to PLMS in any of the above circumstances. IOs conducting Compliance Reviews (CRV) also calculate and recover overpayments due to ministry error and/or client error involving any amount of assistance, if an overpayment is identified during a CRV. IOs do not return overpayments identified during CRVs to EAWs.

[see Overpayment Notification and Overpayment Chart]

Administrative Fairness

Ministry staff must exercise the principles of administrative fairness when recovering overpayments by ensuring that clients:

  • know the details of how the overpayment occurred
  • know how the overpayment was calculated
  • have an opportunity to respond and to provide information
  • are informed about the overpayment in writing
  • are informed of their reconsideration and appeal rights

Informing the Client

The ministry’s policy is to inform clients in writing when they have a debt to the ministry. When a review of a client’s case indicates an overpayment may have occurred, ministry staff must inform the client of:

  • the information required in relation to the debt
  • the reason for the overpayment
  • the recovery process
  • the right to reconsideration and appeal, and
  • the application of a sanction

Ministry staff must give the client the opportunity to discuss the situation and provide additional information.

Staff are to use the appropriate template letter or form [either the Letter for Client Initiated Overpayments (HR3042) or the Letter for Ministry Initiated Overpayments (HR3043)] to arrange an appointment to review the matter with the client. IOs may use the Compliance Review appointment letters (HR3194 A or B).

When the family unit includes a spouse, the spouse must also be notified. Any correspondence sent to the client must be addressed to both the client and the spouse.

The appointment letter advises the client of the following:

  • the role of the staff member
  • the purpose of the review
  • the situation being reviewed
  • a summary of the evidence
  • the purpose of the interview
  • the  preliminary findings
  • the amount of overpayment and how it was calculated
  • the possible consequences of not responding to the matter
  • an appropriate timeframe for written response or personal interview
  • that the client may be accompanied at the interview by an advocate or other person of their choice

Sanctions

If an overpayment is the result of inaccurate or incomplete reporting by the client or their spouse on the application (HR0080), re-application (HR0080R) or monthly report (HR0081), staff may apply a $25 reduction in assistance for the prescribed period. 

[For details on applying sanctions for inaccurate or incomplete information, see Related Links – Sanctions.]

Effective: August 1, 2015

The consequences of ineligibility and reduced assistance have been repealed. If a recipient has a debt related to a conviction for fraud or false or misleading representation under an Act offence or a criminal code offence, that person has an offence overpayment.

For a criminal code offence, a recipient will have a $100 deduction per month until the value of that offence overpayment is reached.

For an Act offence, a recipient will have a $100 deduction per month until the required time has concluded or until the value of the offence overpayment is reached, whichever is earlier.

The value of the offence overpayment is considered to be reached when the total amount deducted is equal to the amount for that offence overpayment. For example, if a client owes $1,000 for a criminal code offence, the ministry will deduct $100 for 10 months. The ministry’s repayment hierarchy is applied when other debt exists for the family unit by Financial and Administrative Services Branch (FASB). 

The deduction for an offence overpayment will end, even if part of that $100 went towards a security deposit repayment or other debt, because the value of the offence overpayment has been reached. Any remaining debt will still be repayable, but at the standard minimum repayment amount.

 Type of Offence

Consequence

Period of Time

Criminal code offences –Convictions prior to and after August 1, 2015 

A recipient with an offence overpayment is subject to a deduction of $100 per month.

If two recipients in a family unit are each convicted and have an offence overpayment, the deduction is $200 a month.

If an individual recipient in a family unit has two or more offence overpayments, the deduction is $100 deduction per month. The deductions for the convictions do not apply at the same time.

Exemptions: see below 

Until the value of the offence overpayment is reached.

Act offences – prior to August 1, 2015

Offence overpayment policy does not apply to Act offences recorded prior to August 1 2015, as these files concluded the sanction/consequence that applied under previous legislation. Standard minimum repayment amounts apply to remaining debt.

Not applicable.

Act offences – after August 1, 2015

A recipient with an offence overpayment is subject to a deduction of $100 a month.

If two recipients in a family unit are each convicted and have an offence overpayment, the deduction is $200 per month.

If an individual recipient in a family unit is convicted and has two or more offence overpayments, they will have a $100 deduction. The deductions for the convictions do not apply at the same time.

Exemptions: see below

1st  conviction – 12 consecutive months (unless the value of the offence overpayment is reached earlier.)

2nd  conviction – 24 consecutive months (unless the value of the offence overpayment is reached earlier.)

3rd (and subsequent) convictions) – until the value of the offence overpayment has been reached.

For 1st  and 2nd  convictions, once the periods of 12 or 24 months of $100 deductions have concluded, any remaining debt will still be repayable, but at the standard minimum repayment amount.

If a family unit is subject to the $100 deduction, they will not have any other minimum repayments at the same time.

If the recipient receives less than $100 per month in assistance, they will repay that amount and not be subject to the $100 deduction. For example, if a recipient is eligible for $90 of income assistance, they will repay $90. The recipient will continue to be eligible for assistance.

If the remaining balance of the offence overpayment debt is less than $100, the recipient would pay the amount remaining for that benefit month. For example, if a recipient only has $50 of an offence overpayment remaining; the recipient would have a deduction of $50 for that month.

If a recipient who has an Act offence or a criminal code offence leaves the family unit and continues to be eligible for income assistance, they continue to be subject to the offence overpayment deduction on their new case. If the remaining recipient in the former family unit has not been convicted of an Act offence or a criminal code offence, they are not subject to the offence overpayment deduction, but would be subject to the standard minimum repayment amount for any outstanding debts.

Effective: August 1, 2015

The ministry may provide an exemption from the offence overpayment deduction where:

  • a recipient in the family unit is homeless or at risk of being homeless, or,
  • if  that deduction would result in danger to the health of a person in the family unit

Exemptions are considered on a case-by-case basis with approval from a Policy and Program Implementation Manager. The debt remains on the recipient’s case and may be recovered at a later date, when the recipient’s need for an exemption has been resolved or when they are no longer receiving assistance.

A decision on whether to grant an exemption from the offence overpayment deduction must be made with respect to the family unit’s individual circumstances, and may continue indefinitely if required. An exemption must not be denied because other assistance (e.g., crisis supplement) or community resources are available.

