CWES Fraud Referrals - Case Loan Procedures

In order to facilitate the investigation and possible prosecution of welfare fraud, the SIU is to be given prompt access to the CWES case files. The SIU has view and print access to the IDM and CalWIN systems. If the information is not available in these systems, the SIU will contact the EC.

The following procedures and processes are to be followed to ensure that:

CWES staff retain all necessary eligibility information pertaining to the client/case; and
SIU have all the information that they need (including needed originals of relevant case documents which have not yet been scanned into the IDM system.)

Requests from SIU

ALL SIU requests for CWES cases (whether open or closed cases/volumes) are to be handled by the office CWES Fraud Designee. Only specified clerical staff within the SIU are responsible for contacting staff for case access.

In emergency situations, SIU Investigators will be allowed to pick up the CWES case folder at the Retention Center, as appropriate, provided that at least 24 hours advance notice has been given. Case files requested for pickup by the SIU Office will have a case loan priority 1.

Note: Retention scans cases into IDM when a case file is requested.

When the cases are received by the SIU, the specified clerical staff within SIU will log the cases in and monitor for adherence to the specified time limits.

Request for Physical Closed CWES Cases

Follow this process to request an active CWES case file that has not been scanned into IDM.

A. The SIU:

Contacts CWES office designee to request the CWES case.

B. The CWES Fraud Designee:

Makes a request to the Retention Center for the CWES case to be delivered to CWES Fraud Designee or arranges for a SIU Investigator to pick up the case from CWES District Office or Retention Center.
Tracks outgoing CWES case according to CWES District Office procedure and forwards the CWES case to the SIU via pony in instances where there is a physical case file.

Reminder: In emergency situations, the SIU Investigator will be allowed to pick up the CWES case directly from the CWES District Office or Retention Center provided that at least 24 hour notice has been received.

C. The SIU:

Receives CWES case and logs the case in as received and monitors for adherence to the specified time lines.
Proceeds with investigation as appropriate.
Returns the CWES case, via pony, to the CWES Fraud Designee at the office the request was made.

Note: The CWES Fraud Designee will receive a list of cases being returned via email.

D. The CWES Fraud Designee:

Logs return of CWES case from the SIU.
Returns the CWES case to Retention or forwards the case file to IDM for scanning.

Time Frames

The following time frames for retention of the CWES case files by the SIU begin with the date the case is received by the SSA SIU.

Case Type	Time Frames
Active or Discontinued Case - Not Closed	The current active or discontinued volume of the CWES case folder may be loaned to SIU for the purpose of filing a criminal complaint for a period not to exceed seven (7) calendar days.
Closed Cases or Prior Volumes of Active Cases at Retention Center	Prior volumes of open or closed cases requested from the Retention Center may be retained by SIU for the purpose of filing a criminal com- plaint for a maximum of 30 calendar days.
Closed Cases or Prior Volumes of Active Cases at CWES District Office	Prior volumes of open or closed cases requested from a district office may be retained by SIU for the purpose of filing a criminal complaint for a maximum of 30 days.

Neither attorneys nor investigators from the SIU will retain any SSA files after a criminal complaint is filed.

SIU Investigator Activity

During the specified time frames, the SIU will:

Review the case record;
Identify relevant documents and have photocopies made, and
File the photocopies in the appropriate place in the CWES case record, as appropriate.

Documents Kept by SIU

Original documents/IDM copies necessary to prove the welfare fraud may be removed from the CWES case for the SIU file. SIU As appropriate, Investigators will photocopy each document removed, stamp the copy indicating that the original is being retained by the SIU Office, and file the photocopies in the appropriate place in the case record prior to returning the case folder. This will all be done within the specified case loan time frame.

The SIU assumes responsibility to ensure that the original documents are returned to the CWES case folder at the conclusion of the investigation and/or prosecution, as appropriate.

Note: If the case is in IDM, a copy is printed.

Return of CWES Cases

ALL cases loaned to the SIU must be returned to the CWES office from which they were loaned, as appropriate.

Exception: If a closed case has been loaned to the SIU from the Retention Center or a District Office and is subsequently required for a CWES Intake Orientation at a different CWES District Office, the case record should be requested by contacting the CWES Fraud Designee. The CWES Fraud Designee will contact the SIU and coordinate delivery of the case to the CWES District Office making the request.