Special Supplement To The MGH COMMUNITY NEWS September 2000
ELIGIBILITY FOR "WELFARE" PROGRAMS IN MASSACHUSETTS
(EAEDC AND TAFDC)
EDITOR'S NOTE: Please note that the write-up of the EAEDC/TAFDC Eligibility training
does not appear in these pages, but has been distributed as a special supplement to the MGH Community
News. Due to the length of the article and the level of detail involved we felt the newsletter layout
might detract from the clarity of the article.
INTRODUCTION
To qualify for both of these programs, applicants must have some type of documented immigration status and must meet
two thresholds: financial and categorical.
Financial Eligibility
Categorical Eligibility
Under the program that preceded EAEDC- General Relief, the long-term unemployed and those with no work history could receive benefits.
These groups were excluded in the creation of EAEDC and no longer qualify on the basis of these conditions.
Financial Eligibility
Categorical Eligibility
Caretakers who qualify:
OTHER TAFDC REQUIREMENTS AND RULES
Time limits- a person can only receive benefits for 24 months within a 60 month (5 year) period. There are exemptions from this- such as one for disability,
which will be discussed in more detail below, and one for domestic violence situations. There are also extensions for which recipients can apply.
Work Requirements - Able-bodied participants with school-age children must work 20 hours a week or participate in a "workfare" program. Note that there is
a disability exemption to this that will be discussed below, as well as the domestic violence waiver as mentioned above. There is also a "Good Cause" exemption for
family or other emergencies, but many DTA workers rarely inform recipients about it.
Family Cap- if a family who already receives TAFDC benefits has an additional child, the birth of that child does not increase the family's grant, nor does that
child exempt the caretaker from work requirements after she/he is 3 months old (mother is exempt from work requirement and time limit for last 120 days of pregnancy as well).
This requirement can be waived in cases of rape, incest, sexual assault and domestic violence.
TIMELINE
DISABILITY DETERMINATION
DURATION OF DISABILITY:
TAFDC- The condition has lasted, or is expected to last, 30 days.
DEFINITION OF DISABILITY:
For copies of the listings please contact the CRC, x6-5807.
Some examples of conditions not included in the listings, but that might qualify- fibromyalgia, migraine headaches, ADHD, PTSD, MR, mild MR, perceptual impairments, and memory
loss. Remember that a combination of impairments may equal a listing. DTA workers often don't explain to TAFDC recipients that mental health and cognitive impairments can qualify.
The disability determination process is fraught with barriers. The system seems blind to the fact that the very limitations that are the basis for a disability claim may also make
it difficult to navigate these complex processes. This is especially pertinent to those with cognitive or certain mental health related disabilities. It is also common for people
to not want to disclose these challenges or not to think them relevant. For example, the application is 10 pages long, complicated and only available in English and Spanish.
Social workers can play a very important advocacy role in helping patients to identify disabling mental health and cognitive conditions and to navigate the disability determination
process.
DISABILITY DETERMINATION PROCESS
When TAFDC recipients are seeking recognition of a disability, it is important to "get it right" the first time. As mentioned above, if a TAFDC applicant is denied because of such a
situation, though she can reapply, she will not be considered disabled during the process. As a result her time-clock keeps running, and she has to meet the work requirements.
It is not uncommon for time-clocks to run out during this process, and then for DES to close the case because someone is no longer receiving benefits! In this scenario there is a little
known subregulatory subpolicy that requires if someone then reapplies, they have to be given benefits if a decision is not made within 26 days. This is little known by DTA workers and
contradicts other DTA policy, so these cases should be brought to the local legal service office.
This is another very important advocacy role for social workers. If we can get the health providers to answer DES' request for information, it may avoid the consultative medical exam
process for our patients. Also we can help patients understand the importance of these appointments, inform them of their rights to transportation, help with applications, etc.
These are things that are easier for lay advocates to assist with than Legal Services personnel as DTA has forbidden DES to communicate directly with anyone from Legal Services.
They can communicate through a liaison, but this makes the process more difficult.
What other benefits are available to participants in these programs?
Do you have to apply for SSI to qualify for these programs?
For a parent to qualify for a "caretaker exemption" from work requirements and time-limits does the child have to be receiving SSI?
No. This parent just needs a one page form filled out by the child's pediatrician saying that the child needs full time care. The child also does not need to meet one of the "listings"
to qualify as needing a caretaker. With this exemption also comes a slightly higher benefit amount (exempt from the grant-cut instituted as part of welfare reform).
ADDITIONAL RESOURCES
Michelle Lerner, staff attorney with Greater Boston Legal Services, Employment and Welfare Unit spoke
in the first CRC presentation of the academic year to an audience of staff from MGH and other area hospitals
and health centers. What follows is largely a summary of her remarks with some additional information
(so if you attended the presentation you still might learn something).
