Author: Stephen Goldberg

CalFresh processing for domestic violence survivors

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The California Department of Social Services (CDSS) has issued instructions about AB 2057 regarding CalFresh processing for domestic violence survivors.  A domestic violence survivor who is a resident of a shelter and whose current CalFresh household includes the abuser can apply for CalFresh as a separate household and may be eligible for an additional allotment of CalFresh once per month.  Shelter residents and their children can be aided as members of the former household and as members of a new household once per month.

If the domestic violence survivor is the head of household, the survivor may ask to close the former CalFresh case that included the abuser.  If the request is made is writing or in the presence of an eligibility worker, the change can be made with adequate notice.  If the request is made verbally, the county must provide both adequate and timely (10 days) notice.

CDSS must provide shelters with information about CalFresh eligibility for domestic violence survivors.  CDSS provided a sample with its instructions.

Domestic survivors are now deferred from mandatory participation in CalFresh Employment and Training.  Counties must accept self-attestation of domestic violence unless there is strong evidence that the self-attestation is not credible.  (ACL 17-30, April 17, 2017.)

Evidence to determine medical equivalence in Social Security cases

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Social Security has issued a ruling regarding evidence needed for a finding of medical equivalence to a listing.  This ruling rescinds and replaces Social Security Ruling 96-6p.

An impairment is considered medically equivalent to a listed impairment if it is at least equal in severity and duration to the criteria of a listed impairment.  Social Security can find medical equivalence in three ways:  1) the individual does not exhibit one or more of the findings required by a listing or one or more of the findings is not as severe as required by a listing, but there are other findings related to the impairment that are at least of equal medical significance to the required criteria; 2) the individual has an impairment not described in a listing but has findings related to the impairment that are at least of equal medical equivalence to an analogous listing or 3) the individual has a combination of impairments no one of which meets a listing but has findings related to the impairment that are at least of equal medical equivalence to an analogous listing

To demonstrate an individual is disabled based on medical equivalence, the record must contain either 1) a prior administrative finding from a medical consultant or psychological consultant; 2) medical expert evidence at the hearing level or 3) a report from the Appeals Counsel medical support staff.  It seems that evidence from the claimant’s provider cannot support a finding of medical equivalence.

An administrative law judge (ALJ) is not required to obtain medical expert evidence if the ALJ believes that the evidence does not reasonably support a finding of medical equivalence.  ALJs are not required to articulate specific evidence to support a finding that an impairment does not equal a listing.  A statement that the impairment does not equal a listing is sufficient.  SSR 17-2p (March 27, 2017).

 

 

 

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IHSS overtime exemption for extraordinary circumstances

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CDSS has issued instructions about the IHSS overtime exemption for extraordinary circumstances.  The criteria and initial instructions for the IHSS overtime exemption for extraordinary circumstances are in ACL 16-22, summarized here.

CDSS’ new instructions address renewal of an extraordinary circumstances exemption.  All conditions on which the exemption was initially granted must remain the same for an exemption to be renewed.  If there has been any changes, the county must submit to CDSS a referral for a new exemption instead of renewal of the existing exemption.

Prior to submitting the renewal request, the recipients must explore and exhaust all options for hiring additional providers in the same manner as for the initial exemption request.  This includes contacting relatives, friends, neighbors or other people the recipient knows about their willingness to be a provider, contacting provider registries both in the county where the recipient lives and in neighboring counties, and utilizing alternative resources such a Regional Center services, to address issues with the recipient’s ability to tolerate an outside provider.

CDSS eliminated the requirement to perform a renewal at the next face-to-face reassessment when reassessment occurs before the end of the six month or one year period of the exemption.  However, requests for renewals must be submitted to CDSS by the county no less than 30 days before the exemption ends.

CDSS also clarified that counties determine when to submit exemption requests to CDSS and the county shall not submit either an initial referral or request to renew to CDSS if the county decides other resources are available.  (ACL 17-13, April 7, 2017.)

Confirmation number for IHSS applications

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CDSS has issued instructions implementing AB 1797 about confirmation numbers for IHSS applications.  AB 1797 added Welfare and Institutions Code Section 12301.16 that requires counties to provide HIS applicants with a confirmation number upon receipt of an IHSS application.

CDSS will use the case number that is randomly assigned by the CMIPS II computer system as the confirmation number.  CDSS developed a notice called “Notice of Application Confirmation Number (SOC 2300)” for IHSS agencies to use when providing notification of the application confirmation number.  Counties must provide the confirmation number either verbally before the end of a telephone call during which an IHSS application is taken or in writing when the application is entered into CMIPS II.  (ACL 17-18, February 16, 2017.)

County Welfare Department Use of Consumer Credit Reports

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NOTE — The section of this ACL regarding the Work Number being used in conjunction with, but not in lieu of, existing income and eligibility sources, is superseded by ACL 21-23.

CDSS has instructions to counties about SB 1232 regarding county welfare department use of consumer credit reports.  An example of a consumer credit report is a report from “The Work Number.”  These requirements are mandatory effective January 1, 2017.

Counties cannot obtain consumer credit reports without written authorization of the applicant or recipient.  Consumer credit reports can be used in conjunction with existing fraud detection resources.  Consumer credit reports cannot be used as the only means of verification.  The SAWS 2 Plus, CF 285 and CF 37 have been modified to include authorization for counties to obtain consumer credit reports.

If a county takes adverse action based on information in a consumer credit report, the county must provide an informing notice in addition to the notice of action.  The informing notice must include the name, address and telephone number of the consumer credit reporting agency, a statement that the consumer credit reporting agency did not make the decision, a statement of the right to free disclosure from the consumer credit reporting agency within 60 days and a statement of the right to dispute the accuracy of the information with the consumer credit reporting agency.

Information from a consumer credit report must be made available to an applicant or recipient who requests it from the county welfare department or if an applicant requests a fair hearing to regarding the information in the consumer credit report.  Note that information received from “The Work Number” is not considered verified upon receipt for CalFresh.  ACL 16-118 (December 30, 2016).

Changes to Rules Regarding the Evaluation of Medical Evidence in Social Security cases

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Social Security has finalized new regulations that dramatically change the way it evaluates evidence.  The new rules are effective for claims filed on or after March 27, 2017.  Most importantly, the new regulations eliminate the “treating physician rule” which required deference to doctors who have a treatment relationship with the claimant.   The new rule calls for evaluating opinions from acceptable medical sources by considering the supportability of the opinion and the consistency of the opinion with underlying medical records.  This evaluation is supposed to consider that the claimant has a longstanding treatment relationship with the treating source.

The new regulations add physician’s assistants, advance practice registered nurses, and, when consistent with scope of practice and state licensing rules, optometrists and audiologists.

The new regulations require express consideration of evidence from all medical sources, including evidence from sources that are not considered acceptable medical sources.  This is the only portion of the new regulations that is effective immediately for all claims.

The regulations expressly do not require a statement of how nonmedical evidence is evaluated.

The regulations state that disability evaluations from other agencies such as the Veterans Administration will no longer be given weight in Social Security’s evaluation.

The regulations repeal Social Security Rulings 96-2p, 96-5p and 96-6p.  The regulations also repeal Social Security Ruling 06-03p but state the substance of that ruling regarding evaluation of medical evidence from sources who are not considered acceptable medical sources is incorporated into the new regulations.

Revisions to Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844 (January 18, 2017).

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