Author: Stephen Goldberg

COVID-19 SSI payment continuation extension

Posted on by

In general, Supplemental Security Income (SSI) claimants who have their benefits reduced or terminated must file a Request for Reconsideration within 10 days of the Notice of Determination, plus five days for mailing in order to have their benefits continue while the Request for Reconsideration is pending.  Claimants are entitled to payment continuation unless they waive that right in writing.

The Social Security Administration has decided that SSI claimants who have their benefits reduced or terminated and file a Request for Reconsideration within 60 days of the Notice of Determination, plus five days for mailing are also entitled to payment continuation unless they waive that right in writing.  The Social Security made this decision because of the hardships and difficulties claimant face because of COVID-19, and because of processing delays because of COVID-19.  This policy is in effect until April 29, 2021.

When the claimant files a Request for Reconsideration after 65 days from the date of the notice, the Request for Reconsideration can be processed and payment continuation paid if the claimant has good cause for late filing. (EM-21064, updated October 29, 2021.)

Verification of self-employment for people who received PUA

Posted on by

People who received Pandemic Unemployment Assistance (PUA) were required to submit documentation showing their work history.  Starting on November 10, 2021, the Employment Development Department (EDD) will send notices by email, text message and UI Online to people who must submit their proof of work history.

In general, notices will go to PUA claimants whose claim started in 2020 and who collected benefits after December 27, 2020, and PUA claimants whose claim started in 2021. People who filed for PUA in 2021 will be required to provide documentation of their 2020 work history even if they have already provided wage information.  People who filed PUA claims after January 31, 2021 will have 21 days to submit proof of work history or request an extension.  People who filed claims before January 31, 2021 will have 90 days to submit proof of work history or request an extension. Claimants can request more time by going to the UI Online homepage and selecting “Request More Time” in the “Upload Employment Documents” section.

Documents that can be used to prove self-employment include but are not limited to business licenses, tax returns, business receipts or invoices, signed affidavits verifying self-employment, contracts or agreements, or bank statements from a business account.

Documents that can be used to prove plans for self-employment include but are not limited to business licenses, state or federal employment identification numbers, written business plans, or lease agreements.

Notices will give the exact time periods that proof work history must be submitted and deadlines for submission or for requesting an extension of time to submit documentation.  EDD will acknowledge receipt of submitted information and will follow-up with a communication indicating whether the documentation was sufficient.

If the claimant does not respond to the notice, a follow-up notice will be mailed.  Failure to respond to the notice could result in a finding that the claimant was ineligible for PUA and an allegation of an overpayment of benefits.  In those situations, EDD will send a Notice of Determination which can be appealed.  If the claimant is found to be ineligible for PUA, EDD will send a Notice of Potential Overpayment which will give the claimant another opportunity to submit information.  If EDD confirms an overpayment, the claimant will receive a Notice of Overpayment which gives the opportunity to appeal or request waiver of the overpayment.  (News Release 21-64, November 5, 2021.)

IHSS able and available spouse rule

Posted on by

The California Department of Social Services (CDSS) has issued clarification regarding the In Home Supportive Services (IHSS) able and available spouse rules.

An able and available spouse is presumed to be available to provide without compensation any IHSS service except for personal care services and paramedical services.  This includes Domestic Services, Related Services, yard hazard abatement, teaching and demonstration, and heavy cleaning.  Spouse includes persons who are legally married or legal domestic partners, or two individuals of the opposite sex are holding out to be married.  As long as the couple remains married and does not obtain a divorce or annulment, or are not legally separated, the able and available spouse rule apples, even if the couple lives in separate locations and are estranged.

Any spouse who does not receive IHSS benefits is presumed to be able to provide all IHSS tasks except for personal care services and paramedical services, unless there is medical verification of the spouse’s inability to do so. If the spouse submits medical verification of inability to perform a task, the county should authorize house for a non-spouse provider to provide those IHSS services.  The spouse would continue to be counted as an able and available spouse for any other services that there is not verification of inability for the spouse to perform.

Services can be performed by another provider when the spouse is unavailable because of employment, health, or other unavoidable reasons such as incarceration, military deployment, a restraining order against the non-recipient spouse, or when recipient spouse has left the home or evicted the non-recipient spouse because of domestic violence, or the recipient spouse has left the home because of domestic violence.  This means that meal preparation, medical accompaniment and protective supervision that must be performed while the spouse is unavailable can be provided by another provider.

In addition, if an able spouse is out of the home for employment, health, or other unavoidable reason, for over 24 hours, the spouse is presumed to be unavailable to provide any IHSS services during the period of absence from the home.

If the spouse must leave full-time employment or is prevented from full-time employment because no other provider suitable is available, the spouse may provider medical accompaniment and protective supervision.

This ACL supersedes ACL 08-18, Question 7, that incorrectly stated that the able and available spouse rule does not apply when a married couple does not reside together.  (ACL 21-91, September 29, 2021.)

 

COVID-19 vaccination requirement for In-Home Supportive Services workers

Posted on by

The State Public Health Officer has ordered that all In Home Supportive Services (IHSS) providers be vaccinated by November 30th 2021.  This requirement does not apply to IHSS providers who live with or are family members of the recipient.

