340:50-11-46. Restoration of lost benefits
(a) Worker responsibility. A worker is responsible for restoring lost Supplemental Nutrition Assistance Program (SNAP) food benefits to the household when food benefits were lost because of an Oklahoma Department of Human Services (DHS) error, per Section 273.17 of Title 7 of the Code of Federal Regulations (7 C.F.R. § 273.17). SNAP food benefits are restored for not more than 12 months prior to the:
(1) month the worker receives a request to restore lost food benefits from the household in writing or verbally;
(2) month the worker is notified or discovers the loss occurred in the normal course of business;
(3) date the household requested a fair hearing to contest the adverse action that resulted in the loss; or
(4) date the household initiated court action.
(b) Disputed benefits.
(1) When the worker determines a household is entitled to restoration of lost food benefits but the household does not agree with the amount to be restored, the household may request a fair hearing. When the household requests a fair hearing:
(A) prior to or at the time lost food benefits are restored, the amount restored to the household is the amount determined by the worker pending results of the fair hearing; and
(B) the worker restores the lost food benefits in accordance with the fair hearing decision, when the decision is favorable to the household.
(2) When the household notifies the worker that it is entitled to restoration of lost benefits and the worker, after reviewing the case record does not agree, the household has 90-calendar days from the date the worker notifies the household of his or her decision to request a fair hearing. The worker restores lost benefits to the household only when the fair hearing decision is favorable to the household.
(c) Computing amount to be restored. After correcting the loss for future months and excluding the months benefits may have been lost prior to the 12-month time limit, the worker calculates the amount to be restored. The worker computes lost food benefits beginning with the month the loss initially occurred and ending with the first month the error is corrected or the first month the household is determined to be ineligible.
(1) When the household was determined eligible, but received an incorrect food benefit allotment, the worker calculates the lost food benefits only for the months the household participated in SNAP.
(2) When an eligible household's application was erroneously denied, the month the loss initially occurred is the application month. For a timely filed certification renewal, the initial loss occurs the month following the expiration of its certification period.
(3) When an eligible household's application is delayed, the worker calculates lost food benefits, per Oklahoma Administrative Code 340:50-9-4.
(4) When a household's benefits were incorrectly closed, the month the loss initially occurred is the first month benefits were not received because of the incorrect closure.
(5) When there is not enough information in the household's case record to determine the correct benefit amount, the worker requests information from the household to determine eligibility for those months. When the household cannot provide the information needed to determine eligibility, the household is considered ineligible for the lost food benefits.
(d) Offsetting claims. When the household has an unpaid overpayment or an overpayment held in suspense, the amount to be restored is offset against the overpayment amount. The balance, if any, is restored to the household. Benefits received at initial certification or because of retroactive certification are not used to offset claims against a household. • 1
(e) Lost benefits to persons disqualified for an intentional program violation (IPV). The worker restores lost food benefits for months the person was disqualified for an IPV only when the disqualification decision is subsequently overturned or reversed, per 7 C.F.R. § 273.17(e). A person is not entitled to restoration of lost benefits for the disqualification period based solely on the fact that a criminal conviction could not be obtained, unless the person successfully challenged the disqualification in a separate court action.
(1) For each month the person was disqualified, the amount to be restored, if any, is the difference between the food benefit allotment the household received and the food benefit allotment the household would have received if the disqualified member was allowed to participate in SNAP.
(2) The lost benefit restoration period cannot exceed 12 months prior to the date DHS was notified or discovered a loss occurred.
(f) Method of restoration. The worker restores benefits equal to the amount of benefits that were lost even when the household is not currently eligible for food benefits. The amount issued is in addition to the food benefit allotment currently eligible households are entitled to receive. • 2
1. Adult and Family Services (AFS) Benefit Integrity and Recovery staff is responsible for determining the amount to apply to an unpaid overpayment.
2. To restore lost benefits, the worker uses the Food Stamp Lost Benefit (FSLB) transaction. When the client has an unpaid overpayment, an error message displays on FSLB to alert the worker. The worker consults a supervisor, and the supervisor emails AFS Supplemental Nutrition Assistance Program (SNAP) at AFS.SNAP@okdhs.org to determine if restored benefits need to be applied to an unpaid overpayment. The worker attaches a copy of the FSLB transaction to the email. AFS SNAP program field representative staff consults with AFS BIR staff regarding the recoupment and notifies the worker of the decision.