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West Virginia Income Maintenance Manual Chapter 20

West Virginia Income Maintenance Manual Page 39 Chapter 20 Emergency and Special Assistance Programs

The applicant must sign and date the application form. The Worker must enter the following information in the recording section: • Action taken on the application - This will include approval, denial, or pending status of the application. In addition, the Worker will indicate if the DFA-BU-2 form was completed by a responsible relative and any other information as required. • The Worker must also indicate whether the deceased was receiving any program benefits from the DOHS at the time of his death. 20.3.4.D Liability of Responsible Relatives As indicated in the Public Welfare Law §9-5-9, liability of relatives for support, certain relatives of the deceased who are financially able shall be responsible to pay the expenses of burial. These relatives are listed in the order of priority: • The spouse (even if living apart, if they are still legally married) • The children • The parents • The siblings "Financially able" is defined as the responsible relative's financial ability to make payment toward or the entire maximum payment allowed by the DOHS. The income of the responsible relative must be verified. The income limit is 133% of the FPL. The needs group and income group would consist of the responsible relative and those living with the responsible relative, at the time of application. The most recent 30 days of income would be counted starting with the date of application. The budgeting rules would follow SNAP Policy. The applicant has 3 days to provide income verification or the application will be denied if income is not verified within that time. The income of the deceased is not counted. In many situations, other relatives (ex-spouse, nephew, niece, etc.) who are not legally liable for payment of burial costs will take the responsibility for arranging the burial and make applications for burial expenses. 20.3.4.E Completion of Form DFA-BU-2, Affidavit of Responsible Relative The purpose of the DFA-BU-2, Affidavit of Responsible Relative is used to determine financial ability of those responsible relatives who are liable for the burial costs of the deceased and to