Transitioning Cases – Previous Hardship Code “B” - Sanctions with Imminent Danger to Physical Health

Cases that were receiving Hardship Code “B” prior to August 1, 2015 are considered to qualify for the exemption until an eligibility review and exemption assessment can be performed [see Related Links - Eligibility Review]. As these clients are transitioning from hardship to regular assistance, the review must include consideration of additional assistance or supplements the family unit may be eligible for.

If the circumstances that qualified the family unit for hardship persist, the family unit is considered to be eligible for the exemption. If the assessment indicates a change in circumstances, it should be noted that, unlike the previous hardship policy, the exemption:

  • Does not require the risk of homelessness or danger to the recipient to be imminent.
  • Does not limit consideration of health to be limited to physical health.

[see Related Links – Crisis Supplement].

Effective: August 1, 2015

Clients will receive an exemption from debt recovery for a family unit where a recipient is in a Long-Term Care facility on a per diem basis and in receipt of a comforts allowance.

Debt may be the result of: 

  • Offence overpayments
  • assistance issued while the client is awaiting income from other agencies
  • assistance issued where there was no eligibility
  • supplements repayable by regulation,  such as security deposits
  • repayable hardship assistance

Effective: October 27, 2006

Financial and Administrative Services Branch (FASB) may take action to secure assets owned by the client in order to protect the Crown’s interest when advised by a Ministry Investigator that an overpayment of assistance in excess of $1,000 has occurred.  The PLMS Supervisor of Criminal Investigation may determine that asset notification is appropriate in cases under $1,000 where circumstances exist which make it cost effective to act on the lesser amount.

FASB submits requests to secure assets, along with supporting documentation, to Ministry of Justice, Legal Services Branch.

Effective: October 27, 2006

When a former client does not repay an overpayment balance voluntarily, the case may be forwarded to Financial and Administrative Services Branch to refer the debt to other government and non-government agencies for collection or legal action.  This only applies to closed cases.

Effective: October 27, 2006

The PLMS Criminal Investigations Unit may request FASB to instruct the Ministry of Justice to initiate civil litigation or may make recommendations to Crown Counsel to initiate criminal prosecution. 

Effective: August 15, 2008

Litigation can be categorized into civil or criminal court actions. 

Civil litigation may result in an Order or Judgement requiring the client to repay an amount ordered by the court.  Criminal prosecution may result in a conviction outlining a period of incarceration and /or a restitution order requiring the defendant to repay an amount ordered by the court.  The court determines the amount of restitution and if the restitution order is less than the actual overpayment, the ministry may seek recovery of the balance.

Procedures

Effective: January 19, 2015

Overpayment Process Overview (Open Case)

To process an overpayment on an open case, follow these steps (see below for details on each step):

  1. Determine if the overpayment is due to ministry or client error
  2. Determine if the overpayment is to be referred to PLMS
  3. Collect information
  4. Calculate the overpayment amount
  5. Notify client (includes opportunity to respond, right to reconsideration, and sanction)
  6. Add debt to case
  7. Send a Ministry Error Recording Form (IOs only) (if applicable)
  8. Add sanction (if applicable)
  9. Attach all documents to the Service Request
  10. Update PLMS System (IOs only)

1.  Determining Ministry or Client error (Open Case)

To determine if the debt is due to ministry or client error:

  1. Review, in relation to the overpayment, the original application, re-application, and monthly reports (HR0080, HR0080R, and HR0081)
     
  2. Confirm if client accurately and completely declared their income, assets, and/or circumstances related to the overpayment
     
  3. Review, in relation to the overpayment, the ministry’s actions on the case
     
  4. A client error overpayment occurs when the client does not accurately and completely declare their income, assets, or circumstances and receives assistance they are not eligible to receive  
     
  5. A ministry error overpayment occurs when the client accurately and completely declares their income, assets, or circumstances, but the ministry makes an error that results in an overpayment. Ministry errors include, but are not limited to:
    • Typographical entry errors  
    • Not entering declared income
    • Not updating shelter, family composition, or other information declared by the client
    • Issuing assistance or supplements outside of the regulation
    • Providing inaccurate information to a client regarding their  reporting obligations (resulting in a client not declaring income, assets, or circumstances that affect eligibility)  
       
  6. Note: Debt is not considered ministry error in situations where the client has a duty to report and does not. For example:
    • A client receives a confirmed job supplement, but the ministry does not set a notification or signal to review earnings in the following month and the client does not declare their earnings. The overpayment is due to client error. In such cases, although the ministry may have prevented the overpayment by using a notification or signal, the client has a legal obligation to declare their income and the overpayment is therefore due to client error

2.  Referring Overpayments to PLMS (Open Case)

EAWs are to refer the case to PLMS for review if the overpayment is due to client error and:

  1.  the estimated amount is greater than three months’ assistance for the family unit
  2. is due to duplicate assistance (collecting on more than one case or under more than one name), an alleged spousal or dependency relationship, or identity theft
  3. there are previous client-error overpayments on the case or
  4. there is an open Investigation associated with the case

[For PLMS referrals, see Related Links – Referral for PLMS Review or Investigation].

3.  Collecting Information (Open Case)

To collect the information required to calculate the debt, EAWs or IOs may complete any or all of the following steps:

  1. If information from the client is required to calculate the debt, contact the client by phone or letter to request the information
    • Staff may request an appointment for the client to provide and discuss the information, or may request the client fax, mail, or drop off the information without an appointment
    • EAWs use the HR3231 and HR3049 if requesting an appointment or the HR3031 if requesting the client provides information without an appointment
    • IOs use the HR3194 (A or B) if requesting an appointment, or the HR3196 if requesting the client provide information without an appointment
    • Staff may offer to obtain information directly from third parties (such as employers) to assist the client. [see Related Links – Individual Case Management – Policy – Staff Assisting Clients]
       
  2. Obtain documents (such as pay records or bank statements) from third parties only after the client has not responded to requests to provide the information, has not provided the information within the specified timeframes, or after the client has agreed to the EAW or IO’s assistance in obtaining the information from the third party.
     
  3. Conduct all third-party checks that may relate to the overpayment, such as Equifax, ICBC, BC Online, Student Loan Match, Web AOB, etc.
     
  4. Gather all relevant documentation from the case, including the application or re-application (HR0080 or HR0080R), monthly reports (HR0081), and documentation (such as paystubs, shelter documents, or other documents applicable to the overpayment). Review the monthly reports relevant to the overpayment to identify what the client declared.

