OAR 461-115-0050: When an Application Must Be Filed

(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 General Assistance (GA) program by completing an application for Oregon Supplemental Income Program Medical (OSIPM). (b) An individual may apply for the Temporary Assistance for Domestic Violence Survivors (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) For Medicare Savings Programs (see OAR 461-001-0000) and OSIPM: (A) The Department determines that an applicant is not eligible in the month containing the date of request and at the same time can determine one or both of the following: (i) Anticipated changes make t he applicant eligible in a subsequent month that is within 45 days from the date of request . (ii) The applicant is eligible in a retroactive month (see OAR 461-180-0140). (B) An individual’s medical benefits were suspended because they became a resident of a public institution (see OAR 461-135-0950) and the Department learns the individual is no longer a resident of a public institution within the 12 calendar months following the date on which the change occurred. (C) Unless the Department determines a new application is required, when an individual establishes a new date of request prior to the end of the month following the month of case closure in the following situations: (i) For individuals receiving OSIPM under OAR 461-135-0750, when the individual’s services and medical benefits closed due to failure to make a liability payment required under OAR 461-160-0610. (ii) In the Oregon Supplemental Income Program Medical-Employed Persons with Disabilities (OSIPM-EPD), when the individual’s case closed due to failure to make a participant fee required under OAR 461-160-0800. (D) An individual not receiving medical benefits is added to an existing case on which any member of the individual’s filing group (see OAR 461-110-0410) is receiving medical program benefits. (E) When redetermining or renewing an individual’s eligibility and the Department has sufficient evidence to determine eligibility for a new medical program. (F) During the 90-day reconsideration period following closure due to failure to return the renewal form or respond to a request for information sent at renewal as follows: (i) The Department must redetermine eligibility for an individual who submits the signed renewal form or provides the requested information within 90 days of the date of closure. (ii) A new date of request is established on the date the renewal form or requested information is submitted. (iii) In the event the individual returns the renewal form or requested information and the subsequent redetermination generates a new request for information, an application is not required regardless of whether the new due date falls outside the 90-day reconsideration period. (iv) If the individual is found eligible for benefits based on the completed redetermination, the effective date of medical benefits is determined in accordance with OAR 461-180-0090. (c) In the Supplemental Nutrition Assistance Program (SNAP), 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. (d) In all programs except Medicare Savings Programs , OSIPM, and SNAP, 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). (e) When the case is closed and reopened during the same calendar month. (f) In all programs except Medicare Savings Programs and OSIPM, 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. (g) In the Refugee Assistance (REF), TA-DVS, and Temporary Assistance for Needy Families (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) The following application requirements apply when adding a newborn child (see OAR 461-001-0000) to a benefit group (see OAR 461-110-0750): (a) In the REF and TANF programs: (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." (b) In the Refugee Assistance Medical (REFM) program, an application is not required to add a newborn child to a benefit group currently receiving Department medical program benefits if there is sufficient information about the child to establish its eligibility . If there is insufficient information, an application is required. (c) In the SNAP and TA-DVS programs, an application is not required. (4) The following requirements apply to adding an individual, other than a newborn child , to a benefit group : (a) 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. (b) In all other programs, an application is not required. (5) Except for an applicant for Medicare Savings Programs , OSIPM, or SNAP, 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 effectuated while the individual is eligible for the first program.