Md. Code Regs. 07.03.17.53

Current through Register Vol. 51, No. 22, November 1, 2024

Section 07.03.17.53 - Restoration of Lost Benefits

A. The local department shall restore lost benefits when:

(1) An error is caused by the local department or by the Social Security Administration during joint processing; or

(2) An administrative disqualification is subsequently reversed by a court decision.

B. The local department may not restore benefits for more than 12 months before the earlier of the date that the local department:

(1) Receives a request for restoration from a household; or

(2) Discovers or is notified that a loss of benefits has occurred.

C. The local department may not restore lost benefits for a household's:

(1) Failure to file a timely recertification application;

(2) Missing an interview; or

(3) Otherwise not completing some aspect of the recertification process.

D. The local department shall restore benefits described in §A of this regulation even if the household is currently ineligible.

E. If the local department knows that the household is entitled to restoration of benefits, the local department shall automatically restore them without requiring further action by the household.

F. If the household was eligible but received an incorrect allotment, the loss of benefits may be only for those months in which the household participated.

G. If the loss was caused by incorrect delay, denial, or termination, the household's lost benefits shall be calculated beginning with the first month that the delay, denial, or termination occurred, but not for more than 12 months.

H. After the local department computes the date the loss initially occurred, the loss shall be calculated for each month after the date until either the:

(1) Error is corrected; or

(2) Household is found ineligible for any reason.

I. For each month affected by the loss, the local department shall:

(1) Determine if the household was actually eligible;

(2) Advise the household if the case record cannot document eligibility; and

(3) Consider the household ineligible if the household cannot establish eligibility.

J. If the household received a smaller allotment than it was eligible to receive, the local department shall restore the difference between the actual and the correct allotment.

K. The local department shall offset restored benefits against any overissued benefits owed by the household, except that an initial allotment may not be reduced to offset claims even if the initial allotment is paid retroactively.

L. If the decision to disqualify is subsequently reversed, individuals disqualified for IPV are entitled to restoration of lost benefits during the months that they were disqualified. The amount to be restored is determined by including the disqualified member.

M. Method of Restoration.

(1) The local department shall restore lost benefits by issuing an allotment equal to the amount of lost benefits.

(2) Lost benefits may be issued in installments at the household's request.

N. The local department shall notify the household in writing of:

(1) The favorable decision;

(2) The amount of benefits to be restored;

(3) Any offsetting that was done;

(4) The method of restoration; and

(5) The right to and the method for requesting a fair hearing.

O. The local department shall restore benefits to:

(1) The household that contains a majority of the individuals who were household members at the time the loss occurred; or

(2) If this household cannot be located, the household containing the head of the household at the time the loss occurred.

P. Disputed Benefits. If the household disagrees with the amount restored or the household requests restoration of lost benefits and the local department determines that no restoration is due:

(1) The household has 90 days from the date the notice described in §N of this regulation is sent to request a fair hearing; and

(2) If the fair hearing decision is favorable to the household, the local department shall restore benefits in accordance with the decision.

Md. Code Regs. 07.03.17.53

Regulations .53 adopted effective December 25, 2000 (27:25 Md. R. 2280)