Current Suspected Overdose Deaths in Delaware for 2024: Get Help Now!
Find school water testing results and additional resources
Attention Medicaid Participants: Eligibility Renewals Restarted April 1, 2023
In re: DCIS No. Redacted Redacted
Appearances:
Redacted, pro se, Claimant
Denise Curtis, Sr. Social Worker/Case Manager, Division of Social Services
Redacted ("Claimant") opposes a decision by the Division of Social Services ("DSS") to deny his application for food stamp benefits.
The Division of Social Services ("DSS") contends that the Claimant failed to provide requested information and is therefore ineligible to receive benefits.
By action taken October 8, 2004, DSS denied Claimant's Food Stamp benefits. (Exhibit 3).
The Claimant filed a request for a fair hearing. (Exhibit 2).
The Claimant was notified by certified letter dated December 20, 2004, that a fair hearing would be held on January 18, 2005. The hearing was conducted on that date in Dover, DE.
This is the decision resulting from that hearing.
On September 7, 2004, after completing an application for benefits, DSS requested that Claimant provide basic program information, and living arrangement information relating to his application for food stamp, general assistance and medical assistance benefits. This information was requested on DSS Appointment and Request for Verification Form (Form 105). (Exhibit 4) On September 9, 2004, the Claimant again came into the DSS office and provided some of the requested information. As a result of that meeting, he was again provided a Form 105 (Exhibit 5) requesting that his landlord complete a Residence and Household Size Verification Form (Form 176) (Exhibit 6) and that he have a Medical Certification form completed (Exhibit 7).
By October 9, 2004, DSS had still not received any of the requested information. As a result of not having the requested information, DSS issued a denial notice. (Exhibit 3). While the Claimant maintains that he provided the information sometime on or about October 14, 2004, DSS obtained only a partially completed Form 176, but not until November 5, 2005. In addition, the Claimant maintains that his landlord was out of the state dealing with her daughter and that was one of the reasons he was unable to obtain the information in a timely manner. However, the Claimant never contacted DSS prior to October 9, 2004 to advise DSS of this problem. In addition, at the hearing, the Claimant testified that he was homeless, yet on November 5, 2004 he returned a partially completed Form 176.
With respect to the medical certification form, as of the date of the hearing DSS had not yet received anything back from the Claimant or any indication from the Claimant that he was unable to have the form completed.
On November 24, 2004, the Claimant requested a hearing for the denial of his food stamp application. (Exhibit 2)
On December 10, 2004, the Claimant provided DSS with some correspondence and a copy of an Administrative Law Judge ("ALJ") Decision relating to disability, dated March 5, 2002. (Exhibit 10)
Unable to verify residence and medical information, DSS denied the Claimant's application for food stamp benefits, citing among other regulations, Division of Social Services Manual ("DSSM") §9029. This particular section of the social services manual sets forth that:
"To be denied, the household must refuse to cooperate, not merely fail to cooperate or be unable to do so. For a determination of refusal to be made, the household must be able to cooperate, but clearly demonstrate that it will not take actions that it can take and that are required to complete the application process."
Additionally, the regulation states,
"If there is any question as to whether the household has merely failed to cooperate, as opposed to refused to cooperate, the household should not be denied, and DSS shall provide assistance."(Emphasis added)
It is clear that the actions taken by the Claimant do not constitute a refusal to cooperate. At the hearing, it was evident that the Claimant was confused about what was actually required of him. This behavior is consistent with his medical condition as described in the ALJ medical disability claim decision from the Social Security Administration. (Exhibit 10) Based upon DSSM 9029, and the record before me, the Claimant did not "refuse to cooperate" and, therefore, assistance should have been provided. However, without benefit of the required information, DSS was unable to establish what level of benefit should have been provided.
Therefore, while the determination to deny his application for food stamp benefits cannot be sustained on the record before me at the hearing, DSS was not aware of the circumstances surrounding this applicant until at the earliest December 10, 2004, and perhaps not fully until the hearing.
For these reasons, the decision of the Division of Social Services to deny the Claimant's application for food stamp benefits is REVERSED. The case is REMANDED to DSS to re-process the Claimant's application and provide assistance to him in obtaining the required information. DSS should make prompt corrective payments pursuant to DSSM §5501.
Date: February 24, 2005
MICHAEL L. STEINBERG
HEARING OFFICER
THE FOREGOING IS THE FINAL DECISION OF THE DIVISION OF SOCIAL SERVICES
POSTED
MLS/vmd
cc:
Redacted
Denise Curtis
EXHIBITS FILED IN OR FOR THE PROCEEDING