Change of Circumstances - Effective Date

Revised April 29, 2008

How does the department determine the date a change affects my benefits?

WAC 388-418-0020

Effective July 17, 2006

WAC 388-418-0020 How does the department determine the date a change affects my benefits?

Unless otherwise specified, the rules in this chapter refer to cash, medical assistance and Basic Food benefits.
If you report a change that happened between the date you applied for benefits and the date we interview you under WAC 388-452-0005, we take this change into consideration when we process your application for benefits.
If we learn about a change in your circumstances from another person, agency, or by matching with any number of systems, we determine the impact this change has on your benefits. We may request additional information under WAC 388-490-0005 or update your benefits based on this information.
For programs other than pregnancy medical and children’s medical, if you report a change in your income that we expect to continue at least a month beyond the month when you reported the change, we recalculate the income we estimated under WAC 388-450-0215 based on this change. Changes in income during a certification period do not affect pregnancy medical or children’s medical assistance.
When a change causes an increase in benefits, you must provide proof of the change before we adjust your benefits.
1. If you give us the proof within ten days from the date we requested it, we increase your benefits starting the month after the month you reported the change.
2. If you give us the proof more than ten days after the date we requested it, we increase your benefits starting the month after the month we got the proof.
3. If you are eligible for more benefits and we have already sent you benefits for that month, we provide you the additional benefits within ten days of the day we got the proof.
When a change causes a decrease in benefits, we reduce your benefit amount without asking for proof.
1. If you report a change within the time limits in WAC 388-418-0007, and you are not reporting this as part of a mid-certification review, we decrease your benefits starting the first month following the advance notice period. The advance notice period:
  1. Begins on the day we send you a letter about the change, and
  2. Is determined according to the rules in WAC 388-458-0025.
2. If you do not report a change you must tell us about under WAC 388-418-0005, or you report a change later than we require under WAC 388-418-0007, we determine your eligibility as if you had reported this on time. If you received more benefits than you should, we set up an overpayment as described under chapter 388-410 WAC:
If we are not sure how the change will affect your benefits, we send you a letter as described in WAC 388-458-0020 requesting information from you.
1. We give you ten days to provide the information. If you need more time, you can ask for it.
2. If you do not give us the information in time, we will stop your benefits after giving you advance notice, if required, as described in WAC 388-458-0030.
Within ten days of the day we learn about a change, we send advance notice according to the rules in chapter 388-458 WAC and take necessary action to provide you the correct benefits. If you request a hearing about a proposed decrease in benefits before the effective date or within the notice period as described in WAC 388-458-0040, we wait to take action on the change.
If you disagree with a decision we made to change your benefits, you may request a fair hearing under chapter 388-02 WAC. The fair hearing rules in chapter 388-02 WAC do not apply for a “mass change”. A mass change is when we change rules that impact benefits for all recipients and applicants.
When you request a hearing and receive continued benefits:
1. We keep giving you the same benefits you got before the advance notice of reduction until the earliest of the following events occur:
  1. For Basic Food only, your certification period expires;
  2. The end of the month the fair hearing decision is mailed;
  3. You state in writing that you do not want continued benefits;
  4. You withdraw your fair hearing request in writing; or
  5. You abandon your fair hearing request; or
  6. An administrative law judge issues a written order that ends continued benefits prior to the fair hearing.
2. We establish an overpayment claim according to the rules in chapter 388-410 WAC when the hearing decision agrees with the action we took.
Some changes have a specific effective date as follows:
1. When cash assistance benefits increase because a person is added to your assistance unit, we use the effective date rules for applications in WAC 388-406-0055.
2. When cash assistance benefits increase because you start paying shelter costs, we use the date the change occurred.
3. When a change in law or regulation changes the benefit amount, we use the date specified by the law or regulation.
4. When institutional medical assistance participation changes, we calculate the new participation amount beginning with the month your income or allowable expense changes.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

WORKER RESPONSIBILITIES

Temporary changes in income:

When a client reports a change in income that we do not expect to last at least a month beyond the month they reported the change, do not change their benefits. This includes having income over the gross income limit for Basic Food. Instead, take the following steps:
1. Document the reported change, that the change is not expected to last at least a month beyond the date the client reported the change; and
2. Leave the person's benefits unchanged.

NOTE:

If you expect the change to last at least a month after the month the change was reported, adjust the person's income for the change. If we averaged this income, you must re-calculate the averaged income based on this new information.

EXAMPLE

On September 19th, Sue reports that her hours have increased because her co-worker is on medical leave through October 15th. We would not re-calculate Sue's income based on this report because the change won't last through the end of October.

EXAMPLE

On November 14th, Dan reports that he will be working full time for the holiday season through January 1st. We re-calculate Dan's income based on this report because we expect the change to last at least through the end of December.

