315.11 Denial or Termination of Assistance (AAM)

315.11 Denial or Termination of Assistance (AAM)

SR 13-12 Dated 07/13 Previous Policy

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Deny or terminate financial assistance for the entire assistance group (AG) and deny or terminate medical assistance for all adults in the AG if any individual in the AG who is potentially eligible for other income or benefits refuses or fails to:

. apply or complete the application process for the other income or benefit(s);

. provide information or verification to obtain the other income or benefit(s);

. cooperate with the eligibility-determining agencies or individuals responsible for the other income or benefit(s);

. meet the application timeframes described Section 315.03 , Application Requirements for Developing Potential Sources of Income , or set by the eligibility-determining agencies or individuals responsible for the other income or benefit(s);

. pursue all appeal options, up to, but not including, court action, if found ineligible for the other income or benefit due to medical reasons; or

. accept the other income or benefit(s) for which they may be eligible.

Deny or terminate Aid to the Permanently and Totally Disabled (APTD) financial assistance when:

. an individual applies for an APTD cash grant on or after July 1, 2011 and has been denied Social Security Administration (SSA)-related benefits due to not meeting SSA medical disability criteria within 12 months prior to the individual's application date, or any time after the individual's application date. Eligibility for APTD medical assistance remains unchanged;

. an individual's application for an APTD cash grant is pending on or after July 1, 2011 and the individual has been denied SSA-related benefits due to not meeting SSA medical disability criteria within 12 months prior to the individual's application date, or any time after the individual's application date. Eligibility for APTD medical assistance remains unchanged;

. an individual was receiving an APTD cash grant as of June 30, 2011 and has been denied Social Security Administration (SSA)-related benefits for a second time due to not meeting SSA medical disability criteria, as long as the following criteria were met:

- only one denial from prior to July 1, 2011 may be used, as long as that denial occurred between the 12 months prior to the individual's application date and June 30, 2011, and

- at least one denial must have occurred any time after July 1, 2011. Note : If no denials occurred between the 12 months prior to the individual's application date and June 30, 2011, then both denials must come on or after the July 1, 2011 date before APTD cash may be terminated.

Eligibility for APTD medical assistance remains unchanged; or

. any APTD financial assistance applicant or recipient does not provide the required proof from SSA within timeframes

If the Department has denied or terminated an individual ' s APTD cash grant due to the individual not meeting the SSA medical criteria, or because the individual did not give the Department the required verification timely, the individual may reapply for APTD cash, BUT they are to be denied until the individual provides the proof described in Section 315.09 , APTD Verification Requirements for SSA Denial .