475 Neb. Admin. Code, ch. 4, § 003

Current through September 17, 2024

Section 475-4-003 - NOTICES

The household will be provided with a notice as soon as a determination of eligibility is made but no later than 30 days after the date the application was filed.

003.01NOTICE OF ELIGIBILITY. If an application is approved, the household will be provided a notice of eligibility which includes the amount of the allotment, the reporting category, and the beginning and ending dates of the certification period. This eligibility notice will inform the household of:

(A) Variations in the benefit level based on changes anticipated at the time of certification;

(B) The initial and following month's benefits if the first issuance contains benefits for the month of application and the following month;

(C) The initial month's benefits and aggregate benefits, if a combined allotment will be issued to an expedited household;

(D) The household's right to a fair hearing including information about free legal services available and the telephone number of the Department;

(E) The reporting requirements for households assigned to Simplified Reporting:

(i) The household's total gross monthly income exceeds the maximum gross monthly income limit for the household size; or

(ii) A non-exempt Able Bodied Adult Without Dependents household member's work, volunteer, or work program hours decrease to below 20 hours per week or below a total of 80 hours per month;

(F) The non-reporting requirements for the household in the Transitional Benefit Reporting category;

(G) The need to reapply for continued participation at the end of the certification period; and

(H) The need for a household entitled to expedited services to provide any remaining required verification necessary to continue benefits.

003.02NOTICE OF DENIAL. If an application is denied, the household is provided with a notice of denial. This denial notice informs the household of:

(A) The reason for the denial;

(B) The household's right to a fair hearing, including information about free legal services available, and the telephone number of the Department; and

(C) If the delay was caused by the household's failure to complete the application process, the Department explains:

(i) The action the household must take to reopen the application process;

(ii) That the case will be reopened without a new application if the household takes the required action within 30 days following the application received date; and

(iii) That the household must submit a new application if at least 60 days have passed following the application received date, and the household:

(1) Has not provided the required information; and

(2) Wishes to participate in the program.

003.03NOTICE OF PENDING STATUS. If an application is held pending more than 30 days because the Department is unable to complete the application process, the Department provides the household with written notice that the application is still pending. This section does not apply to applications received before the end of the certification period.

003.04TIMELY NOTICE. Before any action can be taken to reduce or terminate a household's benefits within the certification period, the Department sends the household a timely notice. When the Department's mail is returned with no forwarding address, it is not necessary to send a notice to an address known to be incorrect.

003.04(A)EXCEPTION TO TIMELY NOTICE. The Department may send an adequate notice to a household whose mail has been returned with no known forwarding address. A household that did not receive a notice and had benefits reduced or terminated retains the right to a fair hearing and restoration of benefits as if the household had received a notice.

003.04(B)TIMELINESS. The notice of adverse action period includes at least ten days from the date the notice is mailed to the date the action becomes effective. Actions become effective on the first day of the month's allotment cycle. An allotment cycle always begins on the first day of the month. In addition, extra time will be allotted when the last processing day falls on a Friday or when a holiday follows the last processing day since notices will not be generated until the next workday. The ten-day period of advance notice allows the household to contest the Department's action before the action becomes effective. The effective date of the adverse action is the first day of the month following the expiration of the ten-day adverse action period.

003.04(B)(i)FAIR HEARING WHEN NOTICE DATE FALLS ON A HOLIDAY OR WEEKEND. If the period of adverse action ends on a weekend or a holiday and a request for a fair hearing and continuation of benefits is received on the next workday, the Department considers the request as being within the period of adverse action.

003.04(C)ADEQUATE NOTICE. The household is notified in writing no later than the date the household receives or would have received its allotment of a benefit reduction or termination when any of the following conditions exist:

(i) The household reports the information in writing which results in the reduction or termination and the Department can determine both eligibility and benefit level based on the household's written information;

(ii) Agency mail to the household has been returned with no forwarding address and the action taken would require a timely notice in normal circumstances; or

(iii) When an individual is disqualified for intentional program violation, the Department notifies the remaining members of their eligibility and benefit level at the same time the disqualified member is notified of his/her disqualification.

003.04(D)NOTICE EXEMPTIONS. Individual notices of action are not required in cases when the agency action is due to:

(i) A mass change;

(ii) The death of all household members;

(iii) The entire household moves out of the state;

(iv) The completion of a restoration of benefits period if the household was previously informed in writing when the increased restoration of benefits would terminate;

(v) Month-to-month variances in the household's allotment provided the household was notified of the exact allotment(s) at the time of certification;

(vi) Initial receipt of an Aid to Dependent Children Program grant provided the household was notified at the time of certification that Supplemental Nutrition Assistance Program benefits would decrease upon approval of the Aid to Dependent Children Program grant;

(vii) A household member being disqualified for intentional program violation;

(viii) Verification being received which would terminate or reduce benefits for an expedited case when a certification period of more than one month was assigned. The household must have been informed at the time of certification that the Department would act on verified information without further notice;

(ix) The conversion of a household from cash repayment of an intentional program violation claim to benefit reduction as a result of failure to make cash repayment;

(x) A resident of a chemical dependency treatment center or group home becoming ineligible because of the facility losing its license with the appropriate state agency. Residents of a group home which loses its license or certification may still apply on their own behalf; and

(xi) The voluntary request of the household that its participation be terminated. If the household does not put the request in writing, the Department will send a letter confirming the request. The written confirmation will allow the household to request a fair hearing but does not have to meet other adverse action requirements.

003.05NOTICE OF EXPIRATION. The Department notifies the households of the expiration of their certification periods by sending a notice. The automated "Notice of Expiration of Certification Period" will be received by the household between the 15^th day of the next to last month and the first day of the last month of the certification period.

003.05(A)TIMELINESS. Regardless of when the Department assigns an interview date, the Department considers the household's application as timely if it is received by the 15^th day of the last month of certification. Households provided a notice of expiration have a minimum of 15 days from the date the notice is received to file a timely application for recertification. If the application is mailed in, the household must allow two days mailing time to ensure that the Department receives the application within 15 days.

475 Neb. Admin. Code, ch. 4, § 003

Amended effective 5/21/2016.

Amended effective 7/4/2020

Amended effective 9/17/2024