Can I get general assistance while waiting for Supplemental Security Income (SSI)?
In order to assist our incapacity clients in their goal to return to employment or reduce their need for assistance, it is important that we follow the basic principles of social work as well as the following:
Be aware of and develop professional working relationships with local service agencies and treatment providers.
Make sound incapacity decisions using clear, objective medical evidence, based upon program rules as described in Chapter 388-448 WAC.
Require and monitor any treatment that will assist the incapacitated client to become employed or reduce the need for assistance.
All social workers are required to use the Inclusive Case Management System (ICMS) as a case management and tracking tool. Use ICMS for all documentation and the generation of forms from the time of the initial application interview through the time the case is closed.
Be aware of accessibility issues and the need to provide Equal Access.
WAC 388-448-0130 Treatment and referral requirements
We refer you to medical providers for available medical treatment or other agencies for treatment, rehabilitation or work activities when we decide it will improve your ability to be gainfully employed or reduce your need for GAU. "Available medical treatment" means medical, surgical, chemical dependency, or mental health services, or a combination of them.
When you are first approved and at each review determination, we give you written information regarding your treatment requirements.
You must accept and follow through on required medical treatment and referrals to other agencies and services, including applying for SSI, unless you have good cause for not doing so. Examples of good cause are found in WAC 388-448-0140.
We may require you to undergo alcohol or drug treatment before reviewing your eligibility for GAU.
You may request a fair hearing if you disagree with the treatment or referral requirements we set for you
Give the person an orientation or have a follow-up interview following incapacity approval as a best practice. Improve treatment results by hearing a person's concerns, identifying goals, and explaining program rules.
1.Gather information about the person’s treatment concerns, employment and health goals, and social network. Explain the program benefits and expectations. This may be accomplished by:
a. A post-approval case management meeting.
b. A General Assistance orientation.
c. Dedicating a portion of the intake interview to case management.
2.Determine what the person is able to do:
a. If the person has a short-term medical condition, it may be appropriate to only require the person to follow through medical appointments as determined by the person’s medical provider.
b. If the person is able to participate in pre-employment activities, include referrals to vocational or rehabilitation services available in the community.
c. If the person appears to meet SSI disability criteria (citizen or SSA qualified alien), refer the person to the SSI facilitator.
d. Refer non-citizens for naturalization services.
NOTE:
If a person has received or approved for 12 months or more of GA-U, the person must participate in pre-employment activities or you must clearly document why a client with chronic impairments does not meet disability criteria, cannot participate in any activities, and what needs to happen before or when the person will become able to participate in pre-employment activities.
Case Plan
Create a GA Case Plan for each person receiving GA. Send a copy to the person.
Help the person understand the participation and verification requirements.
List all the information the person needs to participate.
Give details in the plan. Include the "what, where, and when."
Describe the steps that are necessary to achieve self-sufficiency.
Verification strategies may vary, depending on the assessment.
Monitor regularly, but not necessarily every month.
Ensure progress is being made.
Engage the person in active participation.
Update the GA Case Plan when requirements change.
NOTE:
It is a best practice to discuss a specific agency referral with the client in person, or by telephone, prior to sending a written notice of the referral.
The Veterans Administration (VA) serves persons who were active in military service and honorably discharged. Services may include:
Disability benefits.
Mental health counseling.
Medical services.
Chemical dependency treatment.
Vocational education.
Private and non-profit agencies may also provide services such as vocational education, housing assistance, and counseling. Look for these types of resources in your area. Some well known companies are:
Review the case and decide if the GA Case Plan needs updating.
Provide your contact information with a new GA Case Plan even when there are no changes.
Tracking Referrals
Tracking and verification strategies may vary, depending on the case plan and referral type.
a.Work with the individual’s provider to determine how often you should monitor compliance with treatment referrals.
b.Monitor regularly, but not necessarily every month.
c.Be respectful of the service provider’s time and preferences. Verification of cooperation with a provider can be obtained using the 14-478 treatment monitoring letter, email, or by telephone. Use the method the provider prefers.
d.Document all tracking and verification actions in ICMS.
e.Ensure progress is being made.
f.Engage the person in active participation by explaining the purpose of each referral, and contacting the person after the treatment or service has begun.
WAC 388-448-0140
WAC 388-448-0140
Effective August 1, 2001
WAC 388-448-0140 Good cause for refusing medical treatment or other agency referrals
We may determine that you have good cause for refusing required treatment or referrals to other agencies. We may require you to provide proof to support your good cause claim. Valid reasons for refusing treatment and other agency referrals include, but are not limited to, the following:
Valid reasons for refusing treatment referrals:
You are so fearful of the treatment that your fear could interfere with the treatment or reduce its benefits;
Treatment could cause further limitations or loss of a function or an organ and you are not willing to take that risk;
You practice an organized religion that prohibits treatment; or
Treatment is not available without cost to you.
Valid reasons for refusing treatment or other agency referrals:
We did not give you enough information about the requirement;
You did not receive written notice of the requirement;
The requirement was made in error;
You are temporarily unable to participate because of documented interference, or
Your medical condition or limitations are consistent with the definition of necessary supplemental accommodation (NSA), WAC 388-472-0020, and your condition or limitations contributed to your refusal per WAC 388-472-0050.
The person must provide supporting verification when claiming a reason listed under WAC 388-448-0140. See the Verification chapter in the EA-Z manual.
If necessary, update the GA Case Plan to include only items that the person is capable of participating in.
