OKDHS - OAC 340:65-5-6. Reconsideration of administrative action

340:65-5-6. Reconsideration of administrative action

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Revised 6-1-07

(a) Corrective action is required on any administrative action which results in withholding of benefits, an underpayment for which the client was later determined eligible, or an overpayment of benefits the client was not eligible to receive. A reconsideration of the administrative action is required when:

(1) computer down time prevents action being taken timely;
(2) policy and procedures were not administered correctly; or
(3) new or additional information is received within 30 calendar days of the:
- (A) date action was taken to deny the application; or
- (B) effective date benefits were terminated. • 1

(b) A retroactive payment is authorized to correct an administrative action which resulted in a payment being discontinued, an application denied, or an underpayment. • 2

(1) Payments discontinued for Temporary Assistance for Needy Families (TANF) and State Supplemental Payment (SSP). When the local human services center (HSC) reconsiders its previous action and finds the payment was discontinued in error, a payment is made for the current month and prior months, provided the amount authorized was improperly discontinued in these months and does not exceed the standard on Oklahoma Department of Human Services (OKDHS) Appendix C-1, Maximum Income, Resource, and Payment Standards.
(2) Application denied for TANF and SSP. When an application is denied and local HSC staff subsequently reconsiders its previous action and finds the applicant is eligible, a benefit is issued for whatever period the client is determined eligible but no earlier than the date of application.
(3) Underpayments determined for TANF and SSP. When a benefit was issued for less than the amount for which the client was eligible, the worker authorizes an underpayment for whatever period of time that underpayment was made. • 2

INSTRUCTIONS TO STAFF 340:65-5-6

Revised 6-1-11

1. (a) An incorrect administrative action occurs when:

(1) an application is denied or a case is closed in error;

(2) there is a failure to complete an application due to:

(A) a delay in receipt of a case record from another office;

(B) a computer input error which prevented the application from achieving active benefit status; or

(C) down time on the computer that prevented input; or

(3) a failure to take appropriate action on an active case prior to the next deadline after a change was reported or discovered.

(b) Adverse action that is not the result of an administrative error is:

(1) failure of a client to provide required verification of information within prearranged time limits causes closure or denial, and new or additional information is received within 30 calendar days from the effective date of the closure or denial. If the information establishes the client's eligibility, a closed case may be reopened or a denied application may be certified and no new application is required. After the 30-day period the client must either reapply or request a hearing according to the hearing policies and procedures;

(2) anticipating eligibility establishes the client to be ineligible, but after closure the client's situation changes, and the client remains eligible. If the client notifies the worker within 30 calendar days of the date of closure, the case is reopened after verification that the reason for ineligibility did not occur. The certification and the review dates remain the same but the effective date is the date the benefits were terminated; or

(3) anticipating eligibility establishes the applicant to be ineligible, but after the denial the applicant's situation changes and the applicant is eligible. If the applicant notifies the worker within 30 calendar days of the date action is taken to deny the application, no new application is required and the case is certified after verification that the reason for the denial did not occur.

2. The worker uses Information Management Systems (IMS) transaction:

(1) F17C to issue retroactive or supplemental payments for Temporary Assistance for Needy Families (TANF) or State Supplemental Payments;

(2) F17K to issue retroactive or supplemental payments for the Supported Permanency Program. Refer to OAC 340:10-22-1.

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