IEVS IFDS

The Income and Eligibility Verification System (IEVS) Integrated Fraud Detection System (IFDS) 440 abstracts are received and processed by the IEVS unit quarterly. The information on the IFD 440 is four to six months old. Matches are assigned to Eligibility Examiners (EE) for review. Match reviews must be conducted within 45 days. Eligibility staff are required to review the information at intake and recertification to prevent payment errors and determine program eligibility accurately. 

The IFD is a recipient system which matches:

  • Employer reported wage data from EDD with the wages budgeted by counties for individuals whose data is submitted to CalSAWS on the Welfare Recipient File
  • Clients receiving duplicate aid in our county or other counties and states
  • Clients receiving SSI and benefits in our county.

Reminder: Persons who worked for the federal government, are self-employed, or who worked in another state are not included in this match. Those individuals will be listed on the BEER recipient matches.

CalSAWS Auto-Closures 

Once the IFD data interfaces into CalSAWS, it goes through an auto-closure process to automatically close abstracts that are not required to be reviewed. When the information received has reported earnings: 

  • under the $3,000 threshold, 
  • a Non-Needy Relative on a CalWORKs case with reported earnings, 
  • a student who is under 18 years of age, 

CalSAWS will automatically close the IFD abstract. 

Business Need Filters 

Business need filters further select abstracts that do not need to be processed by staff. When the information received has any of the following: 

  • earnings of a minor, not included in the household, 
  • earnings for a household only receiving General Assistance, 
  • benefit amount issued is $1,000 or less and reported earnings are under $1,000, 
  • is not required to complete a SAR 7 and reported earnings are less than 130% of the Federal Poverty Level,

the abstract is filtered out, and must be manually closed by staff. 

  • When the case is in a closed status for CalFresh and/or CalWORKs, ASB Clerical Staff will manually close the abstracts. 
  • When the case is in an open status for CalFresh and/or CalWORKs, tasks will be generated for the assigned EW to manually close the abstract as non-discrepant. If the case is not assigned, a task will be created and will need to be assigned within the office where the case is located. 

Processing IFD Open Cases

The following process is to be used by the IEVS EE to review IFD open cases:

FINDINGS ACTION
Non-Discrepant (ND) 
  • Updates the Create IEVS IFD Response Document in CalSAWS.
  • Documents action in the case journal. 
Discrepant 
  • Reviews the IFD 440 and determines that the client did not report the earnings on the report and the EW has not recorded the earnings in the system.
  • Receives case and compares the IFD 440 to the case record, and determines whether or not to review for overpayment computation or if there is no impact. If there is:
    • No impact:
      • Updates the response document in the system for that case disposition.
    • An impact and the information is not in the case:
      • Updates the response document in the system and the SCCIEVS.
      • An auto-generated task will generate for the district office EW to follow-up on current income if the case is open/active.
      • Computes claims when verifications to resolve discrepancy have been received according to program rules.
    • An impact and the information is in the case:
      • There is a possible Administrative Error, the household reported the change in income, but the county failed to act.
      • Updates the response document in CalSAWS for that case disposition.
      • Completes the “IEVS Communication” (SCD 1604) for EW action on the case and generates a task for assignment to the current EW.

Eligibility Worker Review of Discrepant IFD Abstracts

Though it is the responsibility of the IEVS Eligibility Examiners to process IFD reports, Eligibility Workers must review IFD reports and resolve any discrepancies when processing:

  • Intake applications,
  • RRRs,
  • SAR 7 reports,
  • Tasks received from IEVS EE.

When the IEVS EE determines a potential discrepancy exists between the IFD report and the income entered in the system, a task is generated for EWs to follow-up on. Upon receipt of the task, EWs must follow the steps in the topic Discrepant IEVS Matches.

Important: IEVS EE will process prior and current OP/OI on active cases if IEVS has the required information to process the claim according to program rules. An SCD 1604 will be sent to the EW assigned to the case to notify claims were computed.

SAR 7 Report Submit Month

The actions in the following chart must be taken for households when a SAR 7 is due:

If the household... Then...
Provides all information / verifications with the SAR 7 report,
  • Use the information to determine future payment period eligibility and take all appropriate budget actions.
  • Calculate an overpayment and/or overissuance for the future payment period if there is insufficient time for a timely NOA.
  • Document actions taken in the case record.
Does not provide employment information or verification with SAR7,
  • The SAR 7 is considered incomplete. Staff must follow program rules for an incomplete SAR 7 and request the missing information to resolve the discrepancy allowing adequate time for the household to return the verification.
  • If the household refuses, fails to respond, or needs help obtaining verification staff must attempt to resolve the discrepancy using a third-party payroll source.
  • If verification is not available or incomplete through the third-party payroll source and the household refuses or fails to respond the report is considered incomplete and benefits must be terminated.
  • If the SAR 7 is already processed when the task for IFD review is received, the EW must send out a CW 2200 requesting the income verification for the next payment quarter.

Exception: For CalWORKs cases only if the household is cooperating but verification cannot be obtained by the household or a third-party payroll source a sworn statement under penalty of perjury is considered sufficient.

