Revised July 25, 2014
Purpose: To explain what the agency considers when denying an application.
If the applicant provides only part of the information we need per the timelines in WAC 182-503-0060, take the following actions:
- Review the case to see if we can determine eligibility for each program based on what we have received; and
- Send the person one of the following letters advising of our reconsideration decision for each program:
- An approval letter if we can determine that the person is eligible;
- A denial letter if we determine the person is not eligible for the original reason or for a different reason.
Note: When partial information is submitted during a reconsideration period, do not pend for additional information. If the applicant is not eligible based on the information provided, the original denial still stands.
Example: We request verification of income and residency due by 5/15/14. This is not provided, and we send a denial letter on 5/20/14. Applicant then provides the residency and income verification on 5/30/04. This is within 30 days of the denial, and is sufficient to determine eligibility. We approve coverage from the appropriate date.
Example: Same as above, but the applicant provides only the income verification. This information shows the person to be over the program’s income standard. We send a new denial letter to the person advising of the change in denial reason.
Example: Same as above, but the applicant provides only the residency verification. We cannot determine eligibility without the income information. We send a letter to the person advising that we received the partial information, but the denial from 5/20/14 stands as we still do not have the income verification we require.