When a third-party agency (HRDC, SAAQ, RRQ, etc.) has made an administrative error and consequently paid out too much in benefits, it may reclaim them from the person who received them. The overpayments may have been counted in calculating last resort financial assistance benefits, which then reduced the amount to which the client was entitled or caused him or her or an applicant to be ineligible for assistance. Making clients repay the overpayment penalizes them by depriving them of assistance they would have been entitled to had they not received the amounts being claimed.
To rectify this situation Income Security makes a retroactive adjustment of assistance on the following conditions:
1. The APPLICATION for adjustment is made in the MONTH FOLLOWING THE CLAIM made by the other agency to the person;
2. The person to whom the claim has been made did NOT CAUSE THE CLAIM by making false or incomplete statements to the third-party agency;
3. The person to whom the claim has been made must show that EVERY REASONABLE RECOURSE WAS TRIED before the counsellor can assess eligibility to receive a retroactive amount;
4. The person to whom a claim has been made must show that the agency refuses to cancel the part of the claim corresponding to the last resort assistance that would otherwise have been granted if the amounts claimed had not been paid out, by obtaining if possible a WRITTEN STATEMENT FROM THAT AGENCY.
The PROCESSING OF CASES will vary depending on whether the person has continued to receive assistance or whether assistance was cancelled or denied after the overpayments by the third-party agency were received.
PERSON CONTINUES TO RECEIVE ASSISTANCE
In these cases monthly statements by the client are available for the period covered by the third-party agency's claim. It is thus possible to recalculate the deficit between the resources of the adult or family, after subtracting the amounts claimed (overpaid), and the needs established for each month in which assistance was paid. The adjustment will cover the whole period for which the claim was made by the agency.
ASSISTANCE CANCELLED OR DENIED
For a retroactive payment to be made the person must have made an APPLICATION for last resort financial assistance.
The person from whom money is claimed by a third-party agency must submit MONTHLY STATEMENTS for the months following the cancellation or denial as required by the Framework Policy, and must do so in the MONTH FOLLOWING the claim by the agency.
The difference is calculated for each month covered by the claim, but no reimbursement is made for a period prior to August 1, 1990.
In all cases where a retroactive adjustment is to be made the PAYMENT must be made directly to the THIRD-PARTY AGENCY.
It is possible that assistance may have to be paid in such cases which will be repaid in future. When the retroactive payment does not allow for satisfaction of the full claim and the third-party agency reduces its benefits to offset the amount still owing to it, last resort financial assistance will be granted taking into account the offsetting reduction in benefits: however, the assistance will have to be repaid up to the amount of the reductions once they cease to be made.