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Health Care Finance and Administration Section: General Administrative Procedures and Compliance Policy Manual Number: 200.015 Chapter: Application for Other Program Benefits

APPLICATION FOR OTHER PROGRAM BENEFITS

Legal Authority: 42 CFR 435.608 1. Policy Statement As a condition of eligibility, individuals are required to take all necessary steps to obtain benefits to which they are entitled, except for public assistance programs to which the individual is entitled, unless the individual can show good cause for failure to apply. If the individual cannot demonstrate good cause for failure to apply for other benefits, he or she is not eligible for benefits.

2. Definitions Benefits: Benefits include financial benefits in the form of annuities, pensions, retirement, and disability benefits, including but not limited to: • Veterans’ compensation, pension and Veterans Affairs (VA) contract payments (but not VA benefits or Aid and Attendance benefits); • Old Age, Survivors and Disability (OASDI) benefits (Social Security); • Railroad Retirement benefits; • Unemployment compensation; and • Workers’ Compensation benefits. Public Assistance: Public Assistance includes Supplemental Security Income (SSI) and Families First/Temporary Aid for Needy Families (TANF).

3. Possible Entitlement Hints

a. Black Lung Benefits

An individual is:

• A coal miner and who is totally disabled due to pneumoconiosis; or • The dependent spouse, surviving or divorced spouse, or the child (under 18) of an eligible miner (or eligible at death).

b. Railroad Retirement Benefits The individual or his Financially Responsible Relative (FRR) worked for the railroad or a company closely connected to the railroad, and he or she is at least age 60 or disabled. c. Social Security Benefits An individual or his or her FRR is:

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