340:65-5-6. Administrative action reconsideration
(a) Administrative action reconsideration. An administrative action reconsideration is required when Temporary Assistance for Needy Families (TANF) or State Supplemental Payment (SSP) benefits are denied or closed in error or the benefit amount received by the client was incorrect. The worker reconsiders an administrative action when: • 1
(1) computer or procedure issues prevents timely action;
(2) policy and procedures were not administered correctly; or
(3) new or additional information is received that shows:
(A) the applicant is eligible for benefits within 30-calendar days of the application denial date;
(B) the recipient is eligible for benefits within 30-calendar days of the closure effective date; or
(C) recipient was underpaid.
(b) Administrative action decision. When the worker reconsiders a TANF or SSP:
(1) closure and finds the benefit was closed in error, the worker reopens the benefit for the current month and any prior months, when applicable. The worker issues a retroactive payment when the benefit is reopened farther back that the immediate prior month; • 2
(2) application denial and finds the application was denied in error, the worker certifies the application for the time period the applicant is determined eligible from the application date. The worker issues a retroactive payment to certify the applicant for any months farther back than the immediate prior month; • 2
(3) benefit reduction and finds that the benefit was reduced in error, the worker issues a supplement for each month the benefit was reduced in error; • 2 or
(4) benefit action and finds that the client received a higher benefit that he or she was eligible, the worker completes an overpayment referral for the overpaid months, per Oklahoma Administrative Code 340:65-9.
INSTRUCTIONS TO STAFF 340:65-5-6
1. (a) An incorrect administrative action occurs when:
(1) the worker denies an application or closes a benefit in error;
(2) an application is not completed timely due to:
(A) a worker delay;
(B) a computer input error that prevented the application from achieving active benefit status; or
(C) computer down time that prevented timely certification; or
(3) a failure to take appropriate action on an active case prior to the next deadline after a change was reported or discovered.
(b) Adverse action that is not the result of an administrative error occurs when the worker:
(1) closes or denies a benefit because the client failed to provide required verification within prearranged time limits and then provides new or additional information within 30-calendar days from the effective closure or denial date. When the information establishes the client's eligibility, a benefit may be reopened or a denied application may be certified without requiring a new application. After the 30-calendar day period, the client must reapply or request a hearing, per Oklahoma Administrative Code (OAC) 340:2-5;
(2) closes a benefit based on an anticipated change, but after closure the client's situation changes, and the client remains eligible. When the client notifies the worker within 30-calendar days of the closure date that the anticipated change did not occur or the income change was less than anticipated and verifies his or her current situation, the worker reopens the benefit. The certification and renewal date remain the same but the effective date is the date the benefits were closed; or
(3) denies an application based on anticipated ineligibility, but after the denial, the applicant's situation changes and the applicant is eligible. When the applicant notifies the worker of the changed circumstances within 30-calendar days of the denial date, a new application is not required. The worker certifies the application back to the application date, when eligible, after the applicant verifies that the reason for the denial did not occur.
2. The worker uses Information Management Systems transaction:
(1) F17C to issue retroactive or supplemental payments for Temporary Assistance for Needy Families (TANF) or State Supplemental Payments;
(2) F17K to issue retroactive or supplemental payments for the Supported Permanency Program. Refer to OAC 340:10-22-1 for Supported Permanency rules.