Work First 104 – THE APPLICATION INTERVIEW

IV. RIGHTS AND RESPONSIBILITIES

A. Explain to each applicant that they have the following rights:

The right to:

• Apply for assistance and reapply at any time if you are found ineligible.
• Have anything you tell us kept private.
• Withdraw from any assistance you get at any time.
• Get a written notice of any information needed to determine your eligibility
• Ask for help from the county in getting the information needed to determine your eligibility.
• Be protected by federal law against discrimination on the basis of race, color, national origin, sex, religion, age, disability, or political beliefs.
• Gets a notice telling you why your application is denied, if it is denied.
• Apply for retroactive Medicaid for up to 3 months prior to your date of application.
• Receive your monthly check until the payment is terminated or withheld by appropriate action.
• Use your check however you want, as long as it is in the best interest of your family. If you do not use your check correctly, another person may be appointed to get your check and use it for you and your family.
• Not have a permanent address as long as you plan to stay in North Carolina.
• Ask for a hearing from the department of social services if:
• Your application was denied, and you think the decision was wrong.
• You believe your assistance is wrong based on the county's use of State or local regulations.
• The county does not take action on your Work First Family Assistance application within 45 calendar days.
• Your assistance is changed or stopped, and you think the decision was wrong based on State or local regulations.

B. Explain to each applicant that they have the following responsibilities:

• Help your case manager develop a Mutual Responsibility Agreement and Plan of Action. It is also your responsibility to carry out the agreed upon actions.
• Provide the Department of Social Services information requested by the date due so that your eligibility can be determined as soon as possible
• Apply for other benefits that you are entitled to, such as Social Security, Unemployment or Veterans Benefits.
• Let your caseworker know of any changes in your situation within 10 days. Report changes in your address, employment, property, resources, expenses or needs, or who lives in your home. If you expect a child to be away from your home longer than 90 consecutive days, you must report the child’s absence within 5 days of knowing this change. If you do not, your check will be reduced or terminated. This child is no longer eligible for cash assistance unless he has good cause for being absent from your home.
• Let your caseworker know immediately if you get more Work First Family Assistance than you are supposed to.
• Tell the truth. It is against the law to make false statements or to willfully withhold information. If you do not tell the truth, you can be taken to court and charged with fraud. Everything you tell the department of social services will be checked by them and, perhaps, by a State or Federal reviewer.
• Your medical records may need to be reviewed by the department of social services. By signing your application, you agree that these records may be reviewed.
• Allow the State to bill the medical insurance of anyone who receives Medicaid benefits. You also agree that, if you get a payment from an insurance company for a bill that Medicaid paid, you will repay the State for the Medicaid payment. You also agree to report to the department of social services if anyone in your Medicaid case receives medical care for an injury resulting from an accident.