Changes Resulting in a Decrease in Benefits 430-05-67-15-10

(Revised 11/01/07 ML3111)

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A worker must not act on changes that will result in a decrease in benefits, unless the change meets the following criteria:

  1. The information is obtained or received from:
  1. Household voluntarily requests case closure.
  2. Household reports actual base month income that exceeds the gross income limit for its household size, the household expects this income to continue and based on this income is not eligible for a benefit.

If the household reports they anticipate their income to exceed the gross income limit, the household expects this income to continue and based on this income is not eligible for a benefit, the case must be closed based on client statement.

  1. Household reports a change that brings an ABAWD’s hours below 20 hours weekly averaged monthly.
  2. A household member who has used their ABAWD benefit months (NE or EE).  
  3. Determination of an IPV or failure to comply with BEST.
  4. The worker becomes aware of information that all household members have died.  Adequate notice is required.  
  5. Household reports the addition or loss of a household member.
  6. When an error is made in a case and corrective action results in a future month decrease or allotment reduction due to an overpayment.
  7. When the worker sends the F814 – Required Verification to obtain verification needed to complete a claim, the F401 must be sent to close the case if the household fails to respond.
  8. When a household refuses to cooperate with Quality Control.  Quality Control will notify the worker.  The worker must terminate the household’s eligibility.  A 10-day advance notice is required.  
  9. If at application, recertification or six month report, a household verified a change for a future month, the change must be acted on whether it results in an increase or decrease in benefits.  

Applications and recertifications cannot be pended for verification of a future change and the worker must not request future verification that is not required to process the application or recertification.

Example:

Household files a recertification application on August 10, 2007 for the benefit month of September. At the interview the household reports they signed a coaching contract to coach track in April and May, but does not provide the contract.  The income from the contract is not anticipated in April and May, as the contract was not verified.  The household must be informed they need to report if the income from the contract puts them over the gross income limit for their household size.

The application cannot be pended for verification and the worker must not ask for the contract, as the contract is not needed to process the application.

 

If the household provided verification of the contract at the time of the recertification, the income must be anticipated when determining April and May benefits, regardless of the effect on the benefit.

 

If the reported change meets the criteria to decrease benefits, it must be acted on within 10 days from the date the change was reported and a 10-day advance notice must be sent. If the change is reported in writing and signed by the household, a 10-day advance notice is not required. Adequate notice is required.

 

If a household reports a change that meets the criteria to decrease benefits and other changes, the worker must use the benefit calculator to determine whether the multiple changes result in an increase or decrease in benefits.

 

If the changes result in an increase in benefits, verification must be requested and all verified changes must be acted on.  

 

If the changes result in a decrease in benefits, then only the change(s) that meet the criteria to decrease benefits are acted on.  The worker must document other changes were not acted on as they resulted in a decrease in benefits and did not meet the criteria.

Examples:

  1. An ongoing case reports that a household member left the home on October 4.  The individual must be removed from the case when determining eligibility and level of benefits for November.  If the change results in a decrease in benefits, a 10-day advance notice is required. If the change is reported in writing and signed by the household, a 10-day advance notice is not required. Adequate notice is required.
  2. The worker is notified on October 10 that an individual in an ongoing case is disqualified for an intentional program violation.  The participation code for the disqualified individual must be changed to “DF” and the IPV disqualification is imposed for November.  Notice F818 – IPV-Food Stamp Overissuance or F823 - IPV/Court Conviction – No FS Overissuance must be sent to the household.  Adequate notice is required.
  3. Household consisting of a husband and wife initially apply on November 3.  The husband is employed 35 hours a week.  The wife is not working and is eligible to receive three non-exempt (NE) ABAWD months.  The household is certified for 12 months.  The first NE month for the wife is December.  In the third month (February), the wife’s participation code must be changed to DI when working March benefits.  A 10 day advance notice is required.
  4. Ongoing simplified reporting case.  In month three the worker discovers they failed to convert income at the time of application.  A claim is completed using the corrected converted amount of income.  Allotment reduction is used to recoup the claim resulting in a decrease in benefits.    
  5. Recertification filed in November for December benefits.  Household consists of husband and wife who have both received their three NE month.  At recert, the wife reports she is pregnant and the husband is now working 40 hours per week. The case is certified with both eligible as a simplified reporting household.  In December, household reports husband lost his job. Since the household is required to report if an ABAWDS hours decrease below 20 hours per week and the change meets the criteria to decrease benefits, the change must be acted on without verification by removing the income and changing the husband’s participation to DI.

In January household reports husband found a new job and anticipates working 25 hours per week at $6.50 per hour.  Based on this information, the change will result in an increase in benefits. The worker sends the F419 requesting verification of the new job and hours.  If the household provides the verification, the change must be acted on to increase benefits.  

 

If after verification is received, the change would result in a decrease in benefits, the change is not acted on (husband remains DI with no income) until six month report.  

  1. Single individual with a 10-year-old is exempt from the work requirements at the time of application as they are working full time.  Individual reports they lost their job.  Worker sends F419 for verification of the terminated income.  Household provides statement from employer that verifies the terminated income but does not substantiate a voluntary job quit.  The change in income must be acted on as it results in an increase in benefits.  

The SFN 385 must be completed at the time of recertification, as this is not a mandatory reportable change.  

  1. Single individual applies in December and reports they plan on applying for unemployment benefits.  Individual was entitled to expedited benefits and approved without postponed verifications for the benefit months of December and January.  January is the individuals first NE month.  In January when working February benefits, the worker received an IEVS UIB alert indicating the individual received two unemployment checks in December.  IEVS UIB meets the criteria to decrease benefits and must be acted on for February.  The individual must also be changed to an exempt ABAWD for February.
  2. Household reports on January 25th that base month income exceeded the gross income limit for its household size in December and the worker determines the household is not eligible for a benefit. The worker must send the F419 to determine if the income will continue to exceed the gross income limit and request verification if it is not expected to continue, allowing the household 10-days to respond.

February benefits are authorized with the same income used for January.

 

If the household verifies by the last working day of February that gross income is below the GIL for its household size, the worker must revert the case to open and determine eligibility and level of benefits for March using the newly verified income.

  1. If the household responds and states they do not expect the income to continue, the household must provide verification other then client statement that their income will not continue to exceed the gross income limit for their household size.  

If the newly verified income results in an increase in benefits, the change must be acted on.

If the newly verified income results in a decrease in benefits, the change must not be acted on until six month report or recertification, whichever occurs first.

  1. ABAWD receiving their NE months reports they started a job and are working at least 20 hours per week averaged monthly.  The worker must send the F419 for verification of the new job and hours the individual is working. If the verification indicates the individual is now an eligible ABAWD working 20 hours per week averaged monthly, the individual’s ABAWD status must be changed to exempt (HR on the ABRE screen) for the following month.  

If the income is provided and using the income results in a decrease in benefits, the change in income is not acted on until six month report or recertification, whichever occurs first.    

 

If the household does not respond to the F419, the individual is eligible for up to 3 months (NE or EE).  Once the NE or EE months have been used, the individual’s participation code must be changed to “DI”.  A 10-day advance notice is required unless the change was reported and signed by the household.  

  1. Household is certified with income over the GIL as they are eligible for a benefit.  The household is not required to report any changes in income. The worker received a child support alert and uses base month child support to determine the effect on the benefit. Based on the household's other income and the child support income, the household is no longer eligible for a benefit. The worker must send the F419 to determine if the increase in income is going to continue and to request verification if the income is not expected to continue.  
  2. If the household does not respond to the F419, the case must be closed for excess income.
  3. If the household responds and expects the income to continue or does not know if the income will continue, the worker must close the case with an advance notice, unless the change was reported in writing and signed by the household.  

If the household verifies by the last working day of February that gross income is below the GIL for its household size, the worker must revert the case to open and determine eligibility and level of benefits.

 

If the newly verified income results in an increase in benefits, the change must be acted on.  

 

If the newly verified income results in a decrease in benefits, the change must not be acted on until six month report or recertification, whichever occurs first.   

 

If the reported change does not meet the criteria to decrease benefits, the worker must not ask for verification or follow-up on the change.  The worker must document why additional information is needed.  The change is acted on at the six month report or recertification, whichever occurs first.

 

Information/changes that do not meet the criteria include, but are not limited to:

  1. FACSES
  2. New Hire Matches
  3. Employer verification signed by the employer, income tax forms or a report from a self-employed household.  
  4. Mail returned by the Postal Service
  5. Day care billing forms
  6. Household report of a new job or increased income
  7. Wage stubs, checks from UIB, Workforce Safety, Child Support, SSA/SSI
  8. Reading information in a newspaper
  9. Becoming aware of a client working

Examples:

  1. Worker receives an alert that child support was received in the base month for an ongoing case.  Using base month child support would result in a decrease in benefits.  The change is acted on at the six month report or recertification, whichever occurs first.
  2. A Food Stamp only household reports and verifies a new source of income.  This income along with all other countable income does not exceed 130% of poverty for the household size. As this change will result in a decrease in benefits and does not meet the criteria, the change is not acted on until six month report or recertification, whichever occurs first.
  3. An individual was DW at the time of application for a job quit.  In the third month of the certification period, the individual reports a new job and provides their first paycheck.  Changing the individual to IN and adding their income results in a decrease in benefits.  The individual’s participation is not changed and the income is not added until the six month report or recertification, whichever occurs first.
  4. Application is approved for a 45 year old dad not working and his 17 year old son who is a full time student with earned income.  In month three of the certification period the 17 year old will turn 18.  No change is made to the case as adding the income will result in a decrease in benefits.  The dad is an eligible ABAWD until recertification as no change was reported.