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Expected to Work/Barriers to Full Employment Policy & Procedures

Published Date: March 26, 2012
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18 Overpayment, Debt and Recovery

Total Ineligibility

POLICY

If a client is deemed totally ineligible, the overpayment includes all benefits issued, including the medical benefits.

The amount of the overpayment cannot exceed the amount of IS benefits issued.

The only situations where total ineligibility may be considered are outlined in the table below (with limitations specified). In all cases, clients must be provided with clear information about the reason for the overpayment, have adequate opportunity to present documentation to support their case and be advised of their right to appeal.

Reason and Limitations for Total Ineligibility

Reason

Limitations

Undeclared Asset(s)
  • The asset must be large enough to render the client ineligible.
Undeclared Income
  • The income must be large enough to render the client ineligible.
  • If a client fails to report partially exempt income when they had an opportunity to do so, they do not receive the income exemption if the worker is satisfied the client intended to mislead the Department.
Undeclared Partner
(married/common-law)
  • The client must be given the opportunity to provide the Department with any documents that will assist in determining eligibility.
  • If the client refuses to or cannot provide convincing documentation the Department may consider deeming the client totally ineligible.
Duplicate Assistance
  • Repayment must be co-ordinated with the other province. Only one province may calculate an overpayment.
Fraud Involvement Charges Laid
  • The client must have intentionally misled the Department to the extent that it cannot be determined what benefits the client would have been eligible for.
  • Where the actual amount can be determined, the restitution/overpayment must reflect that amount.
Incarceration
  • Client was incarcerated during the entire period(s) in question.


PROCEDURES

The worker must file the documentation justifying the decision on Section 1 of the client’s file.