461-115-0050 Temporary Effective 07/01/16 through 12/27/16
When An Application Must Be Filed
- An individual must file an application, or may amend a completed application, as a prerequisite to receiving benefits as follows:
- An individual may apply for the GA program by completing an application for OSIPM.
- An individual may apply for the TA-DVS program as provided in OAR 461-135-1220.
- In all programs except the TA-DVS program:
- Except as provided otherwise in this rule, to apply for program benefits, an individual must submit a complete application on a form approved by the Department.
- An application is complete if all of the following requirements are met:
- All information necessary to determine eligibility (see OAR 461-001-0000) and benefit amount is provided on the application for each individual in the filing group (see OAR 461-110-0310).
- The applicant, even if homeless, provides a valid mailing address.
- The application is signed by the individual, the authorized representative (see OAR 461-115-0090 and 461-115-0140) of the individual, or another individual applying for benefits on behalf of the individual, and received by the Department.
- An individual required but unable to sign the application may sign with a mark, witnessed by another individual.
- An individual submitting an electronic application (see OAR 461-001-0000) must submit the application with an electronic signature.
- A new application is not required in the following situations:
- In the GA program, when an individual is receiving OSIPM on the date of request (see OAR 461-115-0030) for GA.
- In the SNAP program, when a single application can be used both to determine an individual is ineligible in the month of application and to determine the individual is eligible the next month. This may be done when--
- Anticipated changes make the filing group (see OAR 461-110-0370) eligible the second month; or
- The filing group provides verification between 30 and 60 days following the filing date (see OAR 461-115-0040), under OAR 461-180-0080.
- In all programs except the SNAP program, when a single application can be used both to determine an individual is ineligible on the date of request (see OAR 461-115-0030) and to determine the individual is eligible when anticipated changes make the filing group eligible within 45 days from the date of request.
- When the case is closed and reopened during the same calendar month.
- When benefits were suspended for one month because of the level of income, and the case is reopened the month following the month of suspension.
- When reinstating medical benefits for a pregnant woman covered by OAR 461-135-0950, notwithstanding subsection (g) of this section.
- In the ERDC program, when a case closed during the certification period (see OAR 461-001-0000) and the individual reports a change in circumstances prior to the end of the month following the closure and the reported change will make the individual eligible.
- In the OSIPM and QMB programs, when the medical benefits of an individual are suspended because the individual lives in a public institution (see OAR 461-135-0950), if the inmate is released within 12 months of admission and the inmate provides notification to the Department within 10 days of the release.
- When an individual establishes a new date of request prior to the end of the month following the month of case closure, unless the Department determines a new application is required, a new application is not required in the following situations:
- In the OSIPM program, when the individual's case closed due to failure to make a liability payment required under OAR 461-160-0610.
- In the OSIPM-EPD program, when the individual's case closed due to failure to make a participant fee payment required under OAR 461-160-0800.
- A new application is required to add a newborn child (see OAR 461-001-0000) to a benefit group (see OAR 461-110-0750) according to the following requirements:
- In the ERDC and SNAP programs, an application is not required to add the child to the benefit group.
- In the OSIPM, QMB, and REFM programs, an additional application is not required to add an assumed eligible newborn (see OAR 461-135-0010) to a benefit group currently receiving Department medical program benefits.
- In the TANF program:
- A new application is not required if the child is listed on the application as "unborn" and there is sufficient information about the child to establish its eligibility.
- A new application is required if the child is not included on the application as "unborn."
- In all programs other than ERDC, QMB, REF, REFM, SNAP, and TANF, an application is required.
- A new application is required to add an individual, other than a newborn child, to a benefit group according to the following requirements:
- In the ERDC and SNAP programs, a new application is not required.
- In the REF, REFM, and TANF programs, an individual may be added by amending a current application if the information is sufficient to determine eligibility; otherwise a new application is required.
- In all programs other than the ERDC, REF, REFM, SNAP, and TANF programs, a new application is required.
- An individual whose TANF grant is closing may request ERDC orally or in writing.
- Except for an applicant for the OSIPM, QMB, or SNAP program, an individual may change between programs administered by the Department using the current application if the following conditions are met:
- The individual makes an oral or written request for the change.
- The Department has sufficient evidence to determine eligibility and benefit level for the new program without a new application.
- The program change can be effected while the individual is eligible for the first program.
- In the OSIP, OSIPM, and QMB programs, a new application is not required to redetermine eligibility if the following conditions are met:
- The individual is currently receiving benefits from one of these programs.
- The Department has sufficient evidence to redetermine eligibility for the same program or determine eligibility for the new program without a new application or by amending the current application.
Stat. Auth: ORS 409.050, 411.060, 411.070, 411.404, 411.706, 411.816, 412.049, 413.085, 414.025, 414.685
Stats. Implemented: ORS 409.050, 411.060, 411.070, 411.117, 411.404, 411.704, 411.706, 411.816, 412.049, 413.085, 414.025, 414.041, 414.231, 414.685, 414.839