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West Virginia Income Maintenance Manual Chapter 9

West Virginia Income Maintenance Manual Page 20 Chapter 9 Client Notification

If the verification is not received, or is insufficient, the agency may: • Close the case, or • Is to adjust benefits based on the best available information. 9.3.5 DFA-NL-5, WAIVER OF 13 DAYS’ ADVANCE NOTICE Form DFA-NL-5 is used when the information that results in an adverse action is undisputed by the client, he agrees with the action to be taken on his case and understands that he is entitled to receive benefits if the 13-day advance notice requirement is not waived. The waiver allows DOHS to make the change without application of the 13-day advance notice requirement. If the proposed adverse action normally requires a DFA-NL-C, but the client signs a DFA-NL-5, the Worker sends a DFA-NL-B instead of a DFA-NL-C. The DFA-NL-5 must be completed in a face-to-face interview. It is completed in duplicate and must be signed by an adult AG member. The original is given to the client, and the copy is filed in the case record. Change of SNAP AG Example: Fern moves from SNAP AG 1 to SNAP AG 2 on June 20 and reports this the same day. His removal from AG 1 is an adverse action requiring 13 days’ notice. He cannot be included in AG 2 for July because he will still be included in AG 1. However, AG 1 signs a DFA-NL-5 to waive the right to advance notice. He can be removed from AG 1 and included in AG 2 effective July. 9.3.6 DFA-6, NOTICE OF INFORMATION NEEDED; DFA-6A, SPENDDOWN EXPLANATION EXCEPTION: The DFA-NL-5 can be mailed to a client who moves to another state and is unable to comply with the face-to-face interview requirement. Supervisory approval is required and the Worker must completely fill out the form before it is mailed. A written explanation of the effect of signing the form must accompany the form. Under no circumstances are blank DFA-NL-5s to be signed and used at a later date. It is always the client's option to sign or not to sign the form.