Compliance Review

Step 1:  Information Request

The compliance review process begins when the recipient is provided a letter requesting documentation related to eligibility. 

Recipients are advised to submit documents by a set date, which will be at least 16 business days from the date of the letter. 

Should the recipient require more time or need help to obtain or submit documentation, they can contact the ministry.  

For recipients with no fixed address who do not have MySS set as their preferred method of contact, the letter will be attached to the recipient’s next payment at a ministry office.  The 16 business days begins on the date the client picks up the letter.

If the recipient’s mail is returned and the recipient has not submitted verification of a new address, the ministry will attempt to contact the recipient through MySS or phone.  If the ministry is unable to reach the client the ministry may hold the recipient’s assistance payment to verify shelter costs.

For recipients with a legal representative or who receive service through a Third Party Administrator, the ministry will connect with the third party to complete the review.

Step 2:  Reviews Case

If a recipient does not respond to the information request, the ministry will review the case to determine if there are any circumstances that may have impacted the recipient’s ability to respond and act according to ministry policy [see Related Links – Individual Case Management – Policy - Duty to Accommodate].

If some, or all, of the requested documents are submitted by the document submission due date the ministry proceeds by reviewing case notes, documents, and payment history. This includes:

• confirming required identification and valid consent
• completing third party checks
• verifying shelter expenses
• reviewing income and asset information
• assessing current and past eligibility
• updating the case, as needed

Depending on circumstances, the review may also involve:

• completing new consents
• clarifying information with the recipient
• requesting additional information from the recipient
• referrals for other services, programs or supplements

Step 3:  Additional Letters (if required)

If only some of the requested documents are submitted by the document submission due date, a follow up letter is sent which outlines documents still required and provides due dates for documents to be submitted.

Additional request for information letters may be sent when other documents are required to confirm information during the review.

All information requests follow ministry policy [for more information, see Related Links - Information & Verification].

Step 4:

Cheque Hold (if required)

If no documents are submitted by the submission date of the first request letter, the ministry will attempt to contact the recipient by phone (minimum of 2 attempts). 

The ministry will then send a second request letter with a cheque hold notification for the next reasonable cheque following the document submission due date in the second letter and minimum of 16 business days from the date the letter is sent.

In many cases, cheque holds can be released by any authorized staff (EAW, CSW or Service BC agent) with the submission of at least one of the required documents. If staff has any questions in regards to the cheque hold, they can contact Prevention and Loss Management Services (PLMS) [see Contacts].  In some cases the client will need to speak with a Quality and Compliance Specialist (QSC) to have the cheque hold released; for example, the QSC needs to have a conversation with the client in order to establish eligibility.

Should the recipient require more time or need help to obtain or submit documentation, they can contact the ministry.  

If some, or all, of the requested documents are submitted by the document submission due date the ministry proceeds with the review (see Step 2).

If there is still no contact from the recipient, the ministry will proceed with a discontinuation letter (see Step 6).

Step 5:  Notify recipient of Decision

When the review is complete, the ministry will communicate, in writing, the decision resulting from the review, including whether there is:

• no change to assistance
• an increase, decrease or discontinuation of assistance
• an underpayment or overpayment

If there is a change to a recipient’s assistance, they will be provided with information that explains:

• the substantive reason for the change and the specific information used to make the decision
• the relevant legislation applied to their case
• their right to and how to request a review of the decision (reconsideration)

[For more information, see Related Links – Original Decisions.]

Step 6:  Discontinuation of Assistance letter (denial, right to reconsideration)

If the requested information has not been submitted, the ministry will attempt to call the recipient (2 attempts).

The ministry sends a discontinuation of assistance letter which includes the date the recipient’s case will close (26 business days from discontinuation letter), information on their right to a review (reconsideration) of the decision and how to request one.

Should the recipient require more time or need help to obtain or submit documentation, they can contact the ministry.  

If some or all of the requested documents are submitted by the document submission due date the ministry proceeds with the review (see Step 3).