October 2018

Legislative authority

Sections 30 and 32 of the Act.
Sections 77 and 78(4) of Regulation 134/98.

Audit requirements

A copy of the Notice of Appeal Decision is on file.

The amount of the overpayment and appropriate documentation to support calculations and decisions are on file.

A copy of the notice given to applicants or participants regarding the amount of the overpayment, the reason and the period for which it was incurred is on file.

Application of policy

The Social Benefits Tribunal (SBT) has the authority to order payment of interim assistance where the SBT is satisfied that the recipient is experiencing financial hardship, where there are grounds for the appeal and when other conditions of eligibility (except those under appeal) have been met.

Interim assistance can include income assistance and benefits, in accordance with all other eligibility requirements, and cannot exceed the maximum amount payable under the Act and regulations.

Interim assistance does not include employment assistance for the ineligible benefit unit member upon whose behalf interim assistance is being provided.

When an applicant or recipient in receipt of interim assistance loses an appeal to the SBT, withdraws an appeal, or has an appeal denied because he/she did not attend the hearing, the interim assistance paid is recoverable as an overpayment.

The file and the appeal decision are reviewed to determine:

  • the amount of interim assistance the applicant or recipient received during the appeal period
  • the recoverable amount

Overpayment calculations are documented in the Social Assistance Management System (SAMS) and on file. First Nations should document these items using their file systems

Where the SBT’s decision indicates that the recipient was not eligible for any financial assistance, the entire amount of interim assistance is considered an overpayment, with the exception of a benefit that cannot be quantified.

Where the SBT determines that the recipient was eligible to receive financial assistance, but at a lower amount than was paid as interim assistance, the difference between these two amounts may be recovered as an overpayment.

Notice must be given to the recipient of the amount of the overpayment, the reason for it, and the period for which it was incurred in a format and manner approved by the Director.

Calculating an overpayment to recover interim assistance

Example 1

A recipient is terminated from assistance effective August. The recipient subsequently proceeds through the internal review process and then to the SBT. The recipient requests and is granted interim assistance effective September. His monthly basic financial assistance would have been $733 and the interim assistance paid is also $733.

Interim assistance is paid until the appeal decision is received in November. The termination decision is upheld. The total amount of interim assistance paid for September, October and November is an overpayment: 3 × $733 = $2,199.

Notice of overpayment and amounts owing is sent to the recipient and the case is terminated effective November.

Example 2

A recipient with two children ages 10 and 17 receives financial assistance of $1057 per month ($360 basic needs + $697 shelter). In September, the 17 year-old does not attend school, with no plans to return in the future. The Administrator reduces the recipient’s assistance to $1002 ($360 basic needs + $642 shelter) being the amount for a single parent with one child 0-17 years. The recipient appeals the deduction and requests interim assistance.

The SBT orders interim assistance effective October 1, equal to the amount of basic financial assistance the recipient would have received prior to the removal of the dependent child.

Interim assistance is paid in the amount of $1057 until the appeal decision is received in January. The Administrator’s decision is upheld to exclude the 17 year old as a dependent child in the benefit unit.

The difference between the interim assistance and the amount of financial assistance that should have been paid for four months is an overpayment:
$1057 - $1002 = $55, so 4 × $55 = $220 (overpayment).