Unclear or Insufficient Information to Make a Benefit Determination 430-05-67-15-20

(Revised 10/01/18 ML3532)

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IM 5349

 

Amended IM 5338

 

IM 5338

 

 

If a worker receives unclear or insufficient information from a household and the worker is unable to determine the effect on the benefit, the worker must pursue clarification and verification of household circumstances if the change occurred within 60 days of the current month of participation using the following procedures:

1. The worker must send Notice - F419 “Request for Verification” to the household clearly advising the household of the verification it must provide or the actions it must take to clarify its circumstances. The household must be allowed 10 days from the mailing date of F419 to respond and to clarify its circumstances either by telephone or by correspondence.
2. If the household responds and provides sufficient verification within the 10-day period, the worker must act on the reported change within 10 days and send the household the appropriate notice. If the change results in a decrease in benefits or case closure, a 10-day advance notice must be sent. If the change was reported and signed by the household, adequate notice is required.
   
   If the household fails to provide verification within the 10-day period, the case is closed. The worker must send the F401 – Failure to Provide Information. A 10-day advance notice is required.

 

If a worker receives unclear or insufficient information that a change occurred more than 60 days from the date of report , the worker must not act on this information or request verification until the next review unless the information should have been reported at the time of application or review.

 

Examples:

 

1. 20-year-old single individual is approved for SNAP and informed to report if her income exceeds the 130% GIL for a household size of one. During the review period, the 20-year-old moved in with mom. The 20-year-old must include mom’s income in determining if her income exceeds the 130% GIL for a household size of one.
   
   The 20-year-old reports the move in the same month she moved. The worker must send the F419 for the information needed to add mom to the 20 year olds case. If the household responds, mom is added to the 20 year olds case. The worker must then send the F741 –Household Over Gross Income Limit and Eligible- Reporting Requirement (Ongoing Case) or F742 – Household Under Gross Income Limit Reporting Requirement (Ongoing Case), whichever is appropriate, informing the household of their new reporting requirement based on the increased household size.
   
   If the household fails to respond, the case continues until review.
   
   
2. Boyfriend and girlfriend living in the same home apply for SNAP and are determined to be separate households and were approved for benefits. Since separate household status was established at the time of application, they do not need to include each other’s income in determining if their income exceeds the 130% GIL.
   
   During the review period, girlfriend reports they were married. The report was made the same month they were married. The worker must send the F419 for the information needed to add boyfriend to girlfriend’s case. If the household responds, the boyfriend is added to the girlfriend’s case after allowing for advance notice to close the boyfriend’s case. The worker must then send the F741 or F742, whichever is appropriate, informing the household of their new reporting requirement based on the increased household size.
   
   If the household fails to respond, her case is closed.The worker must send the F401. A 10-day advance notice must be sent. If the change was reported and signed by the household, adequate notice is required.
   
   
3. A household applies and is approved for SNAP in April. In August, the household reports they received a pay raise which began in May. This new income increase did not cause the household to exceed the GIL for their household size. The F419 must be sent to the household to request verification of the pay raise.
   
   
4. A household applies and is approved for SNAP in June. In September, the household reports a new address but does not provide any updated expenses. The F419 must be sent to the household.
   
   If the reported change would result in a decrease in benefits and verification is not provided, the change must be acted on using what the household initially reported and a 10-day advance notice is required.
   
   If the reported change would result in an increase in benefits, the F419 must be sent. If the household fails to provide verification within the 10-day period, the case is closed with a 10-day advance notice.
   
   If verification is provided and a benefit decreases or case closure results, a 10-day advance notice is required. If the change was reported in writing and signed by the household, adequate notice is required.
   
   If the reported change would result in a decrease in benefits and verification is not provided, the change must be acted on using what the household initially reported and a 10-day advance notice is required.
   
   If the reported change would result in an increase in benefits, the F419 must be sent. If the household fails to provide verification within the 10-day period, the case is closed with a 10-day advance notice.
   
   If verification is provided and a benefit decreases or case closure results, a 10-day advance notice is required. If the change was reported in writing and signed by the household, adequate notice is required.
   
   If the household provides verification of residence but fails to provide verification of expenses, shelter costs are not allowed and the case is not closed.
   
   If the expense is verified at a later date, the expense is allowed for the next benefit month.
   
   If the household provides verification of residence but fails to provide verification of expenses, shelter costs are not allowed and the case is not closed.
   
   If the expense is verified at a later date, the expense is allowed for the next benefit month.
   
   If the household provides the verification at a later date the change must be acted on for the month after receipt of the verification.