Note: If mail is returned by the post office or courier, it is necessary to verify the client’s residential address to confirm their eligibility for ongoing assistance. Contact client and obtain applicable documents to verify their residence.

4.  Calculating Overpayments (Open Case)

To calculate overpayments on open cases, complete the following steps:

  1. Using the available evidence, calculate the overpayment using the web-based Overpayment Calculator (OPC) tool. The calculation must be substantiated with supporting documentation.
  2. In cases where the Overpayment Calculator is unavailable, EAWs may use the manual Overpayment Chart (HR2179). If time permits, delay calculating the overpayment until the OPC is available. IOs must use the OPC for all overpayments.    
  3. Apply the policies on asset limits and earnings exemptions. [see  Policy – Overpayments - Overpayment due to undeclared asset and Overpayment due to undeclared earnings]
  4. Follow process for supervisor or peer review of the overpayment chart, if required.
  5. For details on calculating overpayments, see below: Specific Types of Overpayments.

5.  Notifying the Client (Open Case)

Note: if there is a spouse on the case, all notifications and correspondence must be addressed to both the client and the spouse. If the client attends an appointment and receives documents without the spouse present, the EAW or IO must mail copies of all documents to the spouse to ensure they are also advised of the overpayment and their right to reconsideration. 

  1. Contact the client by phone or mail (using the HR3042 or HR3043) to set up an appointment time to discuss the overpayment and the monthly repayment amount [see Forms and Letters]. (IOs may also use the HR3194A or HR3194B.) Encourage all clients, especially those who have a disability, are aged, or have barriers to communication, to be accompanied by a friend, family member or advocate, in order to ensure they fully understand the overpayment.  [For language barriers, see Related Links – Individual Case Management – Policy and Procedures – Interpretation Services].
     
  2. In cases where phone contact is made but clients indicate they do not wish to discuss the overpayment on the phone or in person, staff must follow up by sending a letter requesting the client attend an appointment to discuss the overpayment (HR3042 or HR3043). This is to ensure the client understands the nature of the overpayment and has an opportunity to review the information. 

Note: If a draft unsubmitted overpayment chart is provided in advance of the appointment, staff should circle the word “Draft” on the form to indicate to the client that the calculation is not final.

  1. If the client does not attend the appointment, ministry staff:
  1. complete the calculation of the overpayment and submit the chart
  2. add the debt to the case and (if applicable) enter the sanction
  3. mail the HR3092 (Overpayment Notification) and the final (submitted) Overpayment Chart to the client
  4. mail the HR3163 (for PWD) or HR3164 (non-PWD) to advise of the sanction (if applied)
  5. PLMS staff may also mail the HR3199 (Notice of Decision – Overpayment) to provide additional details regarding the overpayment
  1. If the client attends an in-person appointment:
  1. Confirm the client’s identity by:
    • reviewing the photo identification produced
    • reviewing the photo identification on the case or contact, or
    • if no photo identification is available, noting on the case a detailed physical description of the individual(s) and obtaining personal information that may be verified
  2. Advise the client of the purpose of the meeting and that they may leave the meeting at any time.
  1. If the client prefers to discuss the overpayment on the phone, verify their identity by reviewing personal details from the client case. Advise the client that the overpayment chart and supporting documentation will be mailed to them along with an Overpayment Notification.
     
  2. Clearly explain the reason for the overpayment and ensure that the client has an opportunity to respond or to provide additional information that may affect the overpayment calculation.  [see Policy – Overpayments – Administrative Fairness] [For minimum repayment amounts, see Rate Tables – Minimum Monthly Repayment Amounts.]
     
  3. Explain the Overpayment Notification (HR3092).
     
  4. Explain the recovery process.
     
  5. Advise the client of their right to reconsideration of the overpayment decision.
     
  6. If a sanction for inaccurate or incomplete reporting will be applied, advise the client of the amount and duration of the sanction and give them the opportunity to provide information that may affect the decision to impose the sanction. Explain that the sanction is a separate decision from the overpayment, and that they may request a reconsideration.
     
  7. Make notes on the case to document the conversation and confirm that the right to reconsideration was provided for both the overpayment and the sanction.

6.  Adding Debt (Open Case)

Note: in cases where the client has attended an appointment to discuss the overpayment, the debt should be added to the case at that time, unless additional time is required to adjust the amount of debt based on new information. Adding the debt while the client is present will enable the Overpayment Notification and Overpayment Chart to be provided to the client in person. If the client is not present when the Overpayment Notification is generated, mail it to them.

  1. Enter the overpayment information on the MIS system.  This will automatically generate the Overpayment Notification (HR3092) form. On the MIS RAD A screen, enter the debt amount using Code 3 for Ministry Error or Code 2 for Client Error.  
  2. If the debtor is under the age of 19 years, record the overpayment on MIS as ‘debt claimed’ (code 13) providing there is solid evidence to support the overpayment calculation. IOs record debt claimed overpayments in the ‘Unconfirmed Debt’ field on the PLMS system.
  3. Submit the Overpayment Chart in the Overpayment Calculator system at the same time as the debt is added to the case. Comments and a confirmation message will be automatically placed on the case when the chart is submitted.
  4. Review the Overpayment Notification Form with the client
  • Note: The client’s signature on the Overpayment Notification is a confirmation that he or she has been notified of the overpayment and the right to reconsideration.  It is not an acknowledgement of debt and does not affect the client’s right to ask for reconsideration.  If the client is unwilling to sign the Overpayment Notification, make note that the client was given the Overpayment Notification but did not sign it.
  • If there are two recipients on the case, it is preferable that both sign the Overpayment Notification
  1. Ask the client to sign the Overpayment Notification Form, and witness the signature.  Note:  The client signature may be witnessed by trusted third parties:
  • other government staff
  • prescribed health professionals (see EAPWD Regulation, Section 2.2)
  1. Provide a copy of the Overpayment Notification Form and a copy of the Overpayment Chart to the client.
  2. IOs – update the PLMS system
  3. Make notes on all the interactions with the client, evidence and decisions pertaining to the overpayment.

7.  Send a Ministry Error Reporting Form, if applicable (IOs only), (Open Case)

IOs only: If the overpayment was a result of a ministry error, IOs complete a “Ministry Error Reporting Form” and forward it to their Supervisor. This form is available on the PLMS Homepage.

