|
|
|
Previous
AISH Program Policy |
Published Date: April 24, 2024
Bookmark this page |
Overpayments |
|
Criteria for Exempting the Requirement to Repay an Assessed Overpayment
AUTHORITY
INTENT
To describe considerations to exempt a client from the requirement to repay in each instance an overpayment is assessed.
POLICY
An overpayment can be the result of various circumstances that may be attributable to the program, the client, or both. Under section 7(4) of the AISH Act, if the director determines there are appropriate circumstances, the director may exempt a person from the requirement to repay an amount or value, unless:
- The amount owing is a debt due to the Government of Alberta; or
- In the opinion of the director, the person received the benefit by fraud or wilful misrepresentation.
If the director suspects fraud or wilful misrepresentation, the overpayment cannot be exempted from repayment. The director has delegated the authority to make this assessment to program staff. In situations where a worker suspects fraud, the overpayment is not considered for a repayment exemption, and program staff should refer to internal policy on Seniors, Community and Social Services’ Investigation practices.
In other cases, the exemption of repayment of an assessed overpayment can be considered under this policy with reference to the Assessing an Overpayment and Notice of Overpayment policies.
Note
Court ordered restitution, repayment agreements or overpayments as a result of a sponsorship default cannot be exempt from the requirement to repay an assessed overpayment.
The following considerations are generally used by the AISH program to determine whether or not an overpayment meets criteria for wilful misrepresentation, and by extension, whether or not the assessed overpayment may be considered as pure administrative error or other appropriate circumstances for an exemption on repayment.
- The extent of the program’s role versus the client’s role in causing the overpayment;
- Whether the client failed to fulfill the requirements of the program as outlined in the declaration section of the program application form;
- Whether the client provided false information with respect to their income, assets or personal situation in order to receive a benefit to which they were not entitled;
- Whether the client failed to disclose a material fact in order to receive a benefit to which they were not entitled;
- Whether the client made a reasonable effort to advise the program of a change in circumstances;
- Whether the client was aware they were receiving benefits to which they were not entitled and/or which had been issued in error;
- Whether the client’s disability or medical condition contributed to causing the overpayment; and
- Whether the client materially benefited directly or indirectly from the overpayment.
“Pure administrative error” has specific parameters that the overpayment was caused solely by oversight or error on the part of the program. Overpayments in this category cannot be attributed to the actions/inactions of the client in any way.
Examples that would qualify for exemption under a pure administrative error include the following:
- A client notifies the program that they earned $400 in monthly employment income. The worker accidentally enters $40 in the system and discovers that the client was overpaid for one month.
- Two clients with the same name have their files mixed up and one client receives the other client’s higher benefit amount. The client who received the higher benefit amount notified their worker about the error immediately.
Note
Guidelines for decision-making on overpayments that result from retroactive lump-sum payments are described in the Overpayments as a Result of Retroactive Payments policy.
|
|