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CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 1505.10 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Filing an Application ______________________________________________________________________________
1505.10 A. Application Form
1. All applicants are required to complete an application form, except as noted below in 1505.10 A.3.
The Department may utilize a single uniform application for multiple programs, or separate applications for individual programs.
For all programs except Food Stamps, a new application form is not required if the applicant applies not later than thirty days after being released from a correctional or mental disease facility, was a recipient of cash or medical assistance and lost eligibility, directly or indirectly, because of his or her institutionalization within the twenty-four month period preceding the date of his or her release.
B. Requesting Assistance
1. Individuals who desire to obtain aid must file a formal request for assistance.
2. The formal request must be made in writing on the application form.
3. At a minimum, the following information must be presented:
a. the full name and address of the applicant; and
b. the signature of the applicant, caretaker relative or other individual who is requesting assistance on behalf of the applicant.
4. The application may be submitted in person or by mail.
5. Telephone contacts or other requests for aid which are not written, do not contain the required information, or are not made on the prescribed application form are considered inquiries and do not constitute an application.
6. Individuals who appear in person to request assistance must be given an opportunity to file an application for any desired program on the day they personally appear.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1505.10 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Filing an Application ______________________________________________________________________________
1505.10 C. Where to File an Assistance Request
1. Offices of the Department
a. The Department has designated district offices which serve as certification sites for specific geographical regions of the state.
b. Each district office is responsible for applications made by individuals that reside in the geographic region served by such office.
c. A district office may out-post workers, or have designated outreach stations which serve as extensions of the Department.
d. A breakdown of the district regions by cities and towns is made readily available to the general public.
e. An assistance request may be filed at any Department office or extension.
f. Actions other than filing the assistance request must be completed at the district office of appropriate jurisdiction.
2. Social Security Offices (FS only)
In addition to filing with the Department, assistance units in which all members are applicants or recipients of SSI may apply for the FS program at an in-state office of the Social Security Administration, provided that the assistance unit:
a. has not applied for food stamps within the previous thirty days; and
b. does not have a FS application pending with the Department.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 1505.10 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Filing an Application ______________________________________________________________________________ 1505.10 D. Date of Application
1. For AFDC, AABD and MA applications, except for the Medicaid coverage groups noted below in 1510.10 D.2, the date of application is considered to be the date that a signed application form is received by any office of the Department.
2. For the Healthy Start coverage groups, the date of application is the date that a signed application is received at an outreach site or the date it is received by any office of the Department, whichever is sooner. The following are the Healthy Start coverage groups:
a. Pregnant Women Under 250% of the Poverty Level;
b. Pregnant Women Extension;
c. Children Under 185% of the Poverty Level;
d. Children Under 133% of the Poverty Level; and
e. Children Under the Poverty Level
3. For Food Stamp applications, except as noted below in 1510.10 D.4, the date of application is considered to be the date that a signed application form is received by:
a. the appropriate District Office designated to serve the applicant's geographic region of residence; or
b. an office of the Social Security Administration.
4. For prerelease applicants, the application date is the date of release from the institution.
5. The applicant must indicate the programs for which he or she is applying:
a. at the time of the application interview; or
b. when contacted by the Department for that purpose.
6. The date of application is protected retroactively to the original filing date as long as the applicant informs the Department of the programs for which he or she is applying by the appropriate date noted above in 1510.10 D.5.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 1505.10 page 4 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Filing an Application ______________________________________________________________________________
1505.10 D. Date of Application (continued)
7. A separate application is required if the applicant requests aid from an additional program category subsequent to the date noted above in 1510.10 D.5.
8. The application date for the new assistance program is the filing date of the second application form.
E. Self-generated MA Applications
1. Individuals who apply for AABD are automatically considered to have requested assistance from the MA program.
2. A determination of eligibility for assistance under other Medicaid coverage groups is done without requiring a separate application when:
a. AABD is denied or discontinued; or
Medicaid is denied or discontinued in regard to a particular coverage group; or
c. an applicant or recipient of SAGA medical assistance is determined to meet the disability requirement for the Medicaid program.
F. Self-generated State Supplement Applications
1. SSI recipients who apply for or receive Medicaid as residents of long term care facilities are automatically considered to have requested assistance from the State Supplement program.
2. A determination of eligibility for assistance under the State Supplement program is done without requiring a separate application when an applicant or recipient of SAGA cash assistance is determined to meet the disability requirement for the State Supplement program.