us-ca/regulation/mpp/eas/2/40-126 — 40-126 PROCESSING APPLICATIONS

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us-ca/regulation/mpp/eas/2/40-126 — 40-126 PROCESSING APPLICATIONS · Axiom

.1 Promptness Requirement The determination of eligibility, including the gathering of any necessary evidence, shall be completed promptly. One of the following must be mailed within 45 calendar days starting with the first day after the filing of the application: an aid payment, a notice of denial, or a notice that the applicant is eligible.

.11 Inability to Complete Inability to complete the determination of eligibility

the Determination of within the 45-day period shall not be a basis for

Eligibility denying the application unless the delay is caused by the refusal of the applicant to participate in the gathering of evidence in accordance with Section 40-157. (See Section 40-171.11.) The specified time limit may be exceeded in situations where completion of the determination of eligibility is delayed because of circumstances beyond the control of the agency, in which instances the case record shows the cause for delay. These instances include:

.111 Inability on the part of the recipient to provide necessary clarification.

RECEPTION AND APPLICATION

.112 Failure or delay on the part of an examining physician to provide all needed information.

.113 Application is made prior to the date on which the applicant meets the eligibility requirements and the 45-day period terminates before the applicant meets such requirements. (See Section 40-171 regarding application held pending eligibility.)

.2 (Reserved)

.3 Requirements for Obtaining

Evidence

.31 Require Only Evidence The county shall require only evidence necessary to

of Eligibility determine past or present eligibility for the amount or delivery of aid.

.32 Notice of Required Within ten calendar days of application, the county

Evidence shall provide written notice to the applicant of the required evidence and examples of alternative evidence, if any, to determine eligibility.

.321 The ten-day requirement shall be waived if the applicant fails to attend the scheduled interview or if the applicant requests that the interview be delayed beyond ten calendar days following application.

.33 Assist the Applicant in

Obtaining Evidence

.331 Good Faith Effort The county shall assist the applicant in obtaining evidence of eligibility from a third party when the county has determined that the applicant has made a good faith effort to obtain the evidence and the third party fails or refuses to provide the evidence.

(a)A "good faith effort" means that the applicant has…#

(a) A "good faith effort" means that the applicant has attempted to comply within the limits of his/her resources.

RECEPTION AND APPLICATION

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(b)An applicant needs evidence showing the amount in a…#

(b) An applicant needs evidence showing the amount in a bank account to complete the AFDC application. The applicant lacks the evidence. The applicant goes to the bank and discovers that the bank will charge a fee to provide the applicant with the evidence. The applicant has no money to pay the fee. The applicant returns to the county and asks that the county help get the evidence. The applicant has made a good faith effort to obtain the evidence.

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.332 Third Party Fees If necessary, the county shall pay a third party fee to obtain existing evidence of eligibility on behalf of the applicant.

.333 Notice Requirement The county shall notify the applicant, in writing, of the requirements of Section 40-126.33 at the time that such evidence is requested.

.334 Document Failure The county shall document an applicant's failure to

to Make Good make a good faith effort in obtaining necessary

Faith Effort evidence of eligibility in the case file.

.34 Cooperation in Providing The county shall not deny an application for failure to

Evidence of Eligibility provide evidence of eligibility if the county has determined that the applicant is continuing to cooperate by attempting to comply in obtaining necessary evidence.

.341 Denial for Failure A denial due to failure to cooperate shall be made

to Cooperate in when a presumption of noncooperation has been

Providing Evidence established by the county but an act of refusal has not

of Eligibility occurred.

RECEPTION AND APPLICATION

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(a) An applicant owns property which may cause the family to exceed the AFDC property limits. The applicant is told that evidence of the value of the property will be required to establish eligibility for aid. The applicant states that he/she must obtain the needed information from another state. The applicant is given an appointment in two weeks at which time he/she is expected to have the needed evidence. The applicant misses the appointment and does not call.

The next day the applicant calls to say that he/she will be in on the following Wednesday. On Wednesday the applicant fails to show-up or call. On Thursday the eligibility worker sends a letter specifying the evidence required and allows the applicant ten days to provide the evidence. The applicant fails to respond to the letter by the tenth day. The application is denied based on failure to cooperate and the provisions of Sections 40-126.341 and .342 would apply.

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.342 Rescind Denial The county shall rescind a denial and grant aid if the applicant is otherwise eligible based on the original application when:

(a) The denial is based solely on the applicant's failure to cooperate in providing evidence of eligibility; and

(b) The county receives the needed evidence within 30 calendar days of the date of denial.

.343 Notice of Action When the county denies an application based on failure to cooperate in providing needed evidence of eligibility, the notice of action must advise the applicant of his/her rights to submit evidence within 30 calendar days of the date of denial for the denial to be rescinded.

RECEPTION AND APPLICATION

.344 Failure Versus The provisions of Sections 40-126.341 and .342

Refusal to shall not apply to applications which are denied

Cooperate based on the applicant's refusal to cooperate pursuant to Section 40-157.3.

(a) A denial based on refusal to cooperate shall only be made as the result of the applicant's active refusal either orally or in writing to cooperate in the investigation of eligibility.

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Example

(b) An applicant owns property which may cause the family to exceed the AFDC property limits. The applicant is told that evidence of the value of the property will be required to establish eligibility for aid. The applicant states that the value of the property is irrelevant to his current need and states that he will not provide any additional information. The application is denied due to refusal and the provisions of Sections 40-126.341 and .342 would not apply.

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.35 Retrieve Case File The county shall retrieve and examine those existing case files which are in the possession of the county or its agents, in a timely manner, to determine if needed evidence of eligibility is already in the possession of the county when:

.351 Within One Year An applicant applies within one year of the effective date of discontinuance of aid, and

.352 Reasons The applicant is unable to provide the needed evidence of eligibility due to one of the following:

(a) The applicant does not have easy access to the needed evidence; or

RECEPTION AND APPLICATION

(b) There is a cost associated with obtaining the evidence; or

(c)The time needed to obtain the evidence would delay the…#

.36 Evidence Not in Case The county shall not be required to examine the

File existing case file if it would be unreasonable for the evidence to be in the possession of the county because the circumstances for which the verification is needed did not exist during the period the applicant previously received aid.

.361 This evidence includes, but is not limited to, verification of circumstances which can change such as earnings and bank accounts, and evidence of eligibility relating to an individual not previously in the assistance unit.

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.362 Example: A family was discontinued from aid in November. In January a second child is born. The family reapplies for aid the following May. It would be unreasonable to expect the birth certificate of the second child who was born after the family was last on aid to be in the possession of the county.

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.37 Notice Requirements At the time an applicant described in Sections 40-125.93 and 40-126.35 applies for aid, the county shall inform the applicant in writing of the requirements of Sections 40-125.93, 40-126.35, and 40-126.36.

NOTE: Authority cited: Sections 10553 and 10554, Welfare and Institutions Code. Reference: Sections 10554 and 11275, Welfare and Institutions Code.