Revision 13-3; Effective July 1, 2013

 

 

B—810 Entitlement to Restored Benefits

Revision 10-2; Effective April 1, 2010

 

TANF and SNAP

Households are entitled to restored benefits when:

  • legislation, federal regulations or court actions require restoration;
  • the Health and Human Services Commission (HHSC) makes an error in the household's amount of benefits and the household was not at fault;
  • an individual is disqualified for an intentional program violation, which is later reversed by a court; or
  • the Supplemental Nutrition Assistance Program (SNAP) or an authorized representative of a drug and alcohol facility improperly accesses and fails to return the benefits to the individual's EBT account.

Households are not entitled to restored benefits for unreported changes or household errors.

Households are entitled to restored benefits regardless of whether they are currently eligible for or receiving benefits.

 

B—820 Time Frames for Qualifying for Restored Benefits

Revision 10-2; Effective April 1, 2010

 

TANF and SNAP

Restore benefits as directed by a court or if the loss occurred within 12 months of the date:

  • the household:
    • contests an adverse decision,
    • attends a disqualification hearing, or
    • notifies HHSC that it believes it has lost benefits.
  • HHSC discovers that the household may be entitled to a restoration.

The month the agency discovers the household is entitled to a restoration is counted as month zero.

 

B—830 How to Determine the Amount of Restored Benefits

Revision 13-3; Effective July 1, 2013

 

TANF and SNAP

Texas Integrated Eligibility Redesign System (TIERS) Eligibility performs the steps to calculate restored benefits in most instances. The advisor may be required to manually calculate the restored benefit, record the restored benefit and offset information, and issue benefits using the Benefit Issuance – Manual Issuance functional area in TIERS.

  1. Determine the month the loss began.
  2. Exclude months before the 12-month time limit.
  3. Determine if the household was eligible for each month the houshold lost benefits.
  4. Obtain needed information to determine eligibility for any restored benefit month in question.
  5. For each month, compute the amount of benefits the household should have received.
  6. Determine the restored benefit amount by subtracting the correct benefits from the amount of benefits actually issued. If there is a claim, subtract the restored benefit amount from the amount due on the claim. Issue any remainder to the household.

Note: When initial benefits are paid retroactively, do not reduce the retroactive payment to offset previous claims.

Issue restored benefit(s) within 30 days of the date the agency discovers the underpayment.

 

B—831 Procedures for Counting Restored Benefits Toward a Claim

Revision 13-3; Effective July 1, 2013

 

TANF and SNAP

  1. Document the amount of restored benefits owed on the Restored Benefits Details page or Request Manual Issuance page.
  2. Determine if there is a claim, as noted in A-832, How to Verify a Claim Amount. Refer to B-761.1.1, Action on Recoupment Cases.
  3. The nightly interface between TIERS and the Accounts Receivable Tracking System (ARTS) will report the offset.
  4. Notify the individual on Form H1825, Entitlement to Restored Benefits.

 

B—832 How to Verify a Claim Amount

Revision 13-3; Effective July 1, 2013

 

TANF and SNAP

Advisors must go to Benefits Issuance on the left navigation bar and click on View Overpayments to verify a claim amount. TIERS users can search for overpayment information by entering a Social Security number, an Eligibility Determination Group (EDG) number or claim number. The Search Results display columns are: Social Security number, EDG number, EDG Name, Claim number and Individual number. Clicking on the Social Security number hyperlink will display overpayment information, which includes the remaining overpayment balance.

 

B—840 Notice to the Household

Revision 01-3; Effective April 1, 2001

 

TANF and SNAP

Notify the household by Form H1825, Entitlement to Restored Benefits, of

  • their entitlement to restored benefits,
  • the amount and method of restoration,
  • any claim offset, and
  • the right to appeal.

 

B—850 Disputed Benefits

Revision 13-3; Effective July 1, 2013

 

TANF and SNAP

If the household disagrees with the amount of restored benefits, or any other action the advisor takes to restore them, the household may request a hearing within 90 days of the notice date. The advisor continues the restoration while waiting for the hearing decision and adjusts the benefits according to the hearing officer's decision.

The household may request a hearing if the household believes it is entitled to restored benefits but the advisor does not agree. Document on the appropriate worksheet the request for restored benefits, the justification to deny them, and the date.

 

B—860 Method of Restoration

Revision 13-3; Effective July 1, 2013

 

TANF

Restore all benefits owed to the household at the same time. Issue a separate benefit for each month the household is owed benefits.

SNAP

Restore all benefits owed the household at the same time.

Issue a separate EBT benefit for each month the household is owed restored benefits.

 

B—870 Changes in Household Composition

Revision 01-3; Effective April 1, 2001

 

TANF and SNAP

If household membership changes, issue restored benefits to the household containing a majority of the persons who were household members when the loss occurred.

If the worker cannot locate an individual or determine which household contains a majority of members, restore benefits to the household that includes the person who was the head of the household when the loss occurred.

 

B—880 Procedure for Authorizing Restored Benefits

Revision 13-3; Effective July 1, 2013

 

TANF and SNAP

Authorize the restoration within 30 days of the date the agency discovers the underpayment.

A Second Level Review (SLR) is required when, in TIERS Eligibility:

  • Restored benefits are being issued for more than three months prior to the current date.
  • The total restored benefit amount (prior to offset) for TANF is equal to or greater than $50.
  • The total restored benefit amount (prior to offset) for SNAP is equal to or greater than $125.

An SLR is required for all restored benefits requested in Manual Issuance.

 

B—890 Documentation Requirements

Revision 13-3; Effective July 1, 2013

 

TANF and SNAP

Advisors are required to document

  • why the household is entitled to restored benefits;
  • the month the loss of benefits began;
  • the time frames for benefits owed;
  • computations;
  • if there is a claim against the household; and
  • the amount of restoration approved if the household has an offset.

Note: The documentation requirements will be met if appropriate entries are made on the Restored Benefits Details page or Request Manual Issuance page.

Document in the case record the:

  • request for restored benefits;
  • justification to deny the request; and
  • date according to B-850, Disputed Benefits.

Related Policy
Documentation, C-940
The Texas Works Documentation Guide