103-2          REQUEST FOR SERVICE

A completed and signed request for service application is considered an identifiable application. When DPADivision of Public Assistance receives a request for service, the request must be registered in EISEligibility Information System to protect the benefit start date. Certain situations when cases are registered as requests for service include the following:

An applicant comes in to a DPADivision of Public Assistance office and cannot stay to complete the entire application. The applicant may complete and sign page 7 of the GEN 50C and submit it as a request for service application except for all MAGIModified Adjusted Gross Income Medicaid categories. If an applicant requests MAGIModified Adjusted Gross Income Medicaid on page 7, the MAGIModified Adjusted Gross Income Medicaid request will be registered as an application.

Note:

If using page 7 as a request for service for all programs except MAGIModified Adjusted Gross Income Medicaid, staff will need to make a copy of page 7 and return the entire application form to the applicant.

• If the GEN 72 is received in the month following case closure for any reason, the GEN 72 can be used as an initial application form. Refer to MAGI Medicaid MS 806-3 for more information about renewal requirements for MAGIModified Adjusted Gross Income Medicaid.
• If the GEN 72  is received after the month following the end of the certification period, it is considered a request for service except for MAGIModified Adjusted Gross Income Medicaid. Refer to MAGI Medicaid MS 806 and 806-3 for more information about application and renewal requirements for MAGIModified Adjusted Gross Income Medicaid.
• A recipient submits a GEN 72 to recertify for a specific program and requests to add another program to their case. The request to their case. The request is considered a request for service except for MAGIModified Adjusted Gross Income Medicaid. If a recipient requests to add MAGIModified Adjusted Gross Income Medicaid to an existing case, MAGIModified Adjusted Gross Income Medicaid will be registered as an application.

Note:

Senior Benefits application must be registered as an application and not as a request for service. Refer to MS 126-2A for additional information about Senior Benefits' application process.

103-2 A.      REGISTERING AND FILING REQUEST FOR SERVICE APPLICATIONS

When an applicant submits page 7 of the GEN 50C that DPADivision of Public Assistance accepts as a request for service, the rest of the GEN 50C is given back to the applicant to complete. Staff must date stamp the request for service application with the date of receipt, and register it on EISEligibility Information System. Date stamping the request for service application protects the date the applicant initially expressed the need for having their eligibility considered.

Note:

If the request for service comes through electronic means, ILINX will date stamp the date received when submitted through the Capture tab.

When a recipient submits a GEN 72 after the month following the end of the certification period that DPADivision of Public Assistance registers as a request for service, a GEN 50C must also be completed before DPADivision of Public Assistance can authorize benefits for the recipient.

Example:

Certification ends in October. The GEN 72 received in December, which is after the month following the end of the certification period, is considered a late recertification and must be registered as a request for service. This example does not apply to MAGIModified Adjusted Gross Income Medicaid. Refer to MAGI Medicaid MS 806-3 for more information about late renewals for MAGIModified Adjusted Gross Income Medicaid.

When a recipient submits a GEN 72 and requests to add another program to their case, the request must be registered as a request for service except for MAGIModified Adjusted Gross Income Medicaid. If a recipient requests to add MAGIModified Adjusted Gross Income Medicaid to an existing case, MAGIModified Adjusted Gross Income Medicaid will be registered as an application. A GEN 50C must be completed before DPADivision of Public Assistance can authorize benefits for the recipient. A completed GEN 50C is not required for MAGIModified Adjusted Gross Income Medicaid.

To register the request, staff must use the appropriate code:

• RA - Temporary Assistance
• RF - Supplemental Nutrition Assistance Program
• RP - Adult Public Assistance
• RG - Chronic and Acute Medical Assistance
• RR - General Assistance

103-2 B.      NOTICE AND INTERVIEW REQUIREMENT

DPADivision of Public Assistance will notify applicants who submit a request for service application of the interview requirement. Staff must send the N000 (NOTICE OF SCHEDULED INTERVIEW) or N004 (NOTICE OF FLEXIBLE INTERVIEW) if the cold call is unsuccessful. The N000/N004 notice informs the applicant of the receipt of their application, a reminder to complete the entire application packet, and the requirement to attend an interview.

OA actions:

• Mail the GEN 50C or a copy of the incomplete application to the applicant
• Register the Request for Service
• Note: if on GEN 72 with other programs, register recertification
• Scan or import the request for service into ILINX
• Classifying OA will classify document and make entry into current™ in appropriate application track.

Caseworker actions:

• Attempt cold call following normal cold call and BPR processes

Note:

The Supplemental Nutrition Assistance Program has specific and time-sensitive requirements for scheduling interviews and notifying clients about missed interviews. See Food Stamp (SNAP) manual section 601-3.

103-2 C.      APPLICANT PROVIDES THE COMPLETED APPLICATION

If the applicant provides the completed application:

OA actions:

• Close the Request for Service
• Register application using the BSD from the Request for Service
• Scan or upload into ILINX using date application that was received
• Classifying OA will classify and complete an entry in current™ dark gray verification track.

103-2 D.      APPLICANT FAILS TO COMPLETE THE APPLICATION PROCESS

If an applicant fails to attend an interview and complete the application process, their application will be denied 30 calendar days after the application filing date (the application filing date is counted as zero). EISEligibility Information System will automatically deny the application and send the appropriate denial notice based on the programs the applicant requested to receive.

Note:

An interview is not required for MAGIModified Adjusted Gross Income Medicaid.