Changes that cause an increase in benefits:

a. People must verify changes that cause an increase in benefits before we update benefits based on the reported change. We decide when to change benefits based on whether or not they provide the proof we asked for within ten days.

If they take more than ten days to provide this proof, we increase benefits starting the month after the month we received the proof even if they request more time to give us the proof.

b. If a person leaves a community residential facility or a medical institution after the first of the month and they have been receiving CPI monies per WAC 388-478-0045 or388-478-0040, the effective day for the change in benefits is the day they leave the facility.

Benefits are determined by dividing the grant amount by the number of days in the month. The remainder is multiplied by the number of days left in the month counting the date of discharge. The CPI is divided by the number of days in the month and the remainder is multiplied by the number of days the person was in the facility. The two sums are added together and the CPI amount is subtracted from the total.

EXAMPLE

Bill is in an ARC (Adult Residential Care facility) and is receiving CPI, $38.84. He is released from the facility on April 10^th and will be responsible for paying shelter costs. He is eligible for a supplemental payment of $210.11 calculated as follows:

$339 divided by 30 = $11.30

$11.30 x 21 = $237.30

$38.84 divided by 30 = 1.29

$1.29 x 9 = $11.65

$237.30 + 11.65 = $248.95 which rounds up to $249.00

$249.00 – 38.84 = $210.16 (ACES issues the exact amount for the BEG)

If Bill were going into supplied shelter, the same equation applies with the supplied shelter amount being used.

NOTE:

If someone reports a change that would increase their benefits, but fails to provide the needed proof, we do not update the case to increase the AU's benefits. We also do not terminate the AU's benefits based on the missing proof. We continue to allow the current deduction until the next review / recertification.

NOTE:

A reported one-time medical expense may have a different effective date as a deduction depending upon how the person chooses to have it budgeted. See WAC 388-450-0200 for how to treat medical expense deductions.

Changes that reduce benefits:

When people report a change that will reduce their benefits, make the change to reduce their benefits (with advance notice). Do not require proof of the change. We will verify this information at the next eligibility review / recertification or mid-certification review.
When someone reports multiple changes at one time:

When clients report multiple income-related changes at the same time, review each change separately to decide how the change impacts their eligibility and benefits.

EXAMPLE

Rebecca did not receive her March TANF or Basic Food benefits because she moved in February and did not report this change. Her mail was returned, "Moved, left no forwarding address". Her benefits closed without advanced notice on the last day of February.

On March 3rd, she reports her new address. In addition, Rebecca reports a new job. Reinstate her TANF and Basic Food back to March 1st. Give Rebecca 10 day's advanced and adequate notice regarding any benefit changes from the new job. Any reductions to her TANF and Basic Food would be effective in April.

EXAMPLE

Charles lost his job. He applied for TANF benefits and was approved. The first change is that Charles lost his job. The second is that he now receives TANF.

Charles losing the income from his job is a change that increases benefits. If Charles gives us proof of the change timely, we increase his benefits effective the first of the next month.
The second change was that he started to receive income from a new source. This is a change that decreases benefits. We reduce benefits effective the month after the change when this meets advance notice requirements.

Return Mail:

If you receive returned mail for someone take the following steps:
1. Check the case record to determine if they have reported a change and it has not yet been recorded in ACES.
2. If the post office returned the letter, take action on the case as described below:
  1. If marked "Moved, left no forwarding address", "Undeliverable as addressed" or "Vacant" and there is no forwarding address, close without 10 day advance notice. Send the notice of termination to the last known address.
  2. If returned with a new address, update the address in ACES and mail the no change letter to the client's new address. Clients need only report their move. All other verification can be postponed until the next application, review or mid-certification review.
  3. If any other markings, send a request for information to the client. Close benefits with advance and adequate notice if that letter is returned also.
3. Households with benefits closed under (b.) (i.) above are entitled to benefits reinstated back to the first of the month with no change if they contact the CSO with their new address at any time during the month following their termination. Any changes that are voluntarily reported at the time of contact are to be acted on as described in WAC 388-418-0020.
4. Households receiving medical assistance for children or pregnant women with benefits closed for "loss of contact/wehreabouts unknown" may have their assistance unit reinstated back to the month of termination if they provide the CSO with their new address at any time during their original certification period. Also see clarifying information in
  WAC 388-416-0015.

ACES PROCEDURES

	See Interview
Add a Person:	See Add a Person
Add a Program:	See Add a Program
Update AU / Client Data:	See Update Assistance Unit / Client Data
Terminating an AUs / Client's Benefits:	See Close Assistance Unit / Client
Adverse Action:	See Update Assistance Unit / Client Data See Deny an Assistance Unit / Client
Trickling and Sprouting:	See Trickle and Sprout

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