The two state cash assistance programs in Massachusetts are administered by the Department of Transitional
Assistance (DTA) and are known as: Emergency Assistance for the Elderly, Disabled and Children (EAEDC) and
Transitional Assistance for Families with Dependent Children (TAFDC). These programs provide subsistence benefits
to those eligible. Of the two, TAFDC has looser financial eligibility guidelines, and higher grant amounts.
The monthly grant for a single person receiving EAEDC is a little over $300. The TAFDC grant for a non-exempt
family of four is $673 if they are living in subsidized housing. This family would receive a whopping additional
$40 a month if they live in non-subsidized housing.
EMERGENCY ASSISTANCE FOR THE ELDERLY, DISABLED AND CHILDREN- EAEDC
Income is complicated, but generally is below the grant amount one would receive. The asset limit is very
low. One can only have countable assets up to $250. Homes are not considered countable assets. The first $1,500 of
equity in a car is not a countable asset.
Eligibility for EAEDC requires that one fit into one of the following categories:
TRANSITIONAL ASSISTANCE FOR FAMILIES WITH DEPENDENT CHILDREN- TAFDC
Income- 185% of the federal poverty level (see the department's website for FPL amounts for different family sizes) and countable
income must be below the grant level. However, many types of income and assets are noncountable, please contact the CRC
or check with legal services for specifics. Don't advise someone not to apply because they are over-income without all the facts! An advocacy note:
DTA is required to base this on prospective estimates of income, not just past income. This is particularly important when this is a new disability.
Assets- $2,000. The first $4,500 in equity in a car is not a countable asset.
Eligibility for TAFDC, as the name implies, requires that there is a dependent child either under 18 (or not yet born- i.e., a pregnant woman
in the last 120 days of pregnancy) or 18 and attending secondary school full time.
As part of "welfare reform" Massachusetts has enacted some additional rules and requirements for TAFDC. Only those pertinent to the rest of the
presentation are outlined here. (For more detail on time limits see MGH Community News November 1998. For more detail on all the following components
and additional requirements such as "Learnfare", "Shotfare" and residency/school requirements for teen parents see MGH Community News November 1997 and
January 1998. All are available to social service staff on the "Staff Access" section of our webpage).
APPLICATION PROCESS- EAEDC and TAFDC
DTA is required to make a decision within 30 days of receipt of the completed application (this means all verifications have been submitted). If they pass this deadline they
are required to issue benefits while reviewing. Note, the regulations actually say they are to process applications as soon as possible, but no later than 30 days. So in
emergent cases one could try to advocate for it to be processed more quickly.
Benefits are retroactive to the date of application.
Why would one need to establish disability?
For EAEDC disability determination is used to establish categorical eligibility.
For TAFDC disability determination is used in determining if a two-parent family is eligible, or whether participants are exempt from time limits and work requirements.
EAEDC- The condition has lasted, or is expected to last, 60 days.
Applicants can receive benefits during the lengthy disability determination period IF the application is accompanied by a completed EAEDC Medical Report Form,
signed by a physician. These important forms are available on the Resource Wall on FH2 or from the CRC by request.
Applicants are considered disabled during the disability determination period, but only during the first application. This means that during application one's
"time-clock" and work requirements halt. But if one is denied, then on subsequent applications one's time-clock keeps running in what may be a months long process.
More on this later.
To meet the disability threshold one must either:
DTA contracts with the University of Massachusetts Disability Evaluation Services (DES) for disability determinations. DES is required to contact all of the medical providers listed
on the application as having pertinent medical information. If MDs do not respond DES may assume they have no relevant information. DES will then set up their own "consultative medical
examination" and will send a notice to the applicant to appear at a specified appointment time. Unfortunately, while the notice informs the applicant that if she does not make this
appointment (or provide notification that she cannot) that she will be denied, it does not specify that this notification must be to DES, not the MD's office. One frequent cause of missed
appointments, lack of transportation, can also be remedied. Transportation is available through DES, but this too does not appear on the notice.
MISCELLANEOUS QUESTIONS FROM THE AUDIENCE
Recipients of both EAEDC and TAFDC are automatically eligible for Food Stamps and MassHealth.
TAFDC recipients who are working are eligible for child care vouchers for up to a year after they leave TAFDC.
TAFDC recipients are also eligible for Employment Services programs.
Recipients of both programs are eligible for a one-time relocation benefit of up to $750 in payments to vendors if they are living in a homeless or battered women's shelter and moving
into permanent housing.
EAEDC requires one to apply if the disability is expected to last for a year. Frequently people apply for EAEDC while waiting for SSI approval. If SSI denies benefits, EAEDC benefits
would continue (SSI has a stricter definition of disability). If approved for SSI the EAEDC benefits would terminate, as SSI benefits are greater, and part of the retroactive payment
would go to DTA as repayment of EAEDC benefits.
TAFDC cannot require an SSI application. Though it is a good idea to apply. SSI benefits are greater and do not count against the income limits for the rest of the family to qualify
for TAFDC. This can translate into a huge improvement in income. TAFDC recipients who are approved for SSI do not need to repay DTA for any benefits received.
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