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 Quality Compliance Specialists 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 a portion of a lost child benefits cheque, repayable warrant supplement due to hardship, repayable warrant transportation supplement [see Related Links – Security Deposits, Utility Security Deposits, Co-op Share Purchase Supplement, Child Benefits Top-up 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 a portion of a lost child benefits 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 – Child Benefits Top-up 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: February 1, 2019

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
  • any Transitional Transportation Support (TTS) amount issued to persons who have left disability assistance
  • 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:

  • Support and Shelter Allowances, Room and Board, Special Care Facility User Charges and Comforts Allowance
  • Transportation Supplement (TS) 
  • 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.

For a client who is eligible for any amount of disability assistance, the minimum amount of disability assistance issued for a benefit month must be equivalent to the TS amount.

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]

Note: This policy does not apply to clients failing to pursue income or assets or of disposing of assets [for more information, see Related Links - Sanctions].

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

Quality Compliance Specialists (QCS) calculate and recover client error overpayments referred to PLMS in any of the above circumstances. QCSs 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. QCSs 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: February 1, 2019

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 each 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 per month. Deductions for multiple convictions to one recipient 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. Deductions for 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.

If a PWD client is eligible for  disability assistance, and is subject to a deduction for offence overpayment, and their amount of assistance before the offence overpayment deduction is more than $0 and less than $100,  the minimum amount for which they will be eligible in a given benefit month will be the amount of the Transportation Supplement (TS). If the offence overpayment reduces the PWD client’s assistance for that month to an amount below the TS, the assistance amount for the month will default to the TS amount and the amount of the offence overpayment deduction will be adjusted.  

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.

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: February 1, 2019

Overpayments that may meet an estoppel defence

Section 87 of the Financial Administration Act provides for the availability of an estoppel defence when the ministry seeks to recover the assistance from a recipient that they were not eligible to receive. An estoppel defence protects a recipient, who through no fault of their own receives a payment they were not eligible to receive.

When establishing a ministry error overpayment, staff must review the following criteria to see if the overpayment meets all of the criteria of an estoppel defence, as described below. Overpayments that meet the following criteria must be referred to a supervisor.

There may be an estoppel defence when all of the criteria listed below are met:

1.         A recipient received assistance that he or she was not eligible to receive, and,

2.         The ministry represented to the recipient that he or she was eligible for the assistance.

  • This could be an explicit statement by the ministry that the person was eligible, or,
  • An implicit statement by the continued payment of assistance by the ministry despite having all the information needed to determine the recipient was actually ineligible (e.g.  the client had provided sufficient evidence to determine their eligibility); and,  

3.         The recipient had relied on the funds to his or her detriment (detrimental reliance).

  • This detrimental reliance is when a client with non-discretionary income adjusts their living expenses to the increased amount of assistance.
  • It is generally accepted that a person in receipt of assistance will adjust their living expenses to an increased amount of assistance and therefore in almost all cases there will be detrimental reliance on the increased assistance.
  • An estoppel defence recognizes that, where there has been detrimental reliance, requiring an innocent recipient to return a mistaken payment (e.g. overpayment) of assistance would be inequitable. 

Estoppel defence cases are highly dependent on the facts of the situation. The availability and strength of an estoppel defence will vary depending on the circumstances of the ministry’s representation concerning eligibility and the reasonableness of the recipient’s reliance on the information provided.

Examples of circumstances where the file should be referred for further review include the following:

  • A recipient has been told by ministry that while receiving MSO, the recipient will continue to be eligible for the monthly nutritional supplement, which is not an eligible supplement for recipients of MSO.
  • A recipient fails to report disability insurance payments as income, based on mistaken instructions from the ministry that such amounts are exempt income.

In each of these examples, the ultimate opinion as to whether the recipient is likely to have a successful estoppel defence will be determined by Debt Management in the Financial Services Branch.

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: February 1, 2019

For a PWD client who is eligible for any amount of disability assistance, the minimum amount of disability assistance issued for a benefit month must be equivalent to the Transportation Supplement (TS) (as cash or an in-kind bus pass).

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

  1. Determine if the overpayment is due to ministry or client error
    1. If ministry error, review for Estoppel referral and follow that process, if applicable
  2. Determine if the overpayment is to be referred to PLMS
    1. Refer to PLMS if applicable, PLMS will complete the overpayment process
  3. Collect information
    1. First seek information from the recipient
    2. If the recipient does not provide the information, other parties such as employers or landlords may be contacted
  4. Calculate the overpayment amount
  5. Notify client (includes opportunity to respond, right to reconsideration, and sanction)
  6. Add debt to case
  7. Add sanction (if applicable)
  8. Attach all documents to the Service Request

The process on a closed case is the same, with the following exceptions:

  • All overpayments on closed cases are to be referred to PLMS
  • Telephone the client to confirm their mailing address before sending any letter; if client cannot be contacted to confirm the address, do not send any correspondence
  • 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].
  • Online third party checks cannot be conducted on a closed case; contact with third parties such as employers or landlords is limited to information the former recipient has had an opportunity to provide, and requests must specify the timeframe for which information is requested (limited to the timeframe in which the person was a recipient)
  • If the client is not notified of the debt, it is added as a “Debt Claim” and the client is to be advised of the debt at the first opportunity if they contact the ministry in future
  • If a sanction is applicable, it is not added until the person returns to assistance.

