B—810  Entitlement to Restored Benefits

TANF and SNAP

Households are entitled to restored benefits when:

• legislation, federal regulations or court actions require restoration;
• the Health and Human Services Commission (HHSC) makes an error in the household's amount of benefits and the household was not at fault;
• an individual is disqualified for an intentional program violation, which is later reversed by a court; or
• the Supplemental Nutrition Assistance Program (SNAP) or an authorized representative of a drug and alcohol facility improperly accesses and fails to return the benefits to the individual's EBT account.

Households are not entitled to restored benefits for unreported changes or household errors.

Households are entitled to restored benefits regardless of whether they are currently eligible for or receiving benefits.

B—820  Time Frames for Qualifying for Restored Benefits

TANF and SNAP

Restore benefits as directed by a court or if the loss occurred within 12 months of the date:

• the household:
  • contests an adverse decision,
  • attends a disqualification hearing, or
  • notifies HHSC that it believes it has lost benefits.
• HHSC discovers that the household may be entitled to a restoration.

The month the agency discovers the household is entitled to a restoration is counted as month zero.

B—830  How to Determine the Amount of Restored Benefits

TANF and SNAP

1. Correct ongoing benefits for the current certification.
2. Determine the month the loss began.
3. Exclude months before the 12-month time limit.
4. Determine if the household was eligible for each month it lost benefits.
5. Obtain needed information to determine eligibility for any restored benefit month in question.
6. For each month, compute the amount of benefits the household should have received.
7. Determine the restored benefit amount by subtracting the correct benefits from the amount of benefits actually issued. If there is a claim, subtract the restored benefit amount from the amount due on the claim. Issue any remainder to the household.

Note: When initial benefits are paid retroactively, do not reduce the retroactive payment to offset previous claims.

Issue restored benefit(s) within 30 days of the date the agency discovers the underpayment.

B—831  Procedures for Counting Restored Benefits Toward a Claim

TANF and SNAP

1. Document the amount of restored benefits owed on Form H1101, TANF Worksheet (TANF) or Form H1898, Restored Benefits Documentation.
2. Determine if there is a claim, as noted in A-832, Continuous Medicaid Coverage, and TPPG B-15.1, How to Verify a Claim Amount. Refer to B-771.1, Action on Recoupment Cases.
3. Report the amount of offset on Form H1018, Overpayment Claim. Send Form H1018 to the Office of Inspector General, Claim Investigation Unit.
4. Notify the individual on Form H1825, Entitlement to Restored Benefits.

B—832  How to Verify a Claim Amount

TANF and SNAP

In the System for Applications, Verifications, Eligibility Reports and Referral (SAVERR) inquiry screen, press on the space bar. This will display the A2, Recoupment Data screen. The "REC BAL" heading will display the recoupment balance.

B—840  Notice to the Household

TANF and SNAP

Notify the household by Form H1825, Entitlement to Restored Benefits, of

• their entitlement to restored benefits,
• the amount and method of restoration,
• any claim offset, and
• the right to appeal.

B—850  Disputed Benefits

TANF and SNAP

If the household disagrees with the amount of restored benefits, or any other action the advisor takes to restore them, it may request a hearing within 90 days of the notice date. The advisor continues the restoration while waiting for the hearing decision and adjusts the benefits according to the hearing officer's decision.

The household may request a hearing if it believes it is entitled to restored benefits but the advisor does not agree. Document on the appropriate worksheet the request for restored benefits, the justification to deny them, and the date.

B—860  Method of Restoration

TANF

Restore all benefits owed to the household at the same time. Issue a separate benefit for each month the household is owed benefits. If there is not enough space on Form H1000-A, Notice of Application, Form H1000-B, Record of Case Action, and Form H1000-C, Secondary Client Input, Section XI, to request separate benefits, use Form H1008, Authorization for Cancellation or Issuance of Public Assistance Warrants, to issue benefits for remaining months.

SNAP

Restore all benefits owed the household at the same time, unless it requests restoration in installments. Installment allotments must be large enough to complete the restoration within six months. Inform the household in writing the date the higher allotment will end.

Issue a separate EBT benefit for each month the household is owed restored benefits. If there is not enough space on Form H1000-A, Form H1000-B and Form H1000-C Section XI, to request separate issuances, request benefits for the remaining months on a subsequent Form H1000-B and Form H1000-C.

B—870  Changes in Household Composition

TANF and SNAP

If household membership changes, issue restored benefits to the household containing a majority of the persons who were household members when the loss occurred.

If the worker cannot locate an individual or determine which household contains a majority of members, restore benefits to the household that includes the person who was the head of the household when the loss occurred.

B—880  Procedure for Authorizing Restored Benefits

TANF and SNAP

Authorize the restoration within 30 days of the date the agency discovers the underpayment.

TANF

Issue restored benefits for inactive cases by processing a simultaneous open and close. If issuing benefits via EBT, ensure the individual has a card and PIN. See B-200, Issuing Benefits, for card and PIN issuance procedures.

SNAP

1. Use Form H1898, Restored Benefits Documentation, to determine the amount of restored benefits.
2. Obtain the supervisor's approval on Form 1898 to issue the restored benefits and file the form in the case record.
3. Submit Form H1000-A, Notice of Application, Form H1000-B, Record of Case Action, and Form H1000-C, Secondary Client Input, to request benefit issuance.
4. Ensure the individual has a Lone Star card and PIN. See B-200 for card and PIN issuance procedures.

B—890  Documentation Requirements

TANF and SNAP

Advisors are required to document in the TANF worksheet or Form H1898, Restored Benefits Documentation, used for SNAP cases only.

Document:

• the reason HHSC owes restored benefits;
• why the household is entitled to restored benefits;
• the month the loss of benefits began;
• the time frames for benefits owed;
• computations;
• if there is a claim against the household;
• the amount of restoration approved if the household has an offset; and
• the date Form H1018, Overpayment Claim, was sent to the Office of the Inspector General informing of the offset for either an overissuance claim or an intentional program violation.

Note: The documentation requirements for SNAP cases will be met if appropriate entries are made on Form H1898.

Document in the case record the:

• request for restored benefits;
• justification to deny the request; and
• date according to B-850, Disputed Benefits.

Related Policy
Documentation, C-940
The Texas Works Documentation Guide