Special Assistance SA-3110 APPLICATION PROCESS

VII. TIME STANDARD

The time standard covers the time from the date the application is signed to the date of disposition.

A. Processing Time Standard

Process SAA applications within 45 days from the date the application is signed.

B. SAD Processing Time Standard

Process SAD applications within 60 days from the date the application is signed.

C. Pending An Application

1. Information, Including a Disability or Blindness Determination, Needed From SSA

a. Hold an application pending for up to 12 months while awaiting a determination of eligibility for benefits and/or a disability or blindness determination and/or other information needed from SSA. Refer to VI. for instructions for establishing disability.

b. Discuss the applicant’s current and retroactive medical needs and advise the applicant that he/she may make a separate application for Medicaid. Refer to instructions in MA-2525, Disability for establishing disability for Medicaid.

c. If the applicant refuses to apply or does not apply for Social Security benefits within the 60 day processing standard, deny the application at the 60th day. Do not hold the application pending.

Exception: In those few situations where the applicant has applied for Social Security benefits within the last 12 months and was denied for a reason that does not affect SA eligibility (such as income), do not require the applicant to reapply. Verify and document the reason for the SSA denial. Refer to SA 3110, Application Process VI. for instructions for establishing disability if appropriate.

d. If SSA denies the SSDI/SSI application based on non-disability or not meeting criteria for legal blindness; or being denied based on eligibility criteria other than income (such as resources, transfers, fleeing felon, etc.), deny the SA application. An individual must be eligible for SSI or ineligible solely due to income to qualify for SA.

Note: Do not deny the SA application if the reason for the SSA denial of SSI benefits is a transfer of resources that occurred prior to November 1, 2002.

e. If dss denies an SA application based on an SSA decision, advise the applicant that he may appeal the SSA decision. If SSA reverses their denial, the SA application may be reopened. See instructions in SA 3110, VII. Application Process for reopening applications due to SSA appeal reversals.

2. Information Needed From Applicant or Other Third Party

a. The application may pend up to 6 months if awaiting documentation of verification of citizenship and/or identity and the applicant is cooperating to the best of their ability, or when it is the county responsibility to pursue verification on behalf of the applicant based on policy requirements. Assistance in obtaining Citizenship and Identity documentation must be provided upon the applicant’s request or if the applicant has special needs, such as a mental or physical incapacity. See SA-3240, Citizenship and Identity.

b. Do not hold applications pending beyond the processing time standards for information from the applicant or a third party if the following requirements are met:

(1) Request any information needed to process the application during the initial interview using the DMA-5097, Request for Information, and enter the date requested. Include information the applicant/representative needs to provide from a third party or other agency such as SSA/SSI or VA.

(2) Make at least two requests for information needed from the applicant or third party. There must be at least 12 calendar days between the requests.

(3) Explain to the applicant that if more time is needed to provide the required information, an extension may be allowed. If an extension is requested, allow additional time of at least 12 calendar days.

(4) The application is not pending for information from SSA. If you are waiting for information on eligibility or disability from SSA, continue to pend until that information is received. Do not pend an application if you are waiting for the SSI payment to increase to FBR. Instead follow procedure in SA 3210. Once the information from SSA is received, do not continue to pend for other applicant or third party information.

c. If at least two requests for information have been made and the information is not provided, and you are not waiting for information from SSA or for information on citizenship and identity, deny the application on the 45/60th day or 12 days after the second request or the extension, whichever is later.

3. Reducing Resources

a. If the applicant has excess resources and states he/she does not intend to reduce resources (including rebuttal of value) within the processing time standard, accept and document the applicant’s statement and deny the application.

b. If the applicant states intent to reduce resources, explain that the resources must be reduced by the 45th/60th day. If resources are not reduced within the application processing time standard, the applicant is ineligible. Advise the applicant that he/she must provide verification of reduction of resources within the application processing time.

c. If the applicant has not provided verification of reduced resources by the 45th/60th day and the requirements above for requesting information have been met, deny the application.

d. If the requirements for requesting information were not met, pend the application until the end of the second 12-day period or extension or until ineligibility is verified.

e. If the applicant provides verification that resources were reduced prior to the 45/60th, determine eligibility based on the new resource amount. Eligibility begins the month after the month in which resources were reduced to allowable limits.

4. Obtaining a Signed FL-2/MR-2

Do not hold an application pending beyond the time standard awaiting a signed (and/or appropriately completed) FL-2/MR-2 if the requirements for requesting information are met. Deny the application.

5. Document all attempts to verify necessary information.

6. If the application pends beyond the processing time standard, dispose of the application within 5 workdays after the last piece of information is received.

7. If the application pends beyond the processing time standard for both applicant/third party and SSA information, dispose of the application within 5 workdays after the SSA decision is received.

8. When disposing of a pending application, determine eligibility on a monthly basis for all months from date of application onward. Clearly document the application booklet for each month of non eligibility listing the reason/s for non eligibility. Notify the applicant accordingly. When all factors of eligibility are met, clearly document the basis for eligibility, including 1^st moment resource balance when applicable. Reference SA 3110, Application Process, XII.