No reimbursement may be claimed from a person when assistance has been paid to him or her or to their family because of an ADMINISTRATIVE ERROR which they could not reasonably have discovered.
Also, we cannot demand reimbursement for another reason.
Administrative error includes any mistake, omission or deficiency ATTRIBUTABLE TO THE ADMINISTRATION. It also covers any processing of a file that does not follow the instructions of the Income Security Program authorities if the result is an overpayment. The same is true of errors made by people acting on his behalf.
When the ERROR is committed by a THIRD PARTY, the client has the duty to reimburse the assistance unrightfully received. For example, a client has the duty to reimburse overpaid amounts when he or she was assigned an incorrect work income following an inaccurate declaration from his or her employer.
Except for errors in calculation that are independent of any outside influence an administrative error cannot be presumed: it must be justified by vouchers, such as a letter or monthly declaration from the client notifying the office of a change of situation that was filed without noticing the change. As a general rule the same is true of any information filed without action being taken when, as the client met his or her obligations, it should have been processed.
However, the deficit will be recalculated on the basis of the amount of benefit actually paid to the client to determine the retroactive amount to be paid for a month where all or any of the assistance overpaid results from an administrative error.
In addition, the client must NOT HAVE BEEN ABLE to NOTE this ERROR. For example, the fact that the client has cashed two benefit cheques issued for the same month without even inquiring about the reasons for the second payment being made represents a departure from the above-mentioned principle.
This is also true when, after being notified that the assistance will be reduced or cancelled from a particular month, the client continues to receive and cash the same cheques without worrying about the error of issue.
Administrative error cannot reasonably be noticed when:
1. the LACK OF DILIGENCE (more than 2 months after the facts), in PROCESSING a CLAIM is not the client’s fault
AND
2. and results in depriving him or her of assistance that would otherwise have been paid.
This is particularly true of a client who because of a late claim no longer has the proceeds of realization of a right, because the cancellation of assistance forced him or her to draw on this resource.
and
3. furthermore, the Band and/or Tribal Council’s delay in requesting the reimbursement of the conditional assistance must not be attributable to the client.
When all 3 conditions are met, the total of benefits not paid must be deducted from the amount of the realised right.
Example
The client notifies on the month of June 2004 that an amount of $10 000 was realised, representing the monthly income of $1000 unpaid for a period of 10 months terminating on the month of April 2004.
The councillor terminates his or her employment assistance benefit of $1000 per month on June 30, 2004 and establishes the claim on the month of September 2004.
The councillor will deduct $3000 (unpaid benefits from July to September) from the realised right ($10 000) and claim the assistance paid up to this amount ($7000).
LOSS OF THE ACQUIRED RIGHT OR THE DATE OF ELIGIBILITY FOLLOWING A CLAIM FOR ADMINISTRATIVE ERROR
As the beneficiary does not receive a claim for all the assistance paid, the registration of an administrative error claim will not result in making the client lose his or her date of last eligibility, nor his or her acquired rights (single family, children under 6 years of age, housing assistance).
Therefore, after establishing the claim, the concillor records an GCR-type (Comprehensive claim booklet) amendment for each actual month when financial assistance was claimed in its entirety.