109.01 Filing an Application (AAM)

SR 11-40 Dated 10/11

Previous Policy

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The official Filing Date for applications is the date when the application is completed and received by the District Office (DO), if the completed application is received by the DO during business hours on a day that the DO is open for business. If received after hours or on a day when the DO is closed for business, the official fling date of the application is the next day the DO is open for business.

Applications can be submitted:

. online via the NH EASY website;

. in-person at the District Office; or

. via mail.

Personal eligibility interviews are in person at the District Office or, if approved by the District Office Supervisor, by telephone.

Exceptions:

. Applications made using DFA Form 800Q, Assisted Application For Help With Medicare Costs Through the Medicare Savings Program, or applications made using DFA Form 800, Application for Assistance, in which the only program of assistance requested is QMB, SLMB, or SLMB135, may be submitted by mail, and no face-to-face interview is required.

. A Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB/SLMB135), or Qualified Disabled and Working Individual (QDWI) application received by New HEIGHTS as an electronic Low Income Subsidy (LIS) data transmittal from the Social Security Administration (SSA), is considered to be the same as if the applicant had submitted a DFA Form 800, Application for Assistance. No face-to-face interview is required.

A completed application for the adult categories of assistance must, at minimum, contain the applicant's:

. name;

. address;

. signature, or the signature of an authorized representative acting on behalf of the applicant; and

. request for program(s) of assistance.

Individuals have the right to file an application on the same day they contact the District Office.

Exceptions:

. When a resident of an institution applies for assistance prior to leaving the institution, the filing date of the application is the date the applicant is released from the institution.

. For individuals applying for medical assistance at New Hampshire Hospital or any federally qualified health clinic or other agency or outreach site authorized to assist individuals with filing an application, the time frames begin from the date the application is filed at the facility.

. When individuals file applications for LIS at the SSA and consent to have their LIS data transmitted to the Department for determination of eligibility for the QMB, SLMB/SLMB135, or QDWI programs, the date the LIS application is filed at the SSA is the date of application for QMB, SLMB/SLMB135 or QDWI. The date the transmitted data is received at New HEIGHTS is the begin date for processing the application.

Support Staff Process

Direct individuals to the NH EASY website or the DHHS website to apply for assistance, or provide the individual with DFA Form 800, Application for Assistance, upon request. If the paper DFA Form 800 is provided:

. Assist the applicant in completing the form, if requested.

. When the individual returns the application, review to ensure the application is complete as described above, and then date stamp the application.

. Complete the "Agency Use Only" section on the back of the first page (the Coversheet) of DFA Form 800, indicating the date the application was received.

. Review the application for eligibility for expedited Food Stamp benefits (see the Food Stamp Manual, PART 125, EXPEDITED SERVICE). All individuals potentially eligible for expedited Food Stamp benefits are interviewed on the same day that the application is filed. If the applicant cannot be interviewed on the date of application, schedule a personal or phone interview for the next business day or when it is otherwise convenient for the applicant.

. For all other individuals, schedule the individual for an eligibility interview by completing Client Registration (CR) in New HEIGHTS and using the "Schedule Individuals" screen. Do not initiate or print Form 800H, also known as the HAF, at the conclusion of CR. Write a note on DFA Form 797, Eligibility Narrative, to notify the FSS that CR has been completed.

. Give the DFA Form 800 Coversheet plus New HEIGHTS-generated letter CS0002, Schedule Initial Interview, DFA Form 800A, DFA Program and Services Guide, and all other applicable forms to the individual.

. Create an electronic case file for the individual.

Filing of an Application Received in the Wrong DO

If an application is mailed to the wrong District Office (DO), date stamp it and forward it to the appropriate DO on the same day that it was received, unless it meets the criteria for expedited Food Stamp benefits. If information on the application indicates the household is eligible for expedited benefits, process the Food Stamp portion of the application immediately.

If an individual contacts the wrong DO, give the individual the address and telephone number of the correct DO and offer the individual the opportunity to complete an application that same day.

If the individual hand-delivers an application to the wrong DO, schedule an appointment for the correct DO and forward the application to that office. Give the individual the address and telephone number of the correct DO, with the CS0002 indicating the time of the individual's appointment in the correct office.

Special Procedures for Applications Filed by Mail

Once a mailed DFA Form 800 is received in the DO, support staff review all the information on the application and complete the "agency staff only" boxes on the application. Most applicants will then be scheduled for the next available interview appointment. However, the following applications are not immediately scheduled for an interview:

. applications containing information indicating potential eligibility for Expedited Food Stamp benefits. These applications are given to the Supervisor for review once the support staff determines potential eligibility. If the Supervisor confirms the potential eligibility, support staff calls the applicant to schedule an interview for the next business day, or another day convenient to the applicant. If the applicant cannot be reached by phone, an interview is scheduled no sooner than 5 business days from the date of application; and

. applications containing information indicating no potential eligibility for any DFA assistance program or service requested. These applications are given to the Supervisor for review as well. If the Supervisor confirms that there is no potential eligibility for all assistance requested on DFA Form 800, the DFA worker may deny all assistance requested without an interview, per PART 121, INTERVIEWS.