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FOOD STAMP HANDBOOK Handbook FORMS AND INSTRUCTIONS 63-1230 {Cont.}

63-1230 STATE FORMS & INSTRUCTIONS (Continued) 63-1230

DFA 285-C (11/83)

Form Instructions {for the Eligibility Worker)

SUPPLEMENTAL APPLICATION FOR FOOD STAMPS — SPECIAL MEDICAL DEDUCTIONS

Purpose:

The DFA 285-C is a supplemental food stamp application farm completed by any househoid member(s) who is (1) age 60 or older; (2) receiving Title i Social Security disability or blindness payments as a disabled person; (3) a disabled veteran; (4) a disabled surviving spouse of a veteran; or, (5) a disabled surviving child of a veteran. The application gathers information required to calculate special medical deductions for these individuals. The form

is required only for those households entitled to claim excess medical expense deductions, unless they choose not to.

Preparation:

Question Manual Information No. Section Requested EW Action County- Use N/A N/A Enter case name and case number. Section 1 63-102{i} Eligible House- Check that each household member named is at least 63-502.33 hold Members 60 years of age, or will turn age 60 in the month of appli- , cation, or meets one of the definitions for a disabled person. Check that any Social Security payment received is for the household member's own disability. Document in the county-use section if the household member has been approved for but is not yet receiving Title {1 benefits, or is entitled to but is not receiving veterans benefits. 2 Medical Determine the allowability of each item of medical Expenses expense as follows:

63-102(i) 1. Check that each household member receiving

63-502.33 services is an eligible household member listed in question 1.

63-502.33 2. Check that each amount shown is for an allowable

63-503.25 item of expense.

63-300.517 3. Verify the amount of any deductible medical expenses and note the specifics of the verification in the county-use section.

CALIFORNIA-DSS-MANUAL-SS Rev. 1366 replaces issue 2189 Effective 2/15/84