Purpose: This section contains rules and procedures related to application approvals, denials and withdrawals, including notification requirements, eligibility effective dates for approved applications, limits on denial actions, and when we may reconsider a denied application.
The date we approve your application affects the amount of benefits you get. If you are eligible for:
Cash assistance, your benefits start:
The date we have enough information to make an eligibility decision; or
No later than the thirtieth day for TANF, SFA, or RCA; or
No later than the forty-fifth day for general assistance (GAU).
Basic Food, your benefits start from the date you applied unless:
You are recertified for Basic Food. If you are recertified for Basic Food, we determine the date your benefits start under WAC 388-434-0010;
You applied for Basic Food while living in an institution. If you apply for Basic Food while living in an institution, the date you are released from the institution determines your start date as follows. If you are expected to leave the institution:
Within thirty days of the date we receive your application, your benefits start on the date you leave the institution; or
More than thirty days from the date we receive your application, we deny your application for Basic Food. You may apply for Basic Food again when your date of release from the institution is closer.
We were unable to process your application within thirty days because of a delay on your part. If you caused the delay, but submit required verification by the end of the second thirty-day period, we approve your benefits starting the first day of the month following the month you applied for benefits. We start your benefits from this date even if we denied your application for Basic Food.
We initially denied your application for Basic Food and your assistance unit (AU) becomes categorically eligible (CE) within sixty days from the date you applied. If your AU becoming CE under WAC 388-414-0001 makes you eligible for Basic Food, the date we approve Basic Food is the date your AU became CE.
You are approved for Transitional Food Assistance under chapter 388-489-WAC. We determine the date transitional benefits start as described under WAC 388-489-0015.
You receive Transitional Food Assistance with people you used to live with, and are now approved to receive Basic Food in a different assistance unit:
We must give the other assistance unit ten days notice as described under WAC 388-458-0025 before we remove you from the Transitional Food Assistance benefits.
Your Basic Food benefits start the first of the month after we remove you from the transitional benefits. For example, if we remove you from transitional benefits on November 30th, you are eligible for Basic Food on December 1st.
Medical assistance, the date your benefits start is stated in chapter 388-416 WAC.
Transitional Food Assistance (TFA) provides five months of Basic Food benefits as a fixed benefit amount for families leaving TANF or Tribal TANF. When someone moves out of a TFA household, they are not automatically removed from the TFA assistance unit.
Federal rules do not allow people to receive benefits under the Food Stamp program in more than one household at the same time. This includes Basic Food and TFA.
When someone is an active member of a TFA AU moves away and applies for Basic Food in a different household, we must remove them from the TFA before starting Basic Food or adding them to someone else’s Basic Food AU.
The person is eligible for Basic Food effective the first of the month after they were removed from the TFA AU with advance notice.
EXAMPLE
Mark, Heidi and Lance receive TFA with a certification period of March through July. On April 3rd, Lance moves out and is approved to receive Basic Food with his girlfriend Amber. Their worker removes Lance from Mark and Heidi’s TFA AU effective April 30th. Lance is added to Amber’s benefits effective May 1st.
EXAMPLE
Same scenario as above, but Amber applies to add Lance to her Basic Food on April 25th. We do not have time to provide Mark and Heidi 10 days adverse-action notice and remove Lance from their TFA benefits by April 30th.Their worker removes Lance from Mark and Heidi’s TFA AU effective May 31st. Lance is added to Amber’s benefits effective June 1st.
For clients ineligible for benefits because they are institutionalized, open:
Basic Food from:
The date of release from the institution, if released within 30 days from the date of application and we have the information needed to determine eligibility; or
The first of the month following the month of application if there is a delay on the client’s part.
The system does not use a client’s date of release from an institution as the start date for benefits. If the application has already been screened, you must deny the existing application and re-screen for Basic Food using the client’s release date as the date of application.
NOTE:
Cash assistance from:
The date of release if released within 30 days from the date of application and we have the information needed to determine eligibility; or
The date we have the information needed to determine eligibility, but no later than the 30th day for TANF, SFA, or RCA or the 45th day for general assistance (GAU).
Do not prorate Basic Food benefits in the month following the month of application if pended information is provided late. Decide who caused the delay, and issue benefits from either:
The date of application; or
The first of the month following the month of application.
EXAMPLE
Client applies for Basic Food on May 1st. We schedule the appointment for May 20th and give the client until May 30th to provide information needed to determine eligibility. On June 3rd we deny the application. The client gives us the needed information on June 12th. Good cause does not exist.
Since the client caused the delay, open Basic Food from June 1st. Do not request a new application to open benefits.
EXAMPLE
Same scenario as Example 1, except we schedule the appointment on June 1st. The client is given until June 11th to provide information and doesn’t provide it until June 13th.
Since the delay is our fault because we didn’t schedule an appointment timely (see WAC 388-452-0005 (5)(a)), we must open benefits from the date of application (May 1st).
4. Processing an NCS Application:
a. See WORKER RESPONSIBILITIES Non-Compliance Sanctions (NCS) Re-Applicants in WAC 388-310-1600
WAC 388-406-0060
WAC 388-406-0060
Effective December 1, 2003
WAC 388-406-0060 What happens when my application is denied?
