410-5       ACTIONS TAKEN ON THE APPLICATION

 

Every applicant must be provided with adequate written notice of the action taken on the application.  Adequate notice means that the individual is informed of the action taken, the reasons for the action, and the manual sections from the appropriate program policy manual that supports the action.

 

410-5 A.   APPROVING THE APPLICATION

 

An approval notice must be sent to the household following a determination of eligibility.  Except when the application is delayed as described below, approved households must receive benefits no later than 30 days after the application filing date.  To meet this requirement, the caseworker must authorize the benefits by the 28th calendar day following the application filing date.  See manual section 410-5F for policy on when an application is delayed.

 

•   Eligible First Month/Ineligible Second Month:  

A household may be eligible for the month of application and ineligible in the subsequent month.  In this case, the household should be approved only for the month of application.  However, if the anticipated change is expected to last only for the second month, the case should be suspended for the second month according to the temporary ineligibility policy at manual section 480-5A.

 

•   Ineligible First Month/Eligible Second Month:  

A household may be ineligible for the month of application but eligible in the subsequent month.  Even though denied for the month of application, the household does not have to reapply.  The same application is used for the first month denial and the determination of eligibility for the subsequent month.

 

•   Months Following the Initial Months:  

If DPADivision of Public Assistance does not make a decision on an application during the first two initial months (the month that eligibility may begin and the following month), the application is valid through the month that the decision is actually made.  The original application is enough to establish continued eligibility.  A case worker does, however, have the authority to ask for a special review application if he or she believes that circumstances warrant it.

 

If an applicant is found eligible for at least one month during this period, and then becomes ineligible for a following month(s), the case worker can either suspend or terminate the APAAdult Public Assistance case, depending on the circumstances.  (Refer to section 480-6 for the policy on APAAdult Public Assistance suspension or termination.)

 

410-5 B.   BENEFIT START DATE

 

The benefit start date determines the date from which benefits begin.  See manual section MS 410-7 for policy on determining the benefit start date.

 

410-5 C.   PENDING THE APPLICATION

 

When the office needs the applicant to submit a complete application form, or provide information needed to determine eligibility, the application is pended, and a notice is sent.  The notice clearly informs the applicant what is needed to complete the application.  Applicants will be given at least 10 days, but no more than 30 days, from the date of this notice to provide the verification.  The same verification pend time frames will be consistently applied to all applicants within each office.

 

  1. Applicants failing to provide all necessary verification at the interview will be sent a pend notice no later than 30 days after the application filing date requesting the required verification.  
     
  2. Applicants contacting the agency within the pend period expressing difficulty in obtaining required verification will be offered assistance.  The caseworker should extend the pend period if additional time is needed to obtain the information.  A new pend notice should be sent.
     
  3. If the applicant does not complete the application process, the application is denied at the end of the period provided in the notice.

410-5 D.   DENYING THE APPLICATION

 

A denial notice must be sent to the applicant explaining the reason for the denial.  This notice should be sent as soon as possible following the determination of ineligibility, but no later than 30 days following the application filing date.  

 

Applicants denied for failing to provide needed verification by the end of the pend period will be sent a notice of denial at the end of the pend period.  If the applicant provides the verification after the pend period but within 30 days of the application filing date, the caseworker must accept the verification and make an eligibility determination without requiring a new application.  If the household is found eligible, the caseworker will use the original benefit start date.

 

Note:  

When the deadline for processing an application or providing verification does not fall on a workday, it will be extended to the next workday.

See manual section 410-3E for policy on denying applicants for failing to participate in an interview.

 

410-5 E.   WITHDRAWING AN APPLICATION

 

The applicant may voluntarily withdraw the application at any time before the eligibility determination is made.  

 

A written, signed and dated request to withdraw an application for APAAdult Public Assistance is mandatory. The written request can be provided at the time of interview, brought in, faxed in, mailed in or emailed since electronic signatures are acceptable. If the interview is held via telephone the case must be pended for the written request for withdrawal. The client must be given 10 days to provide the requested information. If the information is not provided within the pend period, the case will be denied due to failure to provide requested information. 

 

The reason for withdrawal (if known) shall be documented in the case file. The applicant shall be advised of his or her right to reapply at any time by submitting a new application. A notice shall be sent to the individual denying the withdrawn application.

 

If the individual wants to apply again once an application has been withdrawn, he or she must complete a new application.

 

See MS 410 for application signature requirements.

 

410-5 F.   WHEN THE APPLICATION IS DELAYED

 

If a household's eligibility has not been determined or benefits have not been authorized for an eligible household by the 30th day following the application filing date, the application is delayed.  The caseworker will determine the cause for the delay and take appropriate action:

 

1. Agency-caused delays

 

include cases where the application was not approved, denied or pended within the allowable time limits.

 

If an eligibility determination cannot be made by the 30th day from the application filing date because of action required by the agency, the case is left in a pending status.  The household must be sent a pend notice by the 30th day.

 

In some circumstances, the case worker cannot determine eligibility for APAAdult Public Assistance because the decision must be based upon another agency's action.  In these situations, the case worker may postpone the decision on the APAAdult Public Assistance application.  Written notice must be sent to the applicant within 30 days of the filing date, explaining that the application is being held pending the other agency's action.  This provision applies to findings of disability by the Disability Determination Service (DDSDisability Determination Service) of the Division of Vocational Rehabilitation, eligibility decisions for Supplemental Security Income (SSI) or Social Security Disability Insurance benefits by the Social Security Administration (SSA), and processing delays caused by the SSISupplemental Security Income application process.

 

Individuals who have applied for SSISupplemental Security Income may be eligible for Interim Assistance while waiting for a final eligibility decision on their SSISupplemental Security Income application.

 

2. Household-caused delays

Include situations where the office cannot take further action on the application without an action from the household.

 

If the household fails to submit a complete application form or reschedule an interview by the 30th day from the application filing date the application is denied.
 

3. Delays caused by inability to provide a completed AB 3Review Report on Aid to the Blind or AD 2Preliminary Examination for Interim Assistance .

  

DPADivision of Public Assistance will postpone an eligibility decision for up to an additional 30 days if an applicant who must have an AD 2Preliminary Examination for Interim Assistance or AB 3Review Report on Aid to the Blind examination is unable to do so within 30 days after the date that his or her application was filed for reasons beyond the individual's control.

 

This additional 30 days will also be granted to an applicant who has undergone an AD 2Preliminary Examination for Interim Assistance or AB 3Review Report on Aid to the Blind examination, if the examiner has not furnished a completed AD 2Preliminary Examination for Interim Assistance or AB 3Review Report on Aid to the Blind form to DPADivision of Public Assistance .

 

 

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MC #61 (04/21)