AUTHORITY
Income and Employment Supports Act, section 35(4), (5)

INTENT

To explain the circumstances under which it is appropriate for a client, financial administrator or third party to be exempt from the requirement to repay a benefit.

POLICY

Repayment of an overpayment is required and will not be waived by the Director in the following instances: 

1. The person received the benefit by fraud; or
2. The person received the benefit by willful misrepresentation; or
3. The overpayment is the result of a default sponsorship agreement, or
4. The overpayment is the result of the learner withdrawing from training.

This policy is not intended to apply in circumstances where the overpayment has crystallized into a debt.

Appropriate Circumstances – No Repayment of an Overpayment

The Director (or their delegate) has authority to waive a learner’s requirement to repay an overpayment. Appropriate circumstances for the Director (or their delegate) to waive a learner’s requirement to repay an overpayment are as follows:

Administrative Error

If an overpayment is wholly the result of an administrative error, it is generally waived from the requirement to repay.

The following circumstances are not considered to be an administrative error:

• the learner failed to fulfill the requirements of the program outlined in their signed declaration;
• the overpayment is the result of a combination of a worker/system error and the learner’s failure to accurately declare their circumstance; or
• the overpayment was the result of an exceptional circumstance that affected a significant number of learners and waiving the requirement to repay all of the related overpayments would have a material financial impact on the program.

Other Circumstances

If an overpayment is not the result of an administrative error, the totality of the situation is considered when determining if an overpayment can be waived. Overpayments may be waived when the situation is outside the learner’s control (e.g. medical).  Substantiation may be required depending on the circumstances.

Note
The appeal panel has jurisdiction to rule upon the Director’s (or their delegate’s) decision to approve or deny a learner’s requirement to repay an overpayment.

PROCEDURE 

1. The Learner Benefit Coordinator (LBC) discovers a possible overpayment. When the overpayment is the result of an administrative error, a letter is sent to the learner advising they have an overpayment and repayment is not required.
2. When the overpayment is the result of the learner withdrawing from training, the overpayment is calculated and a letter is sent to learner advising them of the overpayment and their right to appeal.
3. If the LBC determines an overpayment may exist, excluding those resulting from administrative error and withdrawals, a letter is sent to the learner requesting further information related to the circumstances that led to the overpayment. The learner is provided with 30 days to respond. 
4. When the learner provides further information, or after 30 days, whichever occurs first, the LBC escalates to the supervisor to review the information provided and decide whether or not to waive the overpayment.
5. If the overpayment is waived, the LBC completes the calculation and notifies the learner in writing of the decision (reason and amount of the overpayment and the decision to waive the overpayment).
6. If the overpayment is not waived, the LBC completes the calculation and notifies the learner in writing of the decision (reason and amount of the overpayment and the decision to not waive the overpayment) and their right to appeal.
7. If the learner does not provide additional information, the LBC completes the overpayment calculation and notifies the learner in writing of the decision (reason and amount of the overpayment and the decision to not waive the overpayment) and their right to appeal.
8. In all cases, the LBC enters the decision and the rationale in Mobius Notes. 

These steps can also be viewed as a flow chart.

Note
For circumstances where the overpayment is determined to be older than three years, the overpayment is automatically waived by the LBC.

APPROVAL

Learner Benefit Coordinator, LISO
Supervisor, LISO