Determining Ministry or Client error

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)
    • Providing inaccurate information to a client regarding their eligibility (resulting in a client not being aware that they may be receiving funds they are not eligible to receive) 
       
  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

Referring Overpayments to PLMS 

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].

Calculating Overpayments 

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. Apply the policies on asset limits and earnings exemptions [see  Policy – Overpayments - Overpayment due to undeclared asset and Overpayment due to undeclared earnings].
  3. The amount of an overpayment must never exceed the amount of assistance issued.
  4. For details on calculating overpayments, see below: Specific Types of Overpayments.

Note: For PWD clients, Transportation Supplement (TS) is to be included in the calculation of the overpayment. Any Transitional Transportation Support (TTS) amount paid to an MSO client is not to be included in the overpayment amount.

Notifying the Client

If there is a spouse on the case, all notifications and correspondence must be provided to both the client and the spouse. If the client 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. 

Notification of the potential overpayment is provided to the client before the overpayment is finalized and added to the case, to give the client the opportunity to respond and provide information which may impact the calculation of the overpayment amount or the determination of an estoppel defence. Clients are notified by letter and given 20 business days to respond.

If the client responds, the information they provide is considered as part of the overpayment process. If they do not respond, staff continue with the overpayment process to add the debt, repayment, and non-reporting sanction (if applicable).

When discussing an overpayment that is due to inaccurate or incomplete reporting with the client, remind them of their reporting obligations. Advise the client of the amount and duration of the non-reporting 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.

When discussing an overpayment that is due to ministry error with the client, advise them that further review will be completed to determine if they are required to repay it.

Document all conversations with the client by making a note on the client’s case.

Adding Debt 

If the client is over age 19 and received notification of the potential debt (e.g. letter mailed and not returned by post office; staff notified client verbally), the debt is added as type “ministry error” or “client error”.

If the client is under age 19 and/or did not receive notification of the potential debt (e.g. case closed), the debt is added as type “debt claimed”.

Note:  only PLMS staff process debts on closed cases. An alert will be added to the case to notify the client of the debt at their next ministry contact. A second alert may be added to notify PLMS when the client returns so the non-reporting sanction may be applied.

A sanction for non-reporting is applied for client-error debts, and may be waived if the criteria for waiving are met [see Related Links - Sanctions - Applying Sanctions for Inaccurate or Incomplete Reporting].

The client is notified, using the applicable overpayment and/or sanction letters, of the debt and the sanction.

The overpayment chart and all documents that support the debt must be attached to the client’s case. The overpayment package should be provided to the client with the overpayment notification.

Effective: September 1, 2016

If a PWD client is eligible for any amount of disability assistance, the minimum amount for which they will be eligible in a given benefit month will be the value of the TSA as cash or an in-kind bus pass. If an Offence Overpayment reduces the PWD client’s assistance for that month to below the TSA, the assistance amount for the month will default to the TSA as cash or an in-kind bus pass.

Effective: February 1, 2019

  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.

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: February 1, 2019

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.

Apply the reporting period for overpayments due to income

  • Exception – if undeclared income above assistance rates was ongoing at the point of initial application, the reporting period is not applied. The person is ineligible from the month of application  until they leave assistance, or until the income falls below assistance rates, whichever is earlier.

For overpayments due to earned income that occurred October 2004 and later, earnings exemptions are applied if the family unit was eligible for an earnings exemption at the time of the overpayment.

  • Ensure the applicable waiting period for earnings exemptions is applied.
  • Hardship recipients have no eligibility for earnings exemptions.
  • [For overpayments prior to October 2004, see Additional Resources – guidelines – Applying Earning Exemptions]

Annualized Earnings Exemptions (AEE) (PWD recipients only)

  • PWD recipients were eligible for monthly earnings exemptions for earnings up to December 2012 (applied to benefit months up to February 2013).
  • Effective for earnings received in January 2013 (applied to benefit month March 2013 and until December 2014 (applied to benefit month February 2015), some PWD clients were on annual exemptions, some were on monthly exemptions. Staff must look up which exemption model applied to the PWD client for overpayments from March 2013 until February 2015.
  • Effective for earnings received in January 2015 (applied to benefit month March 2015), all PWD recipients receive annual earnings exemptions (AEE)

Amount of Overpayment

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

  • Example:  In May 2012, single employable recipients were not eligible for an earnings exemption. A single person earns $725 income in March 2012, they do not report this income and receive $610 assistance for May 2012.  The overpayment is $610 for May.

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.  

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.

In calculating an overpayment due to earned income, apply earnings exemptions that were in place for the family unit type for that benefit month.

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

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)

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

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

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.

Gather all supporting documentation pertaining to the marriage-like relationship.  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.

[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: February 1, 2019

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 Quality Compliance Specialists and provide approval for the following: to waive discretionary sanctions, for overpayment charts, and for conducting residency verifications and home visits.

Quality Compliance Specialists

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.

Estoppel Review Team (ERT) Responsible for determining if a referral meets the criteria for an estoppel defence (will be done in consultation with Legal Services Branch of the Ministry of Attorney General).

Effective: February 1, 2019

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, including reviewing to see if the overpayment meets all of the criteria of an estoppel referral. Overpayments that meet the criteria must be referred to a supervisor.
  • 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

Supervisors are responsible for:

  • Referring overpayments that meet criteria for an estoppel referral to the Estoppel Review Team (ERT)

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.