Case Rejection Criteria Overview

The case rejection criteria and procedures outlined in this chapter are an agreement between District Office Bureaus. The intent behind rejecting cases is to promote accountability and serve as a learning opportunity for staff. However, customer service and timely benefit issuance must be the top priority for all parties involved. When negotiating a rejection, the impact the case rejection can have on the client must be considered. A delay in benefits to a client is not acceptable. In addition, it is expected that staff reference program handbooks to support their stance on a case rejection. SSPMs have full discretion to settle case rejections without further escalation, including scenarios not currently covered in this chapter. If information referenced in the handbooks is unclear, SSPMs can escalate to the program manager for policy clarification.

Correcting All Errors

When a case contains problems other than the one(s) which meet the case rejection criteria, all errors listed on the “Reject Case Communication Form” (SCD 1096) must be corrected by the worker to whom the case was returned.

Reject Only Once

A case should be thoroughly reviewed by the rejecting EW and Supervisor prior to rejection because a case can only be rejected once for errors which occurred previous to the rejection period, unless those errors listed on the original SCD 1096 were not corrected.

Case Rejection Period

Cases can only be returned within 20 working days from the assigned date of the case.

For intake workers, the first day begins on the date of task assignment to the EW.
For continuing workers with Individual Case Loads, the first day begins on the date the case is assigned to the EW’s caseload in CalSAWS.
For continuing workers with Unit Case Loads, the first day begins on the date the task is assigned to the EW.

Under certain circumstances, cases that contain payment errors may be rejected beyond the 20 day period when an agreement is reached between the SSPMs of both district offices.

Note: Cases assigned to an AD EW at Staff Development are exempt from the 20 working days case rejection period.

Case Returns

Cases will be returned to the EW who last made a change that affected eligibility and/or the program budget within the same office.

Exception: If the error is in regards to Maximum Family Grant (MFG) and/or Time on Aid (TOA), the case will be returned to the EW who last processed the annual re-evaluation (RE) or add-a-person/program.

Unassigned Cases

When a case is unassigned, errors may occur due to the lack of action taken on the case during this time. These errors are not the fault of the previous worker. For a case that was unassigned when an error occurred, the case should not be returned to the former EW based on this error alone. If there are other errors that occurred while assigned to the previous EW, then the case rejection criteria may be followed.

Note: For a case that is unassigned and an error is cited by the Quality Assurance (QA) unit during a CATR review, the case will be reassigned back to the former EW.

Emergency Case Assignments

Unassigned cases may need to be temporarily assigned (typically to a designated Floater) due to an emergency the client is experiencing. After the client’s emergency is resolved, the case may be returned to unassigned status once again. In these situations, the EW that is finally assigned the case, still can review the case within 20 days of the case being assigned to them. If a payment error occurred while assigned to the previous EW [not the worker (typically a designated Floater) that was temporarily assigned to resolve an emergency] the newly assigned EW may reject the case.

Intra-Bureau Rejection Procedures

Intra-bureau rejection procedures may be modified at the discretion of the bureau manager.

Clerical Responsibility

Clerical staff are not responsible for case rejections. Any clerical issues related to case rejections must be brought to the Office Management Coordinator’s (OMC’s) attention.

Mass Transfers

Cases identified as a mass transfer may not be rejected. Exceptions for rejection may be negotiated by SSPMs.

Length of Time to Correct Errors

Case rejections will not be for items that would take longer to reject than to correct. For example, smaller ‘quick fix’ errors, such as an EBT card issue, may be corrected by the rejecting EW with an informational email sent to the EW Supervisor.

Reminder: ‘Quick fix’ errors are determined and agreed upon by district offices. The rejecting EW will need to discuss if the error(s) qualifies as a ‘quick fix’ with their supervisor and/or SSPM.