Ariz. Admin. Code § R6-14-303 - Determining a Claim Amount
A. For all claims other than a claim
resulting from trafficking:
1. The Department
shall determine whether the overpayment of benefits occurred at the time an
eligibility determination was rendered for a new or recertification application
or whether the overpayment occurred during an eligible certification
period.
2. When it is discovered
that the Department rendered an incorrect eligibility determination or issued
an incorrect benefit amount because the Department failed to correctly act on
information provided on the application or reported by the applicant, or
because the applicant failed to provide correct information on the application
or prior to application approval, the Department shall re-determine eligibility
and a benefit amount for that application and for the months in the
certification period, using the application approval or denial policies and
procedures that were in effect at the time the eligibility determination for
the application was rendered. The Department will not consider information that
was not previously reported by the household that would have resulted in an
increase in the benefit allotment at the time of initial approval of benefits.
a. When it is determined that the household
was ineligible, the Department shall establish a claim based on the amount of
benefits issued for each month during the certification period that was
established when the application was originally approved, minus the amount of
benefits that the Department has expunged from the household's EBT benefit
account, for each of the corresponding overpaid months.
b. When it is determined that the household
was eligible, the Department shall establish a claim based on the amount of
benefits that were paid in excess of the correct benefit amount in each month
of the certification period, minus the amount of benefits that the Department
has expunged from the household's EBT benefit account, for each of the
corresponding overpaid months.
c.
When it is determined that the household was eligible and received a smaller
benefit amount than it was eligible to receive because the Department failed to
correctly act on information provided on the application or reported by the
applicant prior to application approval, the Department shall issue a
supplement for each month in the certification period that the household was
paid less than the correct benefit amount as provided in
7 CFR
273.17.
3. When a change occurred during an eligible
certification period:
a. The Department shall
process any change that was reported and re-determine a new benefit allotment
amount for each affected month in the certification period using the change
processing policies and procedures that were in effect for those months under
7 CFR
273.12(c).
i. The Department shall establish a claim
based on the amount of benefits that were paid in excess of the new benefit
amount in each affected month of the certification period, minus the amount of
benefits that the Department has expunged from the household's EBT benefit
account.
ii. The Department shall
issue a supplement for each month the household was paid less than the new
benefit amount.
b. When
the Department discovers a change which was not reported by the household, the
Department shall determine whether the change was required to be reported based
on the change reporting requirement assigned to the household for the
certification period.
i. When the change was
not required to be reported the Department shall not process the change for the
months in the certification period.
ii. When the change was required to be
reported the Department shall re-determine eligibility and a new benefit
allotment amount for each affected month in the certification period using the
change processing policies and procedures that were in effect for those months
under
7 CFR
273.12(c). The Department
shall establish a claim based on the amount of benefits that were paid in
excess of the correct benefit amount in each month of the certification period,
minus the amount of benefits that the Department has expunged from the
household's EBT benefit account.
B. For a claim resulting from trafficking,
the Department shall calculate a claim amount based on the entire value of the
trafficked benefits.
Notes
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