Example Example The EW receives a task on April 20th to review an IFD report for the 21-03 quarter. The April SAR 7 was received on April 10th and has already been processed as complete. The EW must send out the CW 2200 and give the client 10 days to provide verification. On April 30th, the client provides income verification. The EW must budget the income for the May-October payment period and create an overpayment for May 2021. 

RRR Month

The EW will...

Step Action
1 Request the employment verification using a CW 2200 form and allowing 10-calendar days for the household to respond.
2

If the household...

  • Returns the requested information to resolve the match discrepancy:
    • Use the information to determine future payment period eligibility and take all appropriate actions according to program rules.
  • Fails to provide, refuses to provide or needs help obtaining verification:
    • Attempt to obtain verification needed using a third-party payroll source.
 

If the third-party payroll source...

  • Has the verification needed to resolve the match discrepancy:
    • Use the information obtained from the third-party payroll source to determine future payment period eligibility and take all appropriate actions according to program rules.
  • Does not contain the verification needed to resolve the match discrepancy:
    • For CalFresh cases, the application is considered incomplete and benefits must be denied.
    • For CalWORKs cases, if the recipient is trying to cooperate and the information is not available through the third-party payroll source, a sworn statement under penalty of perjury is considered sufficient.
3 Document clearly in the case file all the actions taken including the run date and disposition of the IEVS match.

IFD on Closed Cases

When the IEVS Unit receives an IFD 440 on an already closed case, the abstract must be processed by the end of the following quarter in which it was received.

IFD IEVS Unit Reading Workflow

The following process must be followed for IFD readings:

Step Who Action
1 Information Systems
  • Extracts the IFD 440 reports and applies filter(s) to develop a list of cases for EE review.
  • Uploads assignments to the SCCIEVS application.
  • Notifies the Management Analyst.
2 IEVS Supervisor Verifies the CalSAWS worker schedule is updated prior to SCCIEVS upload.
3 Eligibility Examiner (EE)
  • Receives auto-assignment of IFD 440 abstracts for reading in SCCIEVS application.
  • Reviews cases and determines if D, ND, DC or D - 1604.
  • Indicates status in CalSAWS & SCCIEVS.
If .. Then EE...
D
  • Documents the following in the case journal:
    • Calendar quarter being reviewed,
    • Reason for potential discrepancy, and
    • Other quarters open for review, if any.
  • Updates Reading Status field to Discrepant in SCCIEVS.
  • Generates first client letter in SCCIEVS

  • Note: A task will be auto-generate for the district office EW to follow-up on current income.    
ND
  • Updates Reading Status field to Non-Discrepant in SCCIEVS.
  • Documents in the case journal.
DC
  • Updates Reading Status field to Discrepant-Completed.
  • Updates the Create IEVS IFD Response Document and records claim amounts in CalSAWS.   
D-1604
  • Completes the SCD 1604 if the benefits case is active and OP is due to Administrative Error.
  • Emails SCD 1604 to the IEVS Verification Desk inbox for task creation. 
  • Updates case journal.    
4 EE Lead / Supervisor Monitors and ensures daily readings are processed.
5 Clerical
  • Monitors that readings in DC status are completed and enters claim information in SCCIEVS.
  • Completes SCD 1604s for readings in D-1604 status. 
  • Creates IEVS Working folder when any correspondence is received.
  • Monitors “Client Letter” (SCD 1511-CL), checks electronic Third-Party Payroll Sources, and “Employer Letter” (SCD 1511-EL).

Calendar Days 1-11

If the client... Then...
Returns the SCD1511-CL with complete verifications,
  • Enters receipt in SCCIEVS.
  • Files letter and verification in the IEVS working folder.
  • Attempts to obtain verification through electronic third-party payroll sources.
  • Waits for Employer Letter.

Returns the SCD1511-CL but additional verification is needed, or

Did not return the SCD 1511-CL,
  • Documents in SCCIEVS when incomplete verifications are received.
  • Attempts to obtain verification through electronic third-party payroll sources.

Note: The “First Employer Letter” (SCD 1511-EL1) is automatically generated in SCCIEVS on the 11th working day following the SCD 1511-CL.

Calendar Days 12-23

If the employer... Then...
Returns SCD 1511-EL1 with complete verifications,
  • Enters receipt in SCCIEVS.
  • Files letter and verification in the IEVS working folder.
  • Changes case status to Ready for Assignment in SCCIEVS.

Returns the SCD 1511-EL1 but additional verification is needed, or

Did not return the SCD 1511-EL1,
  • Documents in SCCIEVS when incomplete verifications are received.
  • Attempts to obtain verification through electronic third-party payroll sources.
  • Generates “Second Employer Letter” (SCD 1511-EL2) in SCCIEVS and mails to employer(s).

Calendar Days 34-43

If the employer... Then...
Returns “Final Employer Letter” (SCD 1511-EL3) with complete verifications,
  • Enters receipt in SCCIEVS.
  • Files letter and verification in the IEVS working folder.
  • Updates case status to Ready for Assignment in SCCIEVS.

