420-1 REQUIREMENT TO APPLY FOR AND PURSUE OTHER BENEFITS

420-1 REQUIREMENT TO APPLY FOR AND PURSUE OTHER BENEFITS

420-1 A. REQUIREMENT DEFINED

To be eligible for Adult Public Assistance, an APA applicant or recipient must apply for and diligently pursue any other benefits to which the Division believes he or she may be eligible. Under this requirement, a benefit must meet all of following criteria:

Require an application or similar action; and

Have conditions for eligibility; and

Provide periodic or one-time payments; and

Be a source of income that reduces APA payments.

In addition to applying for the benefit, the applicant or recipient must take all appropriate steps to pursue eligibility for other benefits. This means that he or she must:

Apply for the benefit; and

Provide the source of the benefit with the information necessary to determine eligibility; and

Agree to receive the other benefit; and

Take all necessary steps to receive, and to continue receiving, the benefit.

420-1 B. SSI APPLICANTS OR RECIPIENTS ARE PRESUMED TO BE APPLYING FOR OTHER BENEFITS

An APA client who is applying for or receiving SSI benefits is presumed to be pursuing any other benefits to which he or she is entitled. SSI has a development of income policy which is equivalent to the APA policy. If the case worker becomes aware of an available benefit which is not being used by an SSI / APA client, he or she should inform the servicing SSA office and let the SSI claims representative resolve the matter. Whenever SSI assistance is denied or terminated for failure to apply for and pursue other benefits, the client loses APA eligibility as well.

420-1 C. NON- SSI APPLICANTS OR RECIPIENTS MUST BE ADVISED OF THE REQUIREMENT TO APPLY FOR AND PURSUE OTHER PROGRAM BENEFITS WITHIN 30 DAYS

Whenever a case worker believes that a non- SSI APA applicant or recipient may be eligible for benefits he or she is not already receiving, the individual must be given written notice of the requirement to apply for and pursue the other benefit within 30 days. The 30-day notice period shall not be used as a reason for delaying an eligibility decision on an APA application. If the individual fails, without good cause (such as illness), to apply for and pursue the other benefit within 30 days of the date the notice is mailed, the case worker shall either deny the APA application or close the APA case.

Changes in circumstances may cause a non- SSI APA recipient to become eligible for a benefit to which he or she was not previously entitled. When this occurs, the case worker must provide the client with written notice of the requirement to apply for and pursue the other benefit within 30 days of the date the notice is mailed. The client may continue to receive APA benefits while he or she is applying for the other benefit. If the recipient does not apply for and pursue the other benefit within 30 days of the date that the notice is mailed, the APA case must be closed, and the client provided with timely notice of benefit termination for failure to apply for other program benefits.

Example 1: A disabled APA applicant applies for assistance on April 7, and is interviewed on April 15. During the interview, the case worker discovers that the applicant may be eligible for Workers' Compensation payments for which he has not yet applied. The applicant is otherwise eligible for assistance. The applicant is informed, in writing, that he must provide proof that he has applied for Workers' Compensation payments by May 15. On May 7, the APA application is approved. The individual then fails to provide proof that he has applied for Workers' Compensation payments by May 15, the end of the 30-day notice period. The case worker closes the APA case effective May 31, providing timely notice of termination for failure to apply for other program benefits.

Example 2: A similar situation to the example above, except that the applicant is not otherwise eligible for assistance because the application must be held for a disability determination by either SSA or the DDS . When the individual fails to provide proof that he has applied for the other benefit by May 15, the APA application is denied.

420-1 D. VERIFICATION OF APPLICATION FOR AND PURSUIT OF OTHER BENEFITS

Application for and pursuit of other benefits must be verified. Verification may be obtained by various means, depending upon the type of benefit involved. The client's own documents (for example, award letters, referral letters, benefit-related correspondence, check stubs) are the preferred verifying documents. If the client claims that he or she is applying for the other benefit, but is unable to provide documentary evidence, the case worker must try to get the necessary verification. EIS interface information is one possible verification source; direct contact with the other agency is another acceptable method of verification.

Previous Section Next Section