CWES Overpayment & Underpayment Forms

The following forms are to be used for processing CWES overpayments and underpayments.

“CWES Overpayment/Underpayment Worksheet and Referral” (SCD 1798)

The “CWES Overpayment Worksheet and Referral” (SCD 1798) is used to show the overpayment computation and to refer the calculated overpayment to Collections ONLY when a client or provider is NOT known to CalWIN AND the case closed prior to CalWIN implementation (June 2005). Complete all pertinent information on the form. Once the form is completed, forward to Collections via fax or pony.

When the SCD 1798 is reviewed by an individual (i.e., EC Supervisor, Quality Control, Appeals, etc.), the individual must be able to easily tell how the overpayment occurred and who is responsible for the overpayment.

“Cancellation of Overpayment” (SCD 1851)

The SCD 1851 is used by the EC to notify the client to disregard the prior overpayment notice. This usually happens when the EC reevaluates the cause of overpayment and determines that no overpayment exists.

The SCD 1851 is completed by the EC by making appropriate entries in the spaces provided, based upon the specific situations in the case.

“Temporary Postponement in the Recovery/Collection of Supportive Services Overpayment” (SCD 1853)

The form SCD 1853 is used by the EC to notify the overpaid individual that overpayment recovery/collection is being deferred. The EC makes the deferral determination.

The SCD 1853 is completed by the EC making appropriate entries, based upon the specific situations in the case.

“Child Care Provider Overpayment Notice and Consent” (SCD 1788)

The SCD 1788 is used for child care provider-caused overpayments, where the provider is responsible. Providers have ten (10) days from the form mail date to complete, sign, and return to the EC. When repayment is not made or the provider has not consented to child care payement reduction within 30 calendar days of the SCD 1788 being mailed, the EC refers the the provider to Collections.

“Welfare-to-Work Overpayment/Underpayment Notice” (WTW 11)

The WTW 11 from the DEBS Forms Library is completed when there is an overpayment or underpayment to the client.

The WTW 11 is completed by the EC making appropriate entries, based upon the specific situations in the case. The EC must send this form to the overpaid individual within 30 calendar days from the date of the initial discovery. The Supportive Services Repayment Agreement (WTW 12) is ALWAYS sent with WTW 11 when there is an overpayment.

Note: For each type of Overpayment/Underpayment computation, a separate WTW 11 is to be completed.

“Welfare-to-Work Supportive Services Repayment Agreement” (WTW 12)

The WTW 12 from the DEBS Forms Library is completed when there is an overpayment to the client. It also includes different methods of repayment. The overpaid individual will have to mark their choice of how they would want to repay the overpayment when there is an overpayment.

The EC completes this form by making appropriate entries in the spaces provided, based upon the specific situations in the case.

Reminder: The Overpayment Notice (WTW 11) is ALWAYS sent with the WTW 12.