We (the department) deny your application for cash, medical, or Basic Food benefits if:
You do not show for your interview appointment for cash or Basic Food if required under WAC 388-452-0005 you have not rescheduled, and your application is over thirty days old; or
We do not have the information we need to determine your eligibility within ten days of requesting the information from your assistance unit (AU) under WAC 388-414-0001, and you did not ask for additional time to give us the information; or
Your entire AU does not meet certain eligibility criteria to get benefits; or
For Basic Food, your application has not been processed by the sixtieth day because of a delay on your part.
If we deny your application, you do not get benefits unless:
You mistakenly apply for benefits you already get; or
We reconsider your eligibility under WAC 388-406-0065 and you are eligible to get benefits.
We can reconsider if you are eligible for benefits under the requirements of WAC 388-406-0065 even after your application is denied.
We give or send a letter to you explaining why your application was denied as required under WAC 388-458-0011.
If you disagree with our decision about your application, you can ask for a fair hearing. If we deny your application because we do not have enough information to decide that you are eligible, the hearing issue is whether you are eligible using:
For Basic Food, when the thirty-day period ends on a weekend or a holiday the denial notice is sent the first working day after the thirtieth day.
WORKER RESPONSIBILITIES
If a Basic Food applicant does not show for the required initial interview:
Send a letter immediately informing the client to contact their worker to schedule another appointment.
Pend the application until the 30th day after the date of application. If the 30th day falls on a weekend or holiday, pend until the next working day.
If a Basic Food applicant fails to show for the second interview:
Continue the case as pending until the 30th day after the date of application. If the 30th day falls on a weekend or holiday, pend until the next working day.
Deny the application on the appointment date if the interview is scheduled after the 30th day.
Deny the application on the 30th day if the household does not reschedule the interview. If the 30th day falls on a weekend or holiday send the denial letter on the next working day.
NOTE:
If a client is applying for pregnancy medical as well as other programs, the client is not required to have an interview for the pregnancy medical. Most other programs require an interview. If you have accessed the INTERVIEW function in ACES to start processing the medical, ACES will not automatically deny the other AU based on the Standard of Promptness if the client failed to attend the interview. The worker must manually track the other assistance units and deny the application on the correct date.
WAC 388-406-0065
WAC 388-406-0065
Effective December 1, 2003
WAC 388-406-0065 Can I still get benefits even after my application is denied?
If we (the department) deny your application for benefits, we can redetermine your eligibility for benefits without a new application if:
For cash or medical assistance, you give us the information we need within thirty days from the date we denied your application;
You stop participating as required to reopen cash assistance under WAC 388-310-1600 (12) due to one of the good reasons described in WAC 388-310-1600 (3) or because you get an excused absence, as described in WAC 388-310-0500 (5);
For Basic Food:
You give us the information we need within sixty days of the date you applied for benefits; or
You become categorically eligible for Basic Food under WAC 388-414-0001 within sixty days of the date you applied for benefits.
For medical assistance, if the thirty days to reconsider your application under subsection (1) of this section has ended you can still get benefits without a new application if:
You request a fair hearing timely; and
You give us the information needed to determine eligibility and you are eligible.
If you are eligible for cash or Basic Food, we decide the date your benefits start according to WAC 388-406-0055. If you are eligible for medical assistance, we decide the date your benefits start according to chapter 388-416 WAC. For all programs the eligibility date is based on the date of your original application that was denied.
If the applicant provides only part of the information we need per the timelines in WAC 388-406-0065 (1), take the following actions:
Review the case to see if we can determine eligibility for each program based on what we have received; and
Send the person a letter advising of our reconsideration decision for each program. This includes:
An approval letter if we can determine that the person is eligible;
A new denial letter if we are able to determine that the person is ineligible; or
A second denial letter indicating that the original denial reason and effective date stands and why.
EXAMPLE
We request verification of income, residence, and utilities due by 5/15/04. This is not provided, and we send a denial letter on 5/20/04. Applicant then provides the residence and income verification on 5/30/04. This is within 30 days of the denial, and is sufficient to determine eligibility. We approve the benefits from the appropriate date and advise the person in the approval letter that utilities were not considered in the benefit decision, as that requested verification was not provided.
EXAMPLE
Same as above, but the applicant provides only the income verification. This information shows the person to be over the program’s gross standard. We send a new denial letter to the person advising of the change in denial reason.
EXAMPLE
Same as above, but the applicant provides only the residence verification. We cannot determine eligibility without the income information. We send a letter to the person advising that we received the partial information, but the denial from 5/20/04 stands as we still do not have the income and utility verification we require.
EXAMPLE
Household applies for Basic Food and Children’s Medical. We send a request for income, residence, and household composition verification with a due date of 6/20/04. We do not receive the information and we send a denial letter on 6/22/04 for both programs, as we are unable to determine eligibility. On 6/25/04, we receive the income verification. This is sufficient information to determine the Children’s Medical, but not the Basic Food.
At this point, we send an approval letter for the Children’s Medical and a second denial letter for Basic Food indicating the 6/22/04 denial stands as eligibility cannot be determined from the information provided.
3. NCS Re-applicants who failed to complete their 28 day participation:
a. See WORKER RESPONSIBILITIES Non-Compliance Sanctions (NCS) Re-Applicants in WAC 388-310-1600