To be eligible for these exemptions, the provider must only provide to a single household. If a provider services multiple households, the exemption does not apply and the provider must adhere to the vaccination requirement.

Providers may also be granted an exemption if they provide the recipient with a COVID-19 Vaccination Exemption Form signed by the provider either stating:

  • The provider is declining the vaccination based on religious beliefs; or
  • The provider is excused from receiving the vaccine due to an eligible medical reason (with an exemption form signed by a physician, nurse practitioner, or other licensed medical professional).

The recipient’s responsibilities include requesting documentation showing that the provider has been vaccinated or can provide an exemption form. The recipient is responsible for reviewing the exemption form and determining if the provider has met the criteria to meet one of the exemptions listed above.  A recipient may not enforce the vaccination requirement.

Once the recipient determines that the exemption is met, the unvaccinated provider must meet the requirements when entering or working in the recipient’s residence:

  • The unvaccinated provider must be tested weekly for Covid-19 with either an authentic PCR or antigen test.

 

  • The unvaccinated provider must always wear a surgical mask or respirator while in the home. Each county can distribute Essential Protective Gear to any IHSS recipient or provider who requests it.

The provider’s responsibilities include maintaining all records regarding their vaccination status, vaccination records, or documents showing their medical exemption status. If the provider is exempt, they are responsible for keeping records of their weekly testing results.  Providers who are not currently working with a recipient must show proof of their vaccination or their exemption when they are hired.  Providers may use their annual State sick leave, if eligible, to take time away from work to get vaccinated or tested for COVID-19 infection.

Notices to inform all IHSS providers who are not live-in providers or provide services to nonfamily members have been sent on October 2021 stating the new vaccination/exemption requirements.  (ACIN I-81-20, October 11, 2021.)

 

CalFresh Mid-Period actions

Posted on by

The California Department of Social Services (CDSS) has provided guidance regarding action on information received mid-period for CalFresh.

In general, the county must act on mid-period change that would increase benefits and must not act on mid-period information that would decrease the household’s benefits.  The county must act on the following mid-period information that decreases benefits: the household voluntarily asks that the case be closed, the county has information that is considered verified upon receipt, a household member has been identified as a fleeing felon or parole violator, there has been a change in the household’s CalWORKs, SSI or general assistance grant, and the county certifies that a member of the household has received substantial lottery or gambling winnings (defined as equal to or greater than the CalFresh resource test in a single game or bet).

There are three changes that must be reported within 10 days: gross monthly income over the income reporting threshold, reduction in work hours below average 20 hours per week for persons subject to the Able Bodied Adults Without Dependents time limit, and receipt of substantial lottery or gambling winnings.

The county must also act on certain mass changes mid-period.

The county must ensure that mid-period changes that are reported but not acted on are reported on the household’s next SAR or recertification.

When a household reports a change that results in benefits increase, the change must be effective no later than the first allotment issued 10 days after the change was reported.  There are only two situations when the county must issue a supplement to increase benefits when a change is reported too late in the month to increase the household’s next monthly benefit amount: when there is an increase in benefits because of a new household member, and when there is a decrease of more than $50 in the household’s monthly income.

In cases where the county requires verification to act on the change that would result in increased benefits, the county must inform the household in writing of the additional verification needed and that failure to provide the verification will result in no change to benefits.  If the household does not provide the verification within 10 days but provides it later, the time to take action on the change runs from the date of the verification.  The county cannot require verification of changes in income if the income source has not changed, and the change is less than $50, unless the information is incomplete, inaccurate, inconsistent or older than 60 days.

Households certified with income between 131 and 200 percent of the federal poverty level do not have a mandatory mid-period income reporting requirement because they already have met their income reporting threshold reporting requirement.

Counties must act mid-period on one of 10 changes whether it increases or decreases benefits.  One of those categories is information that is verified upon receipt.  To be verified upon receipt, the information must be obtained from the primary source, complete, not questionable, and requires no further verification. There are 13 categories of information that is considered verified upon receipt.

The county must follow up on information that is unclear, which is when the county cannot readily determine the effect on the household’s eligibility or benefit amount.  The county must follow up on unclear information by sending a CW2200 request for verification form if it is less than 60 days old and was required to have been reported, or if the unclear information presents significantly conflicting information form that used by the county at initial certification or recertification.  If the unclear information is more than 60 days old, the county cannot act on it.

The county does not need to act on information reported for another program, does not result in a change for the other program, but would decrease CalFresh benefits.  (ACL 21-101, October 15, 2021.)

Social Security in-office appointments

Posted on by

The Social Security Administration (SSA) has issued instructions about when to schedule in-office appointments.

In-office appointments are available for two reasons: 1) To address a limited critical need and the client is unable to use automated services, which includes immediate payments, death corrections, economic or health support, needing an original social security card, and needing a replacement social security card to get income, medical care or ither services or benefits; and 2) If SSA needs to review original documents.

In-office appointments are not scheduled for initial claims or redeterminations unless one of the above criteria are met.  Important documents such as driver’s licenses, passports and immigration documents should not be submitted by mail or drop box.  (EM 21056, September 8, 2021.)