5018           DEVELOPMENT OF INCOME

An applicant or recipient who appears to be eligible for a benefit from another program must apply for that program.  This requirement applies to every individual whose needs are included in determining eligibility, unless they are exempt under this section.

For the purposes of this requirement, a "benefit" is anything that

1. requires an application or similar action;
    

2. has conditions for eligibility; and
    

3. provides regular, intermittent, or one-time payments.

"Apply for" means the individual must take all appropriate steps to pursue eligibility for the benefit, including

1. applying for the benefit;
    

2. providing the benefit source with the necessary information to determine eligibility or the amount of the benefit;
    

3. agreeing to receive the other benefit; and
    

4. taking steps to continue receiving benefit payments.

5018 A.       BENEFIT PROGRAMS FOR WHICH APPLICATION MUST BE MADE

The benefit programs for which application must be made include, but are not limited to

1. Worker's Compensation;
    

2. Social Security (SSA Social Security Administration) benefits (such as disability, retirement, early retirement, or survivor's benefits);
    

3. Department of Veteran’s Affairs benefits;
    

4. governmental or employer's private disability programs, and, if the individual is of retirement age, governmental or private employer's retirement programs; and
    

5. Unemployment Insurance benefits (UIB Unemployment Insurance Benefit).

5018 B.       BENEFIT PROGRAMS FOR WHICH APPLICATION IS NOT REQUIRED

Application is not required for

1. Supplemental Security Income (SSI Supplemental Security Income).
    

2. Bureau of Indian Affairs (BIA Bureau of Indian Affairs) General Assistance.
    

3. any Division of Public Assistance program.

5018 C.       APPLYING FOR UNEMPLOYMENT INSURANCE BENEFITS.

All individuals must apply for, pursue, and accept any Unemployment Insurance Benefits (UIB Unemployment Insurance Benefit) they appear eligible to receive, unless specifically exempt.  Pursuit includes complying with all of the UIB Unemployment Insurance Benefit program requirements, including being available to accept employment according to Department of Labor’s determination of availability.

Before referring an individual to the Department of Labor (DOL Department of Labor and Workforce Development) to apply for (UIB Unemployment Insurance Benefit), the caseworker must first determine if the individual qualifies for any of the exemptions listed below.  If the individual does not qualify for an exemption, the caseworker must determine if the individual appears to meet the financial criteria for UIB Unemployment Insurance Benefit.  Refer to Administrative Procedures Manual Section 123 for information on use of the UIB interface.

5018 D.       EXEMPTIONS FOR APPLYING FOR UIB Unemployment Insurance Benefit.

To qualify for UIB Unemployment Insurance Benefit, an individual must be available to accept employment. DPA considers the following individuals generally not available to accept employment and, therefore, are not required to apply for UIB Unemployment Insurance Benefit:

Caretaker Of  Baby:  This is a caretaker relative with one or more children under the age three.

Caretaker Of Disabled Child:  This is a parent or caretaker relative who is providing home care for a child with a disability.  This exemption must be documented by a physician or other licensed medical professional.

Caretaker Of Disabled Adult:  This is a caretaker relative who is providing home care to a related disabled person requiring 24 hour care. This exemption must be documented by a physician or other licensed medical professional.

Medical Reason:  This is an individual who is unable to work for medical reasons, as evidenced by (a) being a recipient of SSI Supplemental Security Income, APA , or SSDI Social Security Disability Insurance; or (b) a physician or other licensed medical professional has documented that the individual is unable to work or pursue employment for medical reasons. The caseworker may waive the medical verification and accept client statement if the caseworker believes

1. there is other evidence to indicate the person would not be able to work for medical reasons; and
    

2. the individual lives in a remote location and is not likely to have access to a physician or other licensed medical professional within 30 days after receipt of the individual’s identifiable application.

Inappropriate Child Care:  This applies when a caretaker relative who lives at home with a child under the age of six demonstrates an inability to find necessary child care because appropriate child care is not available.

Child care is considered appropriate when:

• A provider who is willing to take care of the caretaker relative’s child appears to have the ability to care for children of the same age and development level as the caretaker relative’s children; and
   

• The provider’s location is within 30 minutes travel time by public or private transportation from the caretaker relative’s home or work site.

Child care is considered available when:

• It is located in the family’s community; and
   

• The family has sufficient income, or access to a child care subsidy program, to pay the cost.

If necessary, contact the child care local administrator or resource and referral agency for assistance with this determination.

Under Age 16:  A child under age 16 is exempt from applying for UIB Unemployment Insurance Benefit.

Full-Time Student:  This is an individual who is

1. age 16 or older and attending, full-time, an elementary or secondary school, vocational or technical training program which leads to a high school diploma or G.E.D.; school includes a correspondence study or G.E.D. program, or
    

2. a student in a post-graduate vocational school, technical school, college, or university who attends full-time as defined by that educational institution.

Pregnant Woman:  This is a woman in the second or third trimester of a medically verified pregnancy or is in postpartum recuperation period as verified by a physician.

Employed Or Self-Employed:  An individual who is already employed or self-employed is exempt.  To qualify an individual must be

1. working a monthly average of thirty hours or more per week; and
    

2. receiving monetary compensation equal to or greater than the state minimum wage at least once per month for the work performed.
   
   For a self-employed individual, net adjusted self-employment earnings actually received, or expected to be received, in a month are used to determine the self-employed individual’s hourly rate of pay.  A self-employed individual who works in a month and receives pay for the work performed in another month may not qualify for this exemption.

Vista Volunteers in Service to America Volunteer:  This is an individual who is a full-time VISTA volunteer.

5018 E.       WRITTEN NOTICE OF REQUIREMENT TO APPLY

It is the caseworker’s responsibility to identify these “prior resources”.  If an individual is potentially eligible for benefits from another program, the individual must be given written notice of the requirement to apply.  If otherwise eligible, Medicaid benefits must continue to be authorized during the notice period even if the individual has not taken actions to comply. This notice requirement must never be used to delay acting on an application.

10-DAY NOTICE FOR UIB Unemployment Insurance Benefit:  If an individual appears financially eligible for UIB Unemployment Insurance Benefit, the individual must be given 10 days from the date they are notified in writing to apply for and demonstrate pursuit of UIB Unemployment Insurance Benefit.

30-DAY NOTICE FOR OTHER BENEFITS:  If an individual appears eligible for benefits other than UIB Unemployment Insurance Benefit, the individual must be given 30 days from the date they are notified in writing to apply for and demonstrate pursuit.

5018 F.       PURSUIT OF BENEFITS

For each individual who is required to and who does apply for a benefit program, the caseworker may presume that the requirement for pursuit of benefits is being complied with unless there is evidence to the contrary.  If the caseworker discovers that an individual has not actively pursued benefits for which he or she has applied, the caseworker must investigate to see if there is good cause for this failure.  Prudent judgment is used in determining if good cause exists.  One or more of the exemptions for not applying listed in subsection D may constitute good cause.

5018 G.       PENALTY FOR FAILURE TO APPLY

If anyone who must be included in the household fails, without good cause, to apply for and actively pursue other benefits, the entire household is ineligible following timely notice.  If it appears there is good cause for the individual’s failure to apply, the caseworker may give the individual more time to apply for benefits.  

Note:  

A child remains eligible through the end of their sixth month of continuous eligibility.  See manual section 5007.

If the individual who failed to apply for and pursue other benefits is an optional household member, his or her needs must be removed and the case left open for the remaining members.