8.  Add Sanction (Open Case)

Sanctions are applied in cases of overpayment due to client error. Determine if a sanction is to be applied. [For more information, see Related Links - Sanctions.]

9.  Attach Documents (Open Case)

Scan and profile all documents related to the overpayment to the Service Request (Overpayment Chart, supporting documentation, signed Overpayment Notification, and all correspondence mailed to the client).

10.  Update PLMS System (PLMS staff only)

PLMS staff enter details of the overpayment in the PLMS system.

The following table displays the letters and forms that may be used during the overpayment process:

Letter or Form #

Letter or Form Title

Used by

Purpose

HR3582

Eligibility Review Documents – First Request

EAW

Request for client to provide documents for an Eligibility Review

HR3557 1st CRV Appt (in Person)

First CRV Appointment –in person, PLMS

IO

Request for client to attend in-person appointment to complete HR0080R as part of the Compliance Review

HR3558

First CRV Appointment –telephone, PLMS

IO

Request for client to attend telephone appointment to complete HR0080R as part of the Compliance Review

HR3042

Letter for Client Initiated Overpayments

IO and EAW

Request for client to attend appointment to discuss overpayment.

HR3043

Letter for Ministry Initiated Overpayments 

IO and EAW

Request for client to attend appointment to discuss overpayment.

HR3199

Notice of Decision – Overpayment, PLMS

IO

Written Notice of Overpayment used in addition to HR3092 or when client did not attend appointment to discuss overpayment.

HR3092

Overpayment Notification (open case)

IO and EAW

Generated automatically when debt is added to open case. Used to notify client of debt amount, ongoing deduction, and right to reconsideration.

HR3092A

Overpayment Notification (closed or Medical Services Only case)

IO and EAW

Generated automatically when debt is added to closed case. Used to notify client of debt amount, right to reconsideration, need to contact ministry to arrange repayment, and potential for recovery action by government.

HR3163

Notification of  Sanction – Overpayment for PWD

IO and EAW

For PWD clients: Advises of sanction amount and duration, and of right to reconsideration.

HR3164

Notification of Sanction – Overpayment for BCEA Clients

IO and EAW

For non-PWD clients: Advises of sanction amount and duration, and of right to reconsideration.

(n/a)

Overpayment Chart (from Overpayment Calculator)

IO and EAW

Used to calculate overpayment and demonstrate how overpayment was calculated.

HR2179

Overpayment Chart (from online Forms)

EAW

Used to calculate overpayments only when the Overpayment Calculator is not available. 

Effective: November 24, 2014
 

  1. In cases where a debtor is no longer receiving assistance and contacts the ministry to discuss a recorded overpayment, refer them to Financial and Administrative Services Branch (FASB).  [see Contacts]

  2. In cases where a debtor attends an office to make a payment (cash, cheque, or money order) on a debt, verify in the system that a debt exists. Provide a receipt for the payment specifying the type of payment and forward the payment to FASB using the approved process. Include the Case Number and the name of the person making the payment on the receipt. [see Contacts]

  3. In cases where a former client contacts the ministry to disclose that a previously unrecorded overpayment occurred, record the details on an allegation on an Allegation Fraud Incident. Make note on the allegation that the client has come forward with this information on a closed case. Forward any documentation provided by the client to PLMS.   

  4. Refer new allegations of overpayments on closed cases to PLMS by recording the allegation on an Allegation Fraud Incident.

Overpayment Process (Closed Case – PLMS)

EAWs are to refer all overpayments on closed cases to PLMS.

For closed files, IOs are to see Compliance Review > Procedures and must obtain Supervisor approval prior to initiating the overpayment process on a closed case.

The following steps are followed by PLMS staff only (see below for details on each step):

  1. Determine if the overpayment is due to ministry or client error
  2. Collect information
  3. Calculate the overpayment amount
  4. Add alert if overpayment amount cannot be calculated
  5. Notify client (includes opportunity to respond, right to reconsideration, and sanction)
  6. Add debt to case
  7. Send a Ministry Error Reporting Form (if applicable)
  8. Add alert for sanction
  9. Attach all documents to the Service Request
  10. Update PLMS System

1.  Determining Ministry or Client Error (Closed CasePLMS)

To determine if the debt is due to ministry or client error:

  1. Review, as applicable to the overpayment, the original application, re-application, and monthly reports (HR0080, HR0080R, and HR0081).
     
  2. Confirm if client accurately and completely declared their income, assets, and/or circumstances related to the overpayment.
     
  3. Review, as applicable to the overpayment, the ministry’s actions on the case.
     
  4. A client error overpayment occurs when the client does not accurately and completely declare their income, assets, or circumstances and receives assistance they are not eligible to receive. 
     
  5. A ministry error overpayment occurs when the client accurately and completely declares their income, assets, or circumstances, but the ministry makes an error that results in an overpayment. Ministry errors include, but are not limited to:
  • Typographical entry errors 
  • Not entering declared income
  • Not updating shelter, family composition, or other  information declared by the client
  • Issuing assistance or supplements outside of the regulation
  1. Note: Debt is not considered ministry error in situations where the client has a duty to report, and does not. For example:
  • A client receives a confirmed job supplement, but the ministry does not set a notification or signal to review earnings in the following month and the client does not declare their earnings. The overpayment is due to client error. In such cases, although the ministry may have prevented the overpayment by using a notification or signal, the client has a legal obligation to declare their income and the overpayment is therefore due to client error.

2.  Collecting Information (Closed CasePLMS)

To collect the information required to calculate the debt, IOs may complete any or all of the following steps:

  1. If information from the client is required to calculate the debt, contact the client by phone or letter to request the information.
    • IOs may request an appointment for the client to provide and discuss the information, or may request the client fax, mail, or drop off the information without an appointment.
    • IOs use the HR3194 (A or B) if requesting an appointment, or the HR3196 if requesting the client provide information without an appointment.
       
  2. Gather all relevant documentation from the case, including the application or re-application (HR0080 or HR0080R), monthly reports (HR0081s), and documentation (such as paystubs, shelter documents, or other documents applicable to the overpayment). IOs review the monthly reports relevant to the overpayment to identify what the client declared.
     
  3. On-line third-party checks (Equifax, ICBC, BC Online, Student Loan Match, Web AOB, etc) must not be conducted on closed cases. Third parties such as employers, landlords, or banks may be contacted. The IO must request information from third parties in writing (by letter or fax) with the client consent attached, and must ensure the request specifies the time period during which the client was in receipt of assistance. Third parties may not be contacted unless attempts have first been made to contact the client to give them the opportunity to provide the information directly

3.  Calculate the Overpayment Amount (Closed CasePLMS)

To calculate overpayments on closed cases, complete the following steps:

  1. Using the available evidence, calculate the overpayment using the web-based Overpayment Calculator (OPC) tool. The calculation must be substantiated with supporting documentation.
  2. Apply the policies on asset limits and earnings exemptions. [see Policy – Overpayments - Overpayment due to undeclared asset and Overpayment due to undeclared earnings]
  3. Follow process for supervisor or peer review of the overpayment chart, if required.
  4. For details on calculating overpayments, see Specific Types of Overpayments.

4.  Add Alert if the Overpayment Amount Cannot be Calculated (Closed CasePLMS)

If there is evidence of an overpayment on a closed case, but insufficient details are available to calculate the debt amount, the IO is to place an Eligibility Alert on the contact to ensure the situation is revisited if the client returns to assistance in the future. An example of a situation where this would be necessary is:

A client was on assistance all of 2009 and 2010 and did not declare any earnings. A Canada Revenue Agency (CRA) data match reveals that the client declared $5,000 earnings to CRA in 2009, and $8,000 in 2010. The file is closed and the client cannot be contacted. Although there is strong evidence that an overpayment occurred, the details on net income received in each month are not available, therefore, an overpayment cannot be calculated.

In these situations, the IO is to make detailed notes on the Service Request and the CRV, and note the Service Request number in the Eligibility Alert information.

Note: the IO must make reasonable efforts to obtain the information in order to calculate and establish the debt. For example, if the IO is able to contact the client, they can inquire as to where they were working or ask them to provide payslips. If the employer is known, the IO may be able to obtain the pay records from the employer.

If it appears the overpayment is substantial, a referral to an MI should be considered.

5.  Notifying the Client (Closed CasePLMS)

  1. Prior to sending any correspondence to the last known address, the IO must attempt to verify the address by phoning the client. The IO may check on the contact for an updated phone number. If unable to contact the client, correspondence is to be sent to the last case address reported to the ministry. Correspondence is not to be mailed if the last address reported was No Fixed Address (NFA).
     
  2. Contact the client by phone or mail to set up an appointment time to discuss the overpayment and the monthly repayment amount [see Forms and Letters]. Encourage all clients, especially those that have a disability, are aged, or have barriers to communication, to be accompanied by a friend, family member or advocate, in order to ensure they fully understand the overpayment.  [For language barriers, see – Policy and Procedures – Interpretation Services].
     
  3. In cases where phone contact is made but clients indicate they do not wish to discuss the overpayment on the phone or in person, staff must follow up by sending a letter requesting the client attend an appointment to discuss the overpayment (HR3042 or HR3043). This is to ensure the client understands the nature of the overpayment and has an opportunity to review the information.
     
  4. If the client attends an in-person appointment:
    1. Confirm the client’s identity by:
      • reviewing the photo identification produced
      • reviewing the photo identification on the case or contact, or
      • if no photo identification is available, noting on the case a detailed physical description of the individual(s) and obtaining personal information that may be verified 
    2. Advise the client of the purpose of the meeting and that they may leave the meeting at any time.
       
  5. If the client prefers to discuss the overpayment on the phone, verify their identity by reviewing personal details from the client case. Advise the client that the overpayment chart and supporting documentation will be mailed to them along with an Overpayment Notification.
     
  6. Clearly explain the reason for the overpayment and ensure that the client has an opportunity to respond or to provide additional information that may affect the overpayment calculation.  [see Policy – Overpayments – Administrative Fairness] [For minimum repayment amounts, see Rate Tables – Minimum Monthly Repayment Amounts.]
     
  7. Explain the Overpayment Notification (HR3092).
     
  8. Explain the recovery process.
     
  9. Advise the client of their right to reconsideration of the overpayment decision.
     
  10. Advise the client of the amount and duration of the sanction for inaccurate or incomplete reporting (unless the overpayment was due to ministry error) and give them the opportunity to provide information that may affect the decision to impose the sanction. Advise the client that the sanction will be applied if they return to assistance. Advise that the sanction is a separate decision from the overpayment, and may also be reconsidered.
     
  11. Make notes on the case to document the conversation and confirm that the right to reconsideration was provided for both the overpayment and the sanction.
     
  12. If the client does not attend an appointment to discuss the overpayment in person or on the phone, ministry staff are to mail the HR3092 (Overpayment Notification) and the Overpayment Chart to advise the client of the overpayment, and either the HR3163 (for PWD) or HR3164 (non-PWD) to advise client of the sanction (if applied). PLMS staff may also mail the HR3199 (Notice of Decision – Overpayment) to provide additional details regarding the overpayment.
  • Note: The overpayment chart should be “submitted” in the Overpayment Calculator system before it is provided to the client. In cases where a draft of the chart is provided in advance of the appointment to discuss the overpayment, staff should circle the word “Draft” on the form to indicate to the client that the calculation is not final.  

Notifications of overpayments on closed cases should be sent using Registered mail. If the Registered mail is not picked up, the IO should send the package again by regular mail.  If the regular mail is not returned after one week, it can be assumed that it was delivered to the debtor (Supreme Court Rules deem this as delivered unless there is evidence to the contrary). The 20 day reconsideration period begins at this time.[see Related Links – Reconsideration and Appeal]

6.  Adding the debt (Closed CasePLMS)

Where the IO was able to contact the client:

  1. Record the overpayment amount on the MIS RAD A screen using Code 03 (Overpayment Client Error) or Code 02 (Overpayment Ministry Error). MIS will automatically generate the Overpayment Notification – Closed or MSO (HR3092A) form. The HR3092A instructs the client to contact a toll-free number to negotiate monthly repayment terms.
  2. Enter the entire debt amount in the Monthly Repayment amount field on the RAD A screen.  
  3. Submit the Overpayment Chart in the Overpayment Calculator when adding the debt to the case.
  4. A debt is referred to as “established” when client contact has occurred. IOs record overpayments established through their compliance reviews in the Overpayment fields on the Eligibility tab of the PLMS System.

Where the IO was not able to contact the client:

  1. If the meeting request letters are not returned by the post office and clients either do not respond to the letters or they refuse to meet with staff to discuss the overpayment, the overpayment should be recorded as Ministry Error (code 02) or Client Error on MIS (code 03) providing staff have solid evidence to support the overpayment calculation. Send the client a Notice of Decision – Overpayment letter (HR3199) [see Forms and Letters].
  2. If correspondence requesting to meet with a client regarding a Client Error overpayment on a Closed case is returned  marked 'moved' or 'unknown' and a new address cannot be located,  record the overpayment on MIS as 'debt claimed' (code 13) providing there is solid evidence to support the overpayment calculation. MIS generates a Printed Record when debt code 13 is entered on the RAD screen.
  3. IOs record debt claimed overpayments in the ‘Unconfirmed Debt’ field on the PLMS system.
  4. Add an Eligibility Alert to advise the client of the debt and their right to reconsideration when they next make contact with the ministry.
  5. Submit the Overpayment Chart in the Overpayment Calculator when adding the debt to the case.

Debtors under 19 years of age:

If the debtor is under the age of 19 years, record the overpayment on MIS as ‘debt claimed’ (code 13) providing there is solid evidence to support the overpayment calculation. IOs record debt claimed overpayments in the ‘Unconfirmed Debt’ field on the PLMS system.

7.  Send Ministry Error Reporting Form (if applicable) (Closed Case – PLMS)

If the overpayment was a result of a ministry error, complete a “Ministry Error Reporting Form” and forward it to your Supervisor. This form is available on the PLMS Homepage.

8.  Adding an Eligibility Alert for Sanction (Closed CasePLMS)

Sanctions for inaccurate or incomplete reporting are not added to closed cases. Place an Eligibility Alert on the contact(s) to ensure the sanction is applied if the case re-opens. If the IO was unable to contact the client to advise of the debt and their right to reconsideration, the Alert must also make note to take these steps the next time the client contacts the ministry. 

9.  Attach documents to Service Request (Closed CasePLMS)

Scan and profile all documents related to the overpayment to the Service Request (Overpayment Chart, supporting documentation, signed Overpayment Notification, and all correspondence mailed to the client

10.  Update PLMS System (Closed case)

PLMS staff enter details of the overpayment in the PLMS system.

Effective: September 17, 2009

Recording Child in the Home of a Relative Overpayments resulting from undeclared parental contributions

This overpayment occurs when the relative caregiver does not declare contributions made by the child’s parent(s). 

  1. Overpayments resulting from failure to deduct parental contributions from the CIHR’s monthly rate constitute a claim of overpayment against the CIHR (i.e., the child recipient).  Because the ministry cannot legally advance a claim or pursue recovery from a minor, do not record an overpayment in this situation. 
  2. Reduce the ongoing benefits and inform the EAW of the parental contributions.

Overpayment resulting from assistance paid to relatives for children not in their care

This overpayment occurs when the CIHR child is not actually in the care of the relative caregiver, or the caregiver does not meet the regulatory requirements.  The relative caregiver is responsible for this overpayment.

  1. Complete a manual Overpayment Notification (HR3092A) and ensure the following information is documented on the form. 
    • relative caregiver's full name, address, SIN and date of birth;
    • CIHR child’s given and surname;
    • CIHR –case number.
  2. Send a Request to Record Non-MIS Debt memo explaining the origin of the overpayment along with the Overpayment Notification (HR3092A) to FASB [see Contacts] for recording on the FMIS accounting system and collection action.

Effective: September 17, 2009
 

  1. Send a Request for Debt Review memo with supporting documentation to FASB.  If the case is Open, send a copy of the memo to the Supervisor of the office where the case is held. 
  2. FASB reviews the documentation and may consult with PLMS Operations Manager (OM) if clarification is required.  If the client has information relevant to the calculation that was not previously considered, FASB may request that the OM meet  with the client prior to FASB making a determination.

Effective: January 19, 2015

Undeclared Income

Note: Debt calculations for ministry error overpayments due to inaccurate entry of income declared by the client are processed the same as calculations for undeclared income.

  1. Determine if income is earned or unearned according to Schedule B
     
  2. If income is earned, determine if the client was eligible for earnings exemptions. Earnings exemptions are applied to undeclared earnings based on the client’s eligibility for exemptions at the time the earnings were received. [see Additional Resources - Guidelines – Applying Earning Exemptions]
  • Hardship recipients have no eligibility for earnings exemptions in any time frame.
  • Non-PWD clients may be eligible for a monthly earnings exemptions, based on family unit or client type.
  • PWD clients were eligible for monthly exemptions up to 2012. Effective 2013 (for earnings received in January affecting March assistance) and 2014, PWD clients may have been on monthly or annual exemptions. Staff need to check PWD clients case-by-case to determine exemption type in 2013 and 2014 calendar years. Effective 2015 (for earnings received in January 2015 affecting March assistance), all PWD are on the Annualized Earnings Exemption (AEE) program.
  1. The Overpayment Calculator is programmed to include the applicable exemption amounts, with the exception of AEE clients. Staff are to verify the client’s status (PWD, PPMB, etc) and select the appropriate exemption type in the OPC for each month in the overpayment period. For AEE clients, please see the SOP: Overpayment Calculator: AEE Overpayments due to Earned Income.

    • Example: In May 2012, the single PWD exemption amount was $500 per month. A PWD client earns $985 in March 2012; they do not report this income and receive $906.42 for May. The client would have been eligible for a $500 earnings exemption if the income had been declared for May 2012 assistance, therefore, this exemption is applied when calculating the overpayment. See the SOP: Overpayment Calculator for details on how to apply the exemption.

  1. The amount of the overpayment for each month cannot exceed the amount of assistance issued.

  • Example:  In May 2013, single employable recipients were not eligible for an earnings exemption. A single person earns $710 income in March 2012, they do not report this income and receive $610 assistance for May.  The overpayment is $610 for May.

  1. The amount of an overpayment for a month may exceed the amount of unreported income only when:

  • the client received supplements, and
  • their income (after applying any earning exemption the person was eligible for) exceeded the basic support and shelter rate, rendering the client ineligible for the supplements.

Example: a single person receives $610 support and shelter and a $40 crisis supplement for May 2011.  They received $630 income in March 2011 and did not report the income. There was no earnings exemption to apply. The overpayment is $650. Since their income exceeded the basic support/shelter amount, they were not eligible for income assistance and consequently not eligible for a crisis supplement.  

  1. In calculating the overpayment amount apply the reporting period.  The Monthly Report (HR0081) should be used as evidence the client did not report, unless the monthly report was not submitted (for example, where the client has the PWD designation and is not required to submit the HR0081 in order to receive assistance, there may not be an HR0081 available).

  • Example:  Income received in March affects assistance issued for May.

  1. Ministry staff must only calculate overpayments due to undeclared income if there is sufficient supporting documentation available.  Supporting documentation must include the following:

  • Dates or time period of payment
  • Name and address of employer or source of income, and
  • Amount of NET earnings or income received
  1. Supporting documents may include but are not limited to:

  • Pay-stubs
  • Record of Employment forms
  • T4s, T5s and other tax information
  • Bank statements that list payroll deposits
  • Confirmation of Earnings – Letter (HR2181) and Confirmation of Earnings Form (HR2181A) (These forms are used by PLMS only)
  1. Calculate the overpayment amount by determining how much undeclared income the family unit received and what assistance month that income affected. 

Undeclared non-exempt asset

Note: For property jointly owned with a parent (that the client is not residing in), trust rules may apply. Contact Legislation and Litigation Branch for assistance.

  1. Supporting documents must provide proof for each month the asset was in excess of the allowable asset level for the family unit. 

  2. For assets in the form of equity in investments or other financial vehicles, supporting documents may include, but are not limited to:

  • Detailed statements that identify the client either by name, social insurance number or account number, the name and location of the financial institution, and the cash value of the asset for each calendar month pertaining to the overpayment period
  1. For assets in the form of equity in property, supporting documents may include, but are not limited to:

  • Documents pertaining to the purchase price of the property
  • Land Title documents 
  • Mortgage documents or agreements for sale
  • Other documents relating to amounts owing on the property
  • Market value less encumbrances (to determine equity/cash value)
  1. Review the value of the asset over the overpayment period to determine the maximum value it reached at any time during the overpayment period (e.g., the value of an asset may fluctuate from $2,000 in May up to $5,000 in August and then go back down to $2,000.  The maximum value the asset reached was $5,000).

  2. If the total amount of the overpayment is less than the maximum value the asset reached during the overpayment period, the overpayment amount is the amount of assistance the family unit was not eligible to receive.

  • Example 1: The maximum value of the asset was $5,000.  The family unit (a single person) failed to declare the asset for 3 months and received a total of $1,830 before the case was closed.  The overpayment amount is $1,830.
  • Example 2: The maximum value of the asset was $5,000.  The family unit (a single person) failed to declare the asset for 24 months and received a total $14,640 before the case was closed.  The overpayment amount is capped at $5,000 which is the maximum value the asset reached during the overpayment period.
  1. Enter the dollar value of the asset for each calendar month during the overpayment period.  Note the source of the asset (e.g., RRSP with BMO).

  2. The Overpayment Calculator (OPC) will determine the amount of overpayment based on $0 eligibility for each month in which “assets in excess” is entered as the overpayment reason. Staff need to override the OPC if the overpayment amount calculated exceeds the maximum value of the asset during the overpayment duration.  The final (adjusted) overpayment amount is capped at the maximum value of the asset or amount of assistance, whichever is the lesser.

Both undeclared income and undeclared non-exempt assets

  1. Follow procedures for calculating an overpayment due to undeclared non-exempt assets for each month (do not determine the adjusted overpayment amount).
  2. Follow procedure for calculating an overpayment due to undeclared income and add the undeclared income amount for each month to the chart.
  3. Determine the maximum value of the asset.
  4. Review the overall overpayment in relation to both the asset and the undeclared income.  If the overpayment due to undeclared income is greater than the maximum value of the asset, the greater amount will prevail.

Undeclared marriage-like relationship

  1. If two adults residing together are not legally married and there is no acknowledgement they are a couple, staff must assess the nature of the relationship to determine if a marriage-like relationship exists using the following three factors:

  • The parties resided together for at least 3 consecutive months, or 9 out of the previous 12 months; and
  • Financial dependence or interdependence is consistent with “marriage-like” relationship; and
  • Social and familial aspects are consistent with “marriage-like” relationship.

Note:  Ministry staff can verify information that pre-dates July 1, 2006 based on the current definition of “spouse” only to determine eligibility, not to calculate an overpayment that may have occurred prior to July 1, 2006.
 

  1. In applying these three factors, staff must keep in mind that the amended definition of “spouse” was effective July 1, 2006.
  2. If two unmarried individuals are residing together at the time of an IA application or review, staff can verify information that pre-dates July 1, 2006, in order to determine if they resided together for the previous 3 consecutive months or 9 of the previous 12 months.  This is for the purpose of determining if they are in a marriage-like relationship (factor 1 of above criteria) and eligible for assistance based on the current definition of “spouse,” not for calculating overpayments that may have occurred before July 1, 2006.
  3. Any resulting determination of ineligibility or overpayment based on this definition of “spouse” must be applied or calculated from July 1, 2006 onward only.

Examples:

  1. Determining eligibility – Example 1

An unmarried couple who are living together apply for IA in August 2006.  Since the couple has not declared a “marriage-like” relationship, staff must assess the nature of the relationship based on the current definition of ‘spouse’ (above 3 factors).  Applying the new definition, staff look to see if a) the couple lived together from May-Aug. 2006 (previous 3 consecutive months); or b) the couple has lived together for 9 out of those 12 months between September 2005 and Aug. 2006.  This information that pre-dates July 1, 2006 can be used only for the purpose of determining eligibility for IA, not for calculating any overpayments.
 

  1. Overpayments – â€‹Example 2

Two individuals who are receiving IA are found to be living together at annual review in September 2006.  Staff can apply the three factors to determine the nature of their present living arrangement to assess current eligibility.  However, the definition of spouse cannot be applied retroactively to calculate an overpayment prior to July 1, 2006.  Overpayments can only be calculated for the months of July, August and September 2006.
 

  1. Gather all supporting documentation pertaining to the overpayment.  Supporting documents may include, but are not limited to:
  • Tenancy agreement

  • Financial documents (such as for bank accounts, joint credit or loans, insurance contracts, etc.)

  • Car ownership documents

  • Child’s birth certificate (to see list of parents), or court orders for child support, etc.

  1. Calculate the overpayment amount by determining the period of time (after July 1, 2006, only) the client was ineligible as a single person, how much assistance they received for that period and how much they would have received had they been assessed as the correct family unit size.

[For further information, refer to Related Links – Family Composition.]

Other undeclared circumstances

  1. Gather all supporting documentation pertaining to the overpayment.  Supporting documents must provide proof for each month whether the family unit was totally or partially ineligible for the assistance they received.

  2. Enter all appropriate information onto the overpayment chart. 

  3. Determine the total overpayment of assistance the family unit received due to the undeclared circumstance.

Effective: January 26, 2007

Effective July 18, 2006: To reduce or suspend the monthly recovery of a debt from a client in Long-Term Care (LTC):

  1. Confirm that the client is in LTC on a per diem basis. 
  2. Review client circumstances with Supervisor for approval to reduce or suspend recovery.
  3. Reduce the recovery amount.  Ensure that a note is added on the system explaining the reason for the reduction.

Authorities and Responsibilities

Effective: August 1, 2015

Position

Authority

Supervisors of Criminal Investigations

Assign cases for criminal investigation and impose and remove conviction related sanctions.

 PLMS Supervisors

Oversee compliance reviews conducted by Investigative Officers and provide approval for the following: to waive discretionary sanctions, for overpayment charts, and for conducting residency verifications and home visits.

Investigative Officers

Conduct compliance reviews on open cases, make adjustments to assistance, and calculate and record overpayments on open and closed cases. Impose sanctions for providing inaccurate or incomplete information resulting in an overpayment of assistance.

Ministry Investigators

Investigate allegations of fraud or misrepresentation relating to Assistance Programs. Impose conviction related sanctions.

Employment and Assistance Workers

Conduct eligibility reviews.

Calculate and record overpayments on open cases that results from client error where the amount of the overpayment does not exceed the rate of three benefits months for that family unit.

Calculate and record overpayments resulting from ministry error.

Policy and Program Implementation Managers (PPIMs)

Approving exemptions from the $100 deduction for an offence overpayment

Managers or Directors or Strategic Transformation Branch Directors or Operations Managers

Recommend debt write-off on open cases.

Financial and Administrative Services Branch

Forward requests to secure assets to the Ministry of Justice, Legal Services Branch.

Forward outstanding debt owed by individuals who are no longer in receipt of assistance to government collectors. 

Seek authorization from the Office of the Comptroller General for write-off on open or closed cases.

Supervisors

Approve requests to reduce or suspend recovery of debt from comforts allowance.

Effective: August 1, 2015

Employment and Assistance Workers are responsible for:

  • ensuring assistance is issued in compliance with the EA and EAPWD Acts and Regulations and ministry policy.
  • taking action for overpayments due to ministry error
  • identifying, calculating and recovering overpayments resulting from client error when the repayment amount is less than or equal to three months’ assistance except where any of the following occur:
    • The client has previous client error overpayments
    • There are prior Investigations associated with the case
    • There is an open Investigation associated with the case
    • The overpayment arose from duplicate assistance (collecting on more than one case or under more than one name), identity theft, or an alleged spousal or dependency relationship
  • referring overpayments due to client error for amounts greater than three months’ assistance, or that meet any of the above criteria, to Prevention and Loss Management Services (PLMS) for action
  • Confirming or adjusting current and ongoing eligibility on cases where a referral to PLMS for a past overpayment has been made

Policy and Program Implementation Managers (PPIMs) are responsible for:

  • determining if the recipient meets the criteria for an exemption from the $100 deduction for an offence overpayment

Prevention and Loss Management Services is responsible for:

  • ensuring assistance is issued in compliance with the EA and EAPWD Acts and Regulations and ministry policy.
  • calculating and recording overpayments on open and closed cases
  • calculating and recording overpayments with an estimated amount greater than three months’ assistance or where the client has a history of overpayments resulting from client error, or has an open investigation
  • calculating and recording overpayments arising from duplicate assistance or  identity theft
  • calculating and recording overpayments arising from ministry error when the overpayment is identified during a Compliance Review
  • reviewing and/or investigating allegations of fraud involving income assistance programs
  • imposing and resolving consequences related to Criminal Code or Act convictions (Ministry Investigators and Supervisors of Criminal Investigations only)

Financial and Administrative Services Branch is responsible for:

  • taking action for collection of outstanding debts to the ministry 
  • taking action to collect amounts owed by individuals who are no longer in receipt of assistance
  • authorizing write-offs of debt owed on closed cases
  • applying offence overpayment deductions to reduce the outstanding amount of client debts

A summarized Authority Level matrix is available in Additional Resources.

 

Systems Instructions

Effective: May 26, 2006

The Repayment Agreement Acknowledgement of Debt (Repayable) Form (HR2663) is only used for recovering repayable assistance and supplements.  For overpayments on open cases, staff use the Overpayment Notification Forms (HR3092 and HR3092A).

Effective: September 1, 2015

The following table shows debt codes for Repayment Agreement and the Overpayment Notification forms, descriptions, and the screens used to print the debt description on the systems (MIS) version of these forms:

Repayment Debt Codes

Recoveries

Code

Description

Screen

File Status

Forms

02

Overpayment Admin Error

RAD A

Open

HR3092

Closed, MSO or THS

HR3092A

03

Overpayment Client Error

RAD A

Open

HR3092

Closed, MSO or THS

HR3092A

09

Repayable Hardship

RAD A

Open

HR2663A

11

Criminal Probation Order

RAD A

Printed Record

12

Criminal Restitution Order

RAD A

Printed Record

13

Debt Claimed

RAD A

Printed Record

23

Overpayment –Maintenance (child and spousal support) prior to Sept 2015, and Spousal Support Sept 2015 and later

RAD A

Open

HR3092

Closed, MSO or THS

HR3092A

29

Civil Small Claims Order

RAD A

Printed Record

30

Civil Supreme Court Order

RAD A

Printed Record

32

Utility Security Deposit

RAD A

Open

HR2663A

33

O/S Warrant Supplement

RAD A

Open

HR2663A

34

O/S WRNT – Transport Supp

RAD A

Open

HR2663A

Note:  To view the full list of valid debt codes, press PF1 (Help) on the RAD screen.

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