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UPDATED: FEBRUARY 2005

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INCOME UNEARNED

NEW YORK STATE DISABILITY INSURANCE BENEFITS, WORKERS' COMPENSATION AND SICK PAY

(3) Sick Pay as Unearned Income are any payments made due to sickness and/or accident disability more than six months after the A/R stopped working because of that sickness or disability, is unearned income. Sick pay received during the first six months is earned income (See INCOME EARNED).

Policy: NYS DIB, Workers’ Compensation and sick pay are countable income.

When to Verify: When the A/R indicates in the application that s/he has applied for or is receiving DIB and/or Workers' Compensation Benefits;

When the A/R indicates in the application that s/he has recently been employed or has recently received UIB and indicates in the application that s/he is ill or injured;

When the case record indicates that the A/R was in receipt of DIB, Workers' Compensation and/or sick pay, but the A/R does not declare that s/he is currently receiving DIB, Workers’ Compensation and/or sick pay.

Verification: Benefits may be verified by:

Seeing the benefit check; Seeing a letter from the insurance carrier or the Workers' Compensation Board denying or terminating benefits; Clearing in writing through the usual local district procedure.

Documentation: Sufficient to establish an audit trail:

Date, number and amount of check, and name and address of payer (insurance or state fund);

Date and sender of letter, and disposition;

Returned clearance filed in case record.

NOTE: Workers' Compensation and New York State DIB and sick pay do not establish incapacity or SSI-related disability status for Medicaid purposes. A separate determination of incapacity or disability is done for A/Rs. (See CATEGORICAL FACTORS INCAPACITY)

(MRG)