wf800 - NC DHHS Online Publications
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1. D Approvals The date screen may be corrected or updated the same day or a later day after the DSS 8125 is keyed for the approval as long as the DSS 8125 has not processed overnight 1 Re enter the DSS 8125 and press PF4 to put the DSS 8125 on hold 2 Re enter the date screen and key the updates 3 Re enter the DSS 8125 and press ENTER to remove from hold status E Deletion of the Date Screen The EIS 8124 Date Screen can be deleted by pressing PF1 Press ENTER a second time or press the PF key as indicated by the message displayed at the bottom of the screen r2. APPL DATE P DISPOSITION TYPE DATE REASON NOTICE JOBS WORK SAVINGS R DISPOSITION TYPE DATE REASON NOTICE APPLICANT SIGNATURE CASEWORKER SIGNATURE IF AN INCORRECT INDIV ID IS ENTERED RE ENTER ID AND PRESS PF6 ELSE RECORD NECESSARY INFO AND PRESS ENTER TO UPDATE DATA BASE After all exceptions are resolved and the data has been sent to SSA SSA updates the Z field with response codes A B C or D EJ A003 EIS FORM 8124 FORM ID 0000000 G TYPE APP WORKER CO NO CO CASE DIST Al ADMIN TRANS CASE ID FOOD STP A2 INDS ON APP HOW APP RECEIVED BD FAMPLAN CITY ST ZIP AID PGM CAT Qol HLTH CH C HPAYE DIS DETONG RETRO LN INDIVID CRQD INDIVIDUAL NAME SUF BIRTH SEX SSN CLM Z Ol xxxxxxxxx A 02 Xxxxxxxxx B 03 XXxXxxxxxx C 04 xxxxxxxxx D APPL DATE P DISPOSITION TYPE DATE REASON NOTICE JOBS WORK SAVINGS R DISPOSITION TYPE DATE REASON NOTICE APPLICANT SIGNATURE CASEWORKER SIGNATURE IF AN INCORRECT INDIV ID IS ENTERED RE ENTER ID AND PRESS PF6 ELSE RECORD NECESSARY INFO AND PRESS ENTER TO UPDATE DATA BASE SSA Response Values SSA Code Description Response Code A SSN is verified there is no indication of death and the allegation of citizenship is consistent with SSA data B SSN is verified there is no indication of death and the allegation of citizenship is NOT consistent with SSA data C SSN is verified there is indication of death and the allegation of citizenship is consi
3. codes do not trigger an automated notice as a more specific explanation of the withdrawal is required The codes which require manually issued notices are identified in the codes section of the manual The codes which require manually issued notices are identified in the codes section of the manual NOTE To ensure the applicant is notified in a timely manner the user must issue a Manual DSS 8109 for any denial that has been overridden or if a code is used which requires a manual notice 2 Enter Y in Notice Override on the DSS 8109 to prevent the issuance of an automated withdrawal notice When the user requests an override the user must manually issue the withdrawal notice WF800 06 DATE SCREEN If a Work First application is pending due to Citizenship Identity documentation you may use the Date Screen to exclude days from the processing time You may not use the Date Screen for an application that contains an application type 3 or if the application is an Administrative application 7 Change 1 2012 WORK FIRST USER S MANUAL A To Access Date Screen DSS 8124 SCREEN INSTRUCTIONS June 1 2012 The Date Screen is for pending applications You cannot key changes or additional information once the application has been disposed of EXBO04 FUNCTION NEW APPLICATION REAPPLICATION AGAINST A REAPPLICATION AGAINST A APPLICATION PROCESS MENU CASE DENIED WITHDRAWN APPLICATIO
4. individual should not have been included on the application you cannot remove the individual from the DSS 8124 At approval disposition enter the application date in the individual termination date field of the DSS 8125 See WF1100 02 DSS 8125 General Information DENYING AN APPLICATION Deny all applications using the DSS 81241I Application Turnaround with the exception of an application being denied at the same time it is being entered into EIS For applications being denied at the time of entry use the original DSS 8124 9 Check the denial block in the TYPE field Enter a Disposition Date This is the date all factors have been verified that the applicant is ineligible This cannot be a future date Enter a denial code in the REASON field See WF700 for the appropriate denial code If the user wants an automated notice generated no entry is required in the Notice Override field gt WORK FIRST USER S MANUAL Change 1 2012 DSS 8124 SCREEN INSTRUCTIONS June 1 2012 e If the user does not want an automated notice enter a Y in the Notice Override field In the Signature and Date field sign the application turnaround in the Caseworker s Signature field The county director or his designee must sign and date the form in the Director s Signature and Date field B Disposition Date Disposition dates may remain the same may be changed to the date the DSS 8124 is keyed or may be changed to the next workd
5. 2006 The Disposition Date remains 03062006 2 The Disposition Date is changed to the NEXT WORKDAY when the notice indicator is Blank Example The DSS 8124 is keyed on 03112006 The Disposition Date on the DSS 8124 is 03062006 The Disposition Date is changed to 03122006 C Outputs 1 A DSS 8124l Application Turnaround is produced and forwarded to the county the next workday It shows the denial information for the application The denial is reported on the Caseworker Supervisor Report The number of denials completed is determined from the Worker Number D Notices 1 The Dss 8109A Notice of Denial or Withdrawal of Public Assistance is a system generated notice Unless an override is requested the automated notice is mailed directly to the applicant The Denial Reason Code entered on the DSS 8124 determines the text of the notice The system calculates the 60th calendar day for the notice The date of the automated notice is the next state workday after the DSS 8124 processes This is the date the notice is mailed to the recipient A copy of the notice is not mailed to the county A Notice Register Report is produced each night and is mailed to the county the following workday This report lists vital information E System Generated DSS 8109A 1 The format is designed for a two window envelope The applicant s address is printed on the right with the county DSS s address printed in the upper le
6. 24 is 0302006 The Disposition Date is changed to 03072006 2 The Disposition Date on the DSS 8124 is any month prior to the previous calendar month EIS does not allow a date to be any month prior to the previous calendar month 3 The Disposition Date on the DSS 8124 is after the first five workdays of the month a The Disposition Date on the DSS 8124 is the previous month 1 The Disposition Date keyed on the DSS 8124 is changed to the date the DSS 8124 is keyed when the notice indicator is Y Example The DSS 8124 is keyed on 03112006 The Disposition Date on the DSS 8124 is 02282006 The Disposition Date is changed to 03112006 The Disposition Date keyed on the DSS 8124 is changed to the NEXT WORKDAY when the notice indicator is Blank Example The DSS 8124 is keyed on 03112006 The Disposition Date on the DSS 8124 is 02282006 The Disposition Date is changed to 03122006 The Disposition Date on the DSS 8124 is any month prior to the previous calendar month EIS does not allow a date to be any month prior to the previous calendar month The Disposition Date on the DSS 8124 is the current calendar month 1 The Disposition Date is the Disposition Date keyed on the DSS 8124 when the notice indicator is Y 1 Change 1 2012 WORK FIRST USER S MANUAL DSS 8124 SCREEN INSTRUCTIONS June 1 2012 Example The DSS 8124 is keyed on 03112006 The Disposition Date on the DSS 8124 is 0306
7. 4 is 02282006 The Disposition Date is changed to 03112006 The Disposition Date on the DSS 8124 is any month prior to the previous month EIS does not allow a date to be any month prior to the previous calendar month The Disposition Date on the DSS 8124 is the current calendar month 1 The Disposition Date is the Disposition Date keyed on the DSS 8124 when the notice indicator is Y Change 1 2012 WORK FIRST USER S MANUAL DSS 8124 SCREEN INSTRUCTIONS June 1 2012 Example The DSS 8124 is keyed on 03112006 The Disposition Date on the DSS 8124 is 03062006 The Disposition Date remains 03062006 2 The Disposition Date is the Disposition Date keyed on the DSS 8124 when the notice indicator is Blank Example The DSS 8124 is keyed on 03112006 The Disposition Date on the DSS 8124 is 03062006 The Disposition Date remains 03062006 C Outputs 1 A DSS 81241 Application Turnaround is produced and forwarded to the county the next workday It shows the withdrawal information for the application The withdrawal is reported on the Caseworker Supervisor Report The number of withdrawals completed is determined from the Worker Number D Notices 1 The DSS 8109A Notice of Denial or Withdrawal of Public Assistance is a system generated notice Unless an override is requested the automated notice is mailed directly to the applicant The Withdrawal Reason Code entered on the DSS 8124 determ
8. N RE DISPLAY A PENDING APPLICATION ADD INDIVIDUAL TO A CASE ADD INDIVIDUAL TO AN APPLICATION GO TO 8124 DATE SCREEN FORM ID ENTER KEY APPLICATION TYPE 1 OR 4OR 7 APPLICATION TYPE 2 OR 5 CASE ID AID PROG CAT APPLICATION TYPE 2 OR 5 FORM ID AID PROG CAT RE ENTRY Y FORM ID APPLICATION TYPE 3 OR 6 CASE ID APPLICATION TYPE 6 FORM ID RETRO ONGOING IND CO NUM PF1 13 8125 PROCESS PF2 14 INQUIRY MENU PF3 15 DATA ENTRY PF4 16 PUT APP ON HOLD REDISPLAY 8124 SCREEN PF5 17 REDISPLAY THIS SCREEN 1 From the Application Process Menu use selection GO TO 8124 DATE SCREEN key the application number of the pending application with the G suffix in the FORM ID field 2 Key O in the RETRO ONGOING IND field 3 Key the COUNTY NUMBER 4 Press ENTER The Date Screen displays 18 WORK FIRST USER S MANUAL MED MED BILL DDS DIS DET EMG EMG FOR ALIENS FL2 FL2 MR2 CAP CAP CID CITIZEN IDENTITY EXCL REASON CODE BEG DTE END DTE STATE COUNTY APPEAL REVERSAL DTE NEW INFO REQUESTED RECEIVED RSDI OR SSI APPEAL REVERSAL SSI APPL INCORRECT DENIAL IMPROPER DISCOURAGEMENT DENIAL WITHDRAWAL FOUND BY MONITOR CORRECTIVE ACTION DTE OF INIT DISC ORIG DTE OF APPL ORIG DTE OF DISP ORIG EXCL RSN CDE ORIG BEG DTE ORIG END DTE PF1 PF13 DELETE RECORD PF2 PF14 INQUIRY MENU PF3 PF15 APP PROCESS MENU ONGOING RECORD EXISTING Change 1 2012 DSS 8124 SCREEN INSTRUCTIO
9. NS June 1 2012 EXB946 EIS 8124 DATE SCREEN APPL C286257G RETRO ONGOING Y COUNTYNO 26 CASE ID APPLICANT NAME SSN DDS REQUIRED DATE CREATED 09 01 2006 LAST UPDATED 09 01 2006 EXCLUSIONS REOPENS B Completing the Date Screen The application number Ongoing Indicator Y County Number Case ID number Applicant Name and SSN Date Created and Last Updated are all displayed and cannot be changed The application data displayed is based on information from the application number that was entered Days are excluded from the application processing deadline based on the Begin and End Dates from the Date Screen 1 Enter CID in the EXCL REASON CODE field 2 Enter the Begin Date in the BEG DTE field 3 Enter the End Date in the END DTE field once citizenship identity documentation has been provided 4 Press ENTER NOTE You must press ENTER to register the Date Screen If you press PF2 or PF3 prior to pressing ENTER the information on the Date Screen is not registered WORK FIRST USER S MANUAL Change 1 2012 DSS 8124 SCREEN INSTRUCTIONS June 1 2012 C Denials Withdrawals The Date Screen may be corrected or updated the same day a denial withdrawal of an application is keyed 1 Re enter the DSS 8124 and delete the denial withdrawal information Press PF4 to place the 8124 in hold status 2 Re enter the date screen and key the updates 3 Re enter the DSS 8124 to process the denial withdrawal
10. T ONG RETRO LN INDIVID Z D LN INDIV ID ZD LN INDIVID Z D 01 xxxxxxxxx YY 02 XXXXXXXXX NN 03 xxxxxxxxx X N APPL DATE P DISPOSITION TYPE DATE REASON NOTICE JOBS WORK SAVINGS R DISPOSITION TYPE DATE REASON NOTICE APPLICANT SIGNATURE CASEWORKER SIGNATURE ENTER THE REQUIRED INFORMATION ON THIS SCREEN AND PRESS ENTER TO REGISTER THIS APPLICATION On this screen the FORM ID is system generated and TYPE APP is brought forward from the previous screen Key the WORKER CO NO CO CASE and DIST fields The CASE ID number is system generated A A new one digit field is displayed CTZ Citizenship The worker must enter an X N or Y in this field to document citizenship for each individual listed on the DSS 8124 There must be an entry for each individual listed on the DSS 8124 CTZ Citizenship Values 1 y Individual is applying for assistance and states he is a U S Citizen WORK FIRST USER S MANUAL Change 2 2012 DSS 8124 SCREEN INSTRUCTIONS November 1 2012 2 N Individual is applying for assistance and states he is not a U S Citizen 3 X Casehead is not applying for benefits or individual who states he is a U S Citizen and does not have a social security number NOTE Every individual entered on this screen must be assigned an Individual ID prior to keying If an individual has ever been assigned an individual ID do not assign a new Individual ID Individual ID num
11. WORK FIRST USER S MANUAL Change 2 2012 DSS 8124 SCREEN INSTRUCTIONS November 1 2012 WF800 DSS 8124 SCREEN INSTRUCTIONS Change 2 2012 November 1 2012 The EIS FORM 8124 screen is used to key new applications reapplications add individuals to an application inclusions to a case administrative applications Benefit Diversion applications and Transitional Benefits applications The EIS DSS 8124 screen is also used to change or correct an existing application or to deny or withdraw an application WF800 01 ACCESSING THE DSS 8124 PROCESS From the EIS Update Menu key 7 in the SELECTION field The Application Process Menu appears APPLICATION PROCESS MENU FUNCTION ENTER KEY NEW APPLICATION APPLICATION TYPE 1 OR 4 OR 7 OR 8 REAPPLICATION AGAINST A CASE APPLICATION TYPE 2 OR 5 OR 9 CASE ID AID PROG CAT REAPPLICATION AGAINST A DENIED APPLICATION TYPE 2 OR 5 WITHDRAWN APPLICATION FORM ID AID PROG CAT RE DISPLAY A PENDING APPLICATION RE ENTRY FORM ID ADD INDIVIDUAL TO A CASE APPLICATION TYPE 3 OR 6 CASE ID ADD INDIVIDUAL TO AN APPLICATION APPLICATION TYPE 6 FORM ID GO TO 8124 DATE SCREEN FORM ID RETRO ONGOING IND CO NUM PF 13 8125 PROCESS PF2 14 INQUIRY MENU PF3 15 DATA ENTRY PF4 16 PUT APP ON HOLD REDISPLAY 8124 SCREEN PF5 17 REDISPLAY THIS SCREEN WF800 02 KEYING AN APPLICATION REAPPLICATION A New Application An application is a new application when the case does not exist in EIS in t
12. abase to determine if citizenship can be verified If citizenship is verified EIS automatically changes the Y to a V These codes may be changed as long as the application is pending If the case is SCD MRF or RRF EIS automatically enters a N in the field Change 2 2012 WORK FIRST USER S MANUAL DSS 8124 SCREEN INSTRUCTIONS November 1 2012 Z Citizenship Values a Y Individual is applying for assistance and states he is a U S Citizen b N Individual is applying for assistance and states he is not a U S Citizen C X Casehead not applying for benefits or individual who states he is a U S Citizen and does not have a social security number d V Verified Citizenship has been verified NOTE EIS will no longer display the middle initial on the DSS 8124 The middle initial will continue to be linked to that individual in EIS as long as it was keyed under the Name SSN Individual ID Assignment function 2 SSA Response If citizenship is not verified EIS sends the data for each individual who states he is an U S citizen and has a SSN to be matched with SSA SSA sends a response and the Z field on the DSS 8124 is updated based on SSA responses The DSS 8124 must be redisplayed to view the SSA response codes For all applicants with a Y in the CTZ field on the DSS 8124 EIS changes the indicator on the DSS 8124 from Y to S Sent w
13. ay depending on when the form is keyed and whether the notice indicator is Blank or Y 1 The DSS 8124 is keyed within the first five workdays of the month a The Disposition Date on the DSS 8124 is the previous month 1 The Disposition Date is the Disposition Date keyed when the notice indicator is Y Example The DSS 8124 is keyed on 03062006 The Disposition Date keyed is 02282006 The Disposition Date remains 02282006 The Disposition Date keyed is changed to the NEXT WORKDAY when the notice indicator is Blank Example The DSS 8124 is keyed on 03062006 The Disposition Date keyed is 02282006 The Disposition Date is changed to 03072006 The Disposition Date on the DSS 8124 is any month prior to the previous calendar month EIS does not allow a date to be any month prior to the previous calendar month The Disposition Date on the DSS 8124 is the current calendar month 1 The Disposition Date is the Disposition Date keyed on the DSS 8124 when the notice indicator is Y Example The DSS 8124 is keyed on 03062006 The Disposition Date on the DSS 8124 is 03032006 The Disposition Date remains 03032006 7 WORK FIRST USER S MANUAL DSS 8124 SCREEN INSTRUCTIONS June 1 2012 Change 1 2012 2 The Disposition Date keyed is changed to the NEXT WORKDAY when the notice indicator is Blank Example The DSS 8124 is keyed on 03062006 The Disposition Date on the DSS 81
14. bers are assigned in the Name SSN Individual ID Assignment function See EIS Inquiries B A new one digit field is displayed D Disabled The worker must enter a Y or N in this field for each individual age 18 or older on the DSS 8124 This is only applicable for all AAF applications This field is not required to be keyed on individuals under age 18 on the DSS 8124 D Disabled Values 1 Y Individual age 18 or older states he she is disabled 2 N Individual age 18 or older states he she is not disabled E After keying the family s information on the DSS 8124 Press ENTER The following screen is displayed EJA003 EIS FORM 8124 FORM ID 0000000 G TYPE APP WORKER CO NO CO CASE DIST Al ADMIN TRANS CASE ID FOOD STP A2 INDS ON APP HOW APP RECEIVED BD FAM PLAN CITY ST ZIP A P C QO1 HLTH CH C H PAYE DIS DETONG RETRO LN INDIVID ZC RQD INDIVIDUAL NAME SUF BIRTH SEX SSN CLM 01 XXXXXxxxxx Y y 02 XXXxxXxxxx N N 03 XXXXXXXXX X N 04 xXXxxxxxxx V N APPL DATE P DISPOSITION TYPE DATE REASON NOTICE JOBS WORK SAVINGS R DISPOSITION TYPE DATE REASON NOTICE APPLICANT SIGNATURE CASEWORKER SIGNATURE IF AN INCORRECT INDIV ID IS ENTERED RE ENTER ID AND PRESS PF6 ELSE RECORD NECESSARY INFO AND PRESS ENTER TO UPDATE DATA BASE 1 Z Citizenship EIS automatically updates this field based on the entry keyed in the CTZ field for each individual on the previous screen EIS searches the dat
15. ft corner of the notice WORK FIRST USER S MANUAL Change 1 2012 DSS 8124 SCREEN INSTRUCTIONS June 1 2012 2 The system prints the information for the DSS 8109A based on the data entered on the DSS 8124 and keyed in EIS The printed information includes Date Mailed Worker Number County DSS s Phone Number County Case Number Case ID Date of Application Aid Program Category Applicant Name and Address The system indicates the application is denied and prints the reason for the denial The reason text printed on the notice is the same as the text in the denial codes table Refer to WF700 for the appropriate denial code The appropriate policy manual reference number is also indicated as well as the 60th day from the date of the notice F The Manually Issued DSS 8109 1 Certain denial codes do not trigger an automated notice as a more specific explanation of the denial is required The codes which require manually issued notices are identified in WF700 NOTE To ensure the applicant is notified in a timely manner the user must issue a Manual DSS 8109 for any denial that has been overridden or if a code is used which requires a manual notice 2 Enter Y in Notice Override on the DSS 8109 to prevent the issuance of an automated denial notice When the user requests an override the user must manually issue the denial notice WF800 05 WITHDRAWING APPLICATIONS APPLICATION TYPES 1 2 3 AND 6 Use the follow
16. he same or a related program Type 1 Key application type 1 for families with no previous history in EIS New applications for A AF R RF and SA can only be for the month of application forward However the applicant may be eligible for up to three consecutive months of Medicaid prior to the month of application if applicable according to policy requirements during those months Change 3 2006 B WORK FIRST USER S MANUAL DSS 8124 SCREEN INSTRUCTIONS September 1 2006 Reapplication An application is a reapplication when The case exists in EIS but has been terminated The case is active and an application is made for an aid program category that requires reapplication rather than transfer The case was previously withdrawn or denied in the same or related aid program category NOTE A reapplication must have at least one individual from the old case If there exists in EIS both a previously withdrawn or denied application and a terminated case in the same or a related program reapplication is made against the terminated To key a reapplication enter a Type 2 for A AF R RF and SA A reapplication can only be for the month of application forward However the applicant may be eligible for up to three consecutive months of Medicaid if applicable according to policy requirements during those months Add An Individual Applications is Application Type 3 An administrative add an individual application to add
17. hen the information is sent to SSA for verification of citizenship and identity EJA003 EIS FORM 8124 FORM ID 0000000 G TYPE APP WORKER CO NO CO CASE DIST Al ADMIN TRANS CASE ID FOOD STP A2 INDS ON APP HOW APP RECEIVED BD FAM PLAN CITY ST ZIP AID PGM CAT Q01 HLTH CH C H PAYE DIS DET ONG RETRO LN INDIVID ZCRQ D INDIVIDUAL NAME SUF BIRTH SEX SSN CLM 01 XXxXXxxxxx S APPL DATE P DISPOSITION TYPE DATE REASON NOTICE JOBS WORK SAVINGS R DISPOSITION TYPE DATE REASON NOTICE APPLICANT SIGNATURE CASEWORKER SIGNATURE IF AN INCORRECT INDIV ID IS ENTERED RE ENTER ID AND PRESS PF6 ELSE RECORD NECESSARY INFO AND PRESS ENTER TO UPDATE DATA BASE Some queries may be returned due to exceptions in the data such as Name Date of Birth or SSN not matching the SSA data If SSA finds an exception EIS changes the indicator from S Sent to E Exception Follow up is required by the caseworker The citizenship match data is not resent to SSA until the exception is resolved and the caseworker has changed the indicator from E to ab WORK FIRST USER S MANUAL Change 2 2012 DSS 8124 SCREEN INSTRUCTIONS November 1 2012 EJA003 EIS FORM 8124 FORM ID 0000000 G TYPE APP WORKER CO NO CO CASE DIST Al ADMIN TRANS CASE ID FOOD STP A2 INDS ON APP HOW APPRECEIVED BD FAMPLAN CITY ST ZIP AID PGM CAT QOI HLTHCH C HPAYE DIS DETONG RETRO LN INDIVID Z C RQ D INDIVIDUAL NAME SUF BIRTH SEX SSN CLM 01 xxxxxxxxx E
18. ines the text of the notice The system calculates the 60 calendar day for the notice The date of the automated notice is the next state workday after the DSS 8124 processes This is the date the notice is mailed to the recipient A copy of the notice is not mailed to the county A Notice Register Report is produced each night and is mailed to the county the following workday This report lists vital information E System Generated DSS 8109A 1 The format is designed for a two window envelope The applicant s address is printed on the right with the county DSS s address printed in the upper left corner of the notice 7 WORK FIRST USER S MANUAL Change 1 2012 DSS 8124 SCREEN INSTRUCTIONS June 1 2012 2 The system prints the information for the DSS 8109A based on the data entered on the DSS 8124 and keyed in EIS The printed information includes Date Mailed Worker Number County DSS s Phone Number County Case Number Case ID Date of Application Aid Program Category Applicant Name and Address 3 The system indicates the application is withdrawn and prints the reason for the withdrawal The reason text printed on the notice is the same as the text in the denial codes table Refer to the Codes section for the appropriate withdrawal code The appropriate policy manual reference number is also indicated as well as the 60th day from the date of the notice F The Manually Issued DSS 8109 1 Certain withdrawal
19. ing instructions to withdraw an application A Applications 1 Complete entries in the DISPOSITION fields 2 Check the withdrawal block in the TYPE field Change 1 2012 WORK FIRST USER S MANUAL DSS 8124 SCREEN INSTRUCTIONS June 1 2012 3 Enter the DISPOSITION DATE This is the date the applicant requests withdrawal of the application This cannot be a future date 4 Enter a withdrawal code in the REASON field See WF700 for the appropriate withdrawal code B Disposition Date Disