Application Forms

Opportunity to apply: Local offices must make application forms readily available and provide a form to anyone requesting one. Applying for benefits is separate from any other program requirements. We can't refuse to give an application form to a client because they aren't meeting other program requirements or for any other reason.

Application filing:

We can't require applicants to use a specific form to request benefits . Examples of typical requests for benefits include:

The ACES Request for Benefits (RFB);

ACES 3G Interactive Interview Declaration (IID) with telephonic signatures. Telephonic signatures are captured when an applicant contacts the customer service contact center and requests benefits but hasn't submitted a paper application. Staff complete an ACES 3G IID while on the phone with the applicant. Two telephonic attestation scripts are needed to complete the telephonic signature for an application or review. The first telephonic attestation script captures the date of the application, interactively screening an application into ACES 3G. A second telephonic attestation script completes the the telephonic signature after the IID is reviewed and the applicant confirms the information is correct.

The name, address, and signature on the DSHS 14-001(X) Application for Benefits form;

The name, address, and signature on the DSHS 14-078(X) Eligibility Review form; or

Part 1 of the online application.

Another form of written request that includes a name, address, and signature.

3. Adding a request for assistance to a pending application or eligibility review for another program:

Applicant or recipient can add a request for any cash or food benefits to a pending application or an unprocessed eligibility review verbally without submitting a new 14-001 or 14-078.

The applicant or recipient may make the request in writing by checking the appropriate boxes on the 14-001 or 14-078 form and, dating and initialing the form.

Use the date the applicant or recipient added the new request as the date of application for the new program. See WAC 388-406-0012 .

If application or eligibility review for the other program has already been processed, the applicant or recipient must submit a new request for benefits.

4. Handling multiple applications from the same household:

This applies to additional applications received before we determine eligibility on the first application: Don't deny the additional application(s). Review the application(s) for impact on eligibility or benefit level and whether the household is applying for any additional programs that weren't selected on the first application. If the household isn’t applying for additional programs, document the case that additional application(s) were received and that the department is still considering eligibility under the original application date. Treat the application as a new application for the additional programs only and continue to consider any requests for programs which are still pending under the original application date. Document in ACES and explain any additional information used to determine eligibility and/or benefit level. Don't extend the Standards of Promptness period for the original application. NOTE: If the additional application is received before we determine eligibility on the first application but isn’t acted on until after the first application has been denied, follow procedures under (b.) below.

5) This applied to additional applications received after we determine eligibility on the first application:

If we denied the first application, treat this as an initial application according to WAC 388-406-0010 except, for Basic Food, if we denied the first application due to lack of information, treat this as a reapplication and follow procedures under WAC 388-406-0040 (6)

If we approved the first application, review the additional application(s) to determine if household circumstances have changed. Take appropriate actions on any changes reported.

Deny additional applications for the same program and same persons to avoid duplicate participation.

NOTE: When denying additional applications as described in (c.) above, avoid creating a new AU if an old AU is available.