Are You Under Review? The Ministry of Social Development's Powers of Investigation

By: 

Thea McDonagh

TAPS has recently seen a significant increase in the number of clients seeking assistance after being informed that the Ministry of Social Development and Social Innovation (the “Ministry”) is conducting an eligibility review of their file. These reviews can be the result of the Ministry becoming aware of some new information relating to a client file. The Ministry can receive allegations of overpayment of assistance or fraud either from external sources, such as calls from the public, or internally through Employment and Assistance Workers (EAWs) or other ministry staff.

Ministry staff must refer all matters of suspected or alleged fraud to the Prevention and Loss Management Services Branch (PLMS). This is a branch of the Ministry dedicated to preventing and/or reducing instances where clients receive benefits they are not entitled to. Typically, once your file has been referred to PLMS it gets assigned an Investigative Officer who will send you a letter advising you that your eligibility is being reviewed and requesting information from you. Receiving this letter is often a very stressful and frightening experience for people. It is important to remember that just because the Ministry is reviewing your eligibility does not mean you have done something wrong. TAPS income assistance advocates are able to help if you receive one of these letters.

Here is what you need to know if your file is under review:

The Ministry can collect information regarding your continued eligibility. We often hear from clients that they feel it is a violation of their privacy or that they don’t believe the Ministry should be able to demand this information from them. Although it may feel invasive, the Ministry can, under Section 10 of the Employment and Assistance Act, collect information to confirm eligibility.

The Ministry can request information regarding:

  • Your income and assets
  • Your family size and composition
  • Your shelter costs

The Ministry can hold your cheque if you do not provide this information. Typically, after the investigative officer has sent out a letter informing that your file is under review, if they do not hear from you they will send a second letter. If two more weeks pass without contact from you the Investigative Officer will send out a letter advising that they have put a hold on your cheque until you comply with the original letter and provide the information requested.
Your file can be closed. If, a month after your cheque is put on hold, the investigative officer has still not heard from you they will close your file. This is one reason why it is so important to ensure that the Ministry has up to date contact information for you.
 
You may not be able to obtain all the information that the Ministry has requested. If you have attempted to collect requested information and have been unable to due to circumstances beyond your control, you need to communicate this to the Investigative Officer assigned to your file. For example, the Ministry often requests bank statements; if you do not have a bank account you will be unable to provide the Ministry with bank statements.
 
You may receive an overpayment. If, after reviewing your information, the Ministry determines that you received benefits that you were not entitled to, they will calculate how much you were overpaid and depending on the amount and whether you have been overpaid in the past, you may:

  • Have to enter into a repayment agreement to repay the overpayment
  • Have your benefits reduced for a specified amount of time depending on the circumstances
  • Face civil or criminal charges 

If the Investigative Officer determines that you have been paid over $5000 in benefits that you were not entitled to, they can refer your file to a Ministry Investigator to determine whether to recommend criminal charges by the crown prosecutor. If a client is charged and convicted of a criminal charge they can receive:

  • A restitution order ordering them to repay the amount
  • A sentence of jail time
  • A lifetime ban from income assistance.

Please note that the vast majority of eligibility reviews are not referred to Ministry Investigators and even less result in criminal charges. If you have received a letter notifying you that your eligibility is being reviewed or you have an overpayment that you disagree with, call TAPS and ask to speak with an income assistance advocate.