Current through Register Vol. 63, No. 9, September 1, 2024
(1) An individual must file an application,
or may amend a completed application, as a prerequisite to receiving benefits
as follows:
(a) An individual may apply for
the GA program by completing an application for the OSIPM program.
(b) An individual may apply for the TA-DVS
program as provided in OAR
461-135-1200.
(c) In all programs except the TA-DVS
program:
(A) 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.
(B) An application is complete if all of the
following requirements are met:
(i) 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).
(ii) The applicant, even if an individual who
is experiencing homelessness, provides a valid mailing address.
(iii) The application is signed by the
individual, the
authorized representative (see OAR
461-115-0090) of the individual,
or another individual applying for benefits on behalf of the individual, and
received by the Department.
(I) An individual
required but unable to sign the application may sign with a mark, witnessed by
another individual.
(II) An
individual submitting an electronic application (see OAR
461-001-0000) must submit the
application with an electronic signature.
(2) A new application
is not required in the following situations:
(a) In the GA program, when an individual is
receiving OSIPM on the date of request (see OAR
461-115-0030) for GA.
(b) 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--
(A)
Anticipated changes make the filing group (see OAR
461-110-0370) eligible the
second month; or
(B) The
filing group provides verification between 30 and 60 days
following the filing date (see OAR
461-115-0040), under OAR
461-180-0080.
(c) In all programs except the
SNAP program, when a single application can be used both to determine an
individual is ineligible on the filing date (see OAR
461-115-0040) or the
date of request as applicable to the term used by the program,
and to determine the individual is eligible when anticipated changes make the
filing group eligible within 30 days from the filing
date or 45 days from the date of request (as
applicable to the term used by the program).
(d) When the case is closed and reopened
during the same calendar month.
(e)
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.
(f) When reinstating medical benefits for a
pregnant individual covered by OAR
461-135-0950.
(g) In the OSIP, OSIPM, and QMB programs,
(A) When a new application is not required
under section (2) or (4) of OAR
410-200-0110, except subsection
(4)(b), including provisions that specify they are for "HSD Medical"
programs.
(B) When the medical
benefits of an individual are suspended because the individual lives in a
public institution (see OAR
461-135-0950), if the Department
is notified within 10 calendar days of the release.
(h) In the REF, TA-DVS, and TANF programs,
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 -
(A) Anticipated changes make the
filing group (see OAR
461-110-0330 and OAR
461-110-0430) eligible in the
following month; or
(B) Amending a
current application if the information is sufficient to determine eligibility;
otherwise a new application is required.
(3) 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:
(a) In the OSIPM program, when the
individual's case closed due to failure to make a liability payment required
under OAR 461-160-0610.
(b) 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.
(4) 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:
(a) In the SNAP
program, an application is not required to add the child to
the benefit group.
(b) 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.
(c) In
the TANF program:
(A) 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.
(B) A new application is required if the
child is not included on the application as
"unborn."
(d) In all
programs other than QMB, REF, REFM, SNAP, and TANF, an application is
required.
(5) A new
application is required to add an individual, other than a newborn
child, to a benefit group according to the
following requirements:
(a) In the QMB, OSIP,
OSIPM, and SNAP programs, a new application is not required.
(b) 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.
(6) 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:
(a) The individual makes an oral or
written request for the change.
(b)
The Department has sufficient evidence to determine
eligibility and benefit level for the new program without a
new application.
(c) The program
change can be effected while the individual is eligible for the first
program.
Statutory/Other Authority: 409.050, 411.060, 411.070,
411.404, 411.706, 411.816, 412.014, 412.049, 413.085, 414.025 &
414.619
Statutes/Other Implemented: 411.060, 411.070, 411.404,
411.706, 411.816, 409.010, 411.447, 411.704, 412.014, 412.049, 413.085,
414.025, 414.041, 414.231, 414.619, 414. 117, CFR 435.916 &
412.072
