Continued Benefits
Revised October 28, 2015
Purpose:
If a client meets continued benefits eligibility requirements, the client receives the level of benefits they were receiving prior to the administrative hearing request until the hearing decision is issued.
If the hearing decision affirms the department action (i.e. reduction, suspension, or termination of benefits) the continued benefits paid to the client pending the administrative hearing may become an overpayment for the client. See WAC 388-458-0040.
Clarifying Information:
- Continued benefits for clients are governed by WAC 388-458-0040.
- Continued benefits are authorized at the benefit level the client was receiving before the action was taken by the department which resulted in the hearing request.
- Clients must be notified in writing of their eligibility for continued benefits.
Administrative Hearing Coordinator (AHC) Responsibilities:
1. Review each administrative hearing request to determine eligibility for continued benefits.
Note: A client is eligible for continued benefits at the level of benefits they were receiving before the department took the action that reduced, suspended, or terminated their benefits, until the end of the month when the hearing decision was issued, unless:
a) The client failed to request the administrative hearing within the 10 day period after the change letter was mailed by the department.
b) The client’s Basic Food certification has ended.
c) The client’s Medical Certification Period has ended.
d) The client requested in writing that the department not give them continued benefits.
e) The client withdrew their administrative hearing request.
2. When the AHC determines the client is eligible for continued benefits.
a) Reinstate terminated benefits or make changes to the ACES record to cancel a reduction or suspension of benefits.
b) Send notice of eligibility to client which includes the following information:
i) Benefits have been continued based on your hearing request;
ii) Some or all of the continued benefits may be considered an overpayment if the department action is affirmed; and
iii) If you do not wish to receive continued benefits, you must make that request to the department in writing.
2. If the AHC determines that the client is not eligible for continued benefits, send an ACES letter general correspondence letter (0050-01). The following information should be included:
a) Why continued benefits cannot be authorized, citing the regulation; and
b) The information regarding Administrative Hearing rights.
3. Call the Office of Administrative Hearings (OAH) to schedule an expedited administrative hearing when clients appeal the hearing decision regarding continued benefits.
4. Notify the Social Service Specialist /Case Manager when continued benefits terminate.
5. AHC will establish overpayments that result from the payment of continued benefits to clients, if appropriate.
Financial Services Specialist (FSS)/Case Manager Responsibilities:
1. Continue to process all case actions or changes that do not apply specifically to the administrative hearing issue.
2. Notify the AHC of any case actions or changes that result in a reduction, suspension or termination of cash, food, or medical benefits.