Apply the appropriate penalty using a 14-118 when there is not good cause for non-participation
Penalty Requirements
Use a 14-118, Incapacity Decision to notify financial services to stop GA benefits when you determine that the person doesn’t have good cause.
When the period of ineligibility penalty coincides with the last month of incapacity, send a14-217, Notice of Information Required for Incapacity Review, to the person.
If the person agrees to cooperate before GA benefits terminate (before the end of the month that a termination letter was sent with 10 day notice), use a 14-118 to notify financial services to reinstate GA benefits without a penalty period.
If benefits have already closed and the person reapplies:
Deny GA benefits when the person continues to refuse requirements.
When the person agrees to cooperate, use DSHS 14-118, Incapacity Decision to notify financial services to reopen GA benefits after the appropriate penalty period. The person must demonstrate willingness to pursue the program requirements.
EXAMPLE
Danny’s case plan includes a requirement to contact DVR about vocational education services. He didn’t contact DVR. Danny appeared for his good cause appointment scheduled for 15 of the month and states he didn’t go to DVR because he felt like he had better things to do, like hanging out with his friends. The social worker explains that DVR offers services that could help Danny gain new skills and he is required to discuss these services with DVR. Danny agrees to contact DVR this week. Since he has agreed to participate before his benefits have ended, the social worker sends a 14-118 to financial services to reinstate ongoing GA benefits.
EXAMPLE
Ann’s case plan includes a requirement to complete any recommended course of treatment. Here doctor’s treatment plan includes bi-weekly physical therapy sessions. The physical therapist states Ann is only attending once a week. Ann does not appear for her good cause appointment, but contacts her social worker the first of the next month when she does not receive her GA grant. Ann states she only attends her physical therapy appointments once a week because she does not like to ride the bus across town for her appointments. The social worker explains Ann needs to follow her doctor’s recommendations so she can heal as quickly as possible. Ann agrees to start attending her appointments twice a week. Since her benefits have already ended, and Ann did not have good cause for not following her doctor’s recommendations, she must re-apply for benefits and serve a one-week penalty period starting the day she re-applies for benefits.
WAC 388-448-0200
WAC 388-448-0200
Effective May 1, 2004
WAC 388-448-0200 Can I get general assistance while waiting for Supplemental Security Income (SSI)?
You may receive general assistance benefits while you are waiting to receive Social Security Supplemental Security Income (SSI) benefits only when you:
Have filed your SSI application with the Social Security Administration (SSA), follow through with SSA directions and requirements to process your application including keeping all interview and consultative examination appointments, and do not withdraw your application;
Agree to assign the initial or reinstated SSI payment to us provided under WAC 388-448-0210;
Are otherwise eligible according to 388-400-0025; and
If a person fails to apply for SSI, or follow through with any SSA requirement:
1.Sendform 14-509 GA Good Cause letter to schedule an appointment with a SSIF.
2.If the person had good cause for failing to comply with the SSI application process, explain the requirement and coordinate with DDDS or SSA to help the person fulfill the requirement.
3.If the person failed to file an SSI application, reconsideration, or hearing request, complete the application or request for appeal at the good cause appointment regardless of whether good cause is established.
4.Use the 14-118 to notify financial services toterminate GA cash benefits until the person has signed the IARA, filed the SSI application, completed the consultative examination, or any other SSA requirement regardless of whether good cause is established.
5. If the person complies with signing the IARA or the SSA application process requirement beforeGA benefits have terminated, use the 14-118 to notify financial services to reinstate GA benefits.
NOTE:
For a person identified as potentially disabled, compliance with DSHS and SSA is a condition of eligibility for GA. When cash assistance has been terminated because the person failed to comply with pursuing disability benefits even if they claim good cause, only authorize further GA cash assistance after the person verifies they have taken action to comply.
5. Apply the appropriate penalty using a 14-118 when there isn’t good cause for non-participation and the person didn't comply with signing the IARA or other SSA requirement before GA benefits ended.
EXAMPLE
Ken is receiving GA-U, but does not appear to be disabled based on the medical evidence he provided. Ken applied for SSI on his own and is required to follow with the SSI application process. Ken failed to appear for the consultative exam scheduled by DDDS and states that he didn’t feel like seeing a doctor on the day of the exam. Ken’s GA is terminated due to failure to comply with the SSI application process and he isn’t eligible to receive GA benefits until after he reschedules the consultative exam appointment and serves the sanction penalty period.
Penalty Requirements
Use a 14-118, Incapacity Decision to notify financial services to stop GA benefits when you determine that the person doesn’t have good cause.
When the period of ineligibility penalty coincides with the last month of incapacity, send a14-217, Notice of Information Required for Incapacity Review, to the person.
When the person reapplies:
Deny GA benefits when the person continues to refuse requirements.
When the person agrees to cooperate, use DSHS 14-118, Incapacity Decision to notify financial services to reopen GA benefits after the appropriate penalty period. The person must demonstrate willingness to pursue the program requirements.
NOTE:
The penalty periods in WAC 388-448-0150 are defined in RCW 74.04.005. Termination and penalties for failure to accept a referral for services which can reasonably be expected to enable the person to work, or reduce the need for assistance, is mandated by State Law.
4. The period of ineligibility penalty begins the date of re-application or the first of the following month, whichever is later.
a.Impose a subsequent period of ineligibility (second, third, and subsequent failures) only when there is an additional refusal to cooperate with the same treatment or referral requirement as the previous penalty.
b.Failure to cooperate with a different treatment or referral requirement counts as a new first failure.