Returns the SCD 1511-EL3 but additional verification is needed, or

Did not return the SCD 1511-EL3,
  • Assigns case to EE lead as a “Verification Desk Closing”.
6 EE
  • Receives IEVS case folder from Assignment Desk.
  • Follows Benefit Calculation Process. 

 

Benefit Calculation Process

The following is the Overpayment (OP) computation chart to be followed by the EE or EW:

If... And... Then...
CalSAWS has an “Open” case status, Aid and/or CalFresh program is “Open” with an Administrative Error identified in the first quarter, District office case carrying EW will compute the OP.
Cash and/or CalFresh program is “Open” with Client Error, IEVS EE will compute the OP.
CalSAWS has a “Closed” case status, Either Client or Administrative Error, IEVS EE will compute the OP

The table below outlines the steps when calculating OP:

Step Who Action
1 EE
  • Receives IEVS working folder from clerical.
  • Conducts review to determine if there is sufficient documentation to complete a computation.
  • If the documentation in the IEVS case is:
    • Sufficient:
      • Continues with processing the OP.
    • Not sufficient: 
      • Determines if additional verifications are needed and attempts to obtain necessary information by any means available.
      • Updates Case Status field in SCCIEVS to Pending Verification and follows up within 30 days of request.
      • Documents reason in the case journal.
      • Updates the Status field to Processed, No Discrepancy on IEVS abstract. 
      • Updates Case Status field to Simple Close and selects a Close Reason in SCCIEVS after 30 days of request.
  • Determines, based on the CalSAWS case status, if IEVS case will be ready for computation. If the case is at intake, waits for intake disposition before performing computation.

  • Note: Consult with supervisor if guidance is needed to determine if information on file is sufficient for computation.
2 EE Supervisor Reviews a sample of simple close cases from EEs.
3 EE
  • Once required verifications are received, begins OP computation either manually or in CalSAWS.
  • Documents case journal.
  • Completes “Overpayment Worksheet” (SCD 11).
  • Refers case to SIU via CalSAWS 
  • Adds claim number, claim amount and claim reason to SCCIEVS.
  • Updates the Case Status to Completed in SCCIEVS.
4 IEVS Supervisor
  • Reviews the following on all cases over $3000 and a sample of assignments under $3000:
    • Completed assignments and validates closings.    
    • Benefit calculation accuracy and NOAs.
  • Submits IEVS working folder to clerical imaging.
5 Clerical
  • Scans case information into imaging.
  • Returns folders with OI/OPs over $3,000 to IEVS Supervisor.
6 IEVS Supervisor
  • Forwards physical case folders with OI/OPs over $3,000 to SIU. Refer to General Fraud. 

 

IEVS Communication Form (SCD 1604)

The “IEVS Communication” (SCD 1604) form is used to communicate the requests from the IEVS unit and actions taken by the EWs.

The following process is to be used when an SCD 1604 form request is received:

STAGE WHO ACTION
1 EW
  1. Reviews SCD 1604 form and completes requested actions:
    1. Discontinues case if applicable
    2. Sends a timely Notice of Action (NOA) which contains all of the pertinent information regarding the OP/OI or ineligibility
    3. Documents action taken in the case journal.
  2. If the EW assigned to the task has new information or knowledge regarding IEVS findings, the EW must communicate the new information with IEVS to resolve the discrepancies.
2 Supervisor
  • Reviews case actions taken
  • Signs and dates the SCD 1604 form
  • Ensures form is sent to imaging. 

If the case was discontinued/closed at the request of the IEVS EE for failure to cooperate or failure to report assets and the client reapplies, EW must clear all eligibility factors with IEVS unit before the case can be restored, regardless of whether restoration is in continuing or intake.

Compliance Desk Process

This subsection outlines the processes when an IEVS case involves a benefit case that is active in the District Offices (DO).

Sending IEVS Communication to DO

The process below must be followed when it is determined that the “IEVS Communication” (SCD 1604) must be sent to an EW :

Step Who Action
1 EE
  • Determines that IEVS case is linked to an active/pending benefit case and action must be taken on the client’s benefits.
  • IDs the active/pending benefits case in CalSAWS and completes the SCD 1604.
  • Forwards the completed SCD 1604 to the IEVS Verification Desk inbox.
  • Updates the Case Status to Pending SCD 1604 if the case is currently assigned to them as computation assignment.
2 Clerical
  • Generates CalSAWS task for SCD 1604.
3 District Office
  • EW completes task within 5 working days.
  • Documents actions on SCD 1604 and gives to Supervisor for review.
  • EWS reviews case actions taken and sends documents to imaging. 
4 Clerical
  • Receives email from EWS.
  • If the case is:
    • Unassigned:
      • Updates Case Status to Completed in SCCIEVS.
    • Assigned: 
      • Forwards to EE for review.
5 EE
  • Receives SCD 1604s for cases currently under computation assignment.
  • Validates computation
  • Updates SCCIEVS case status to Completed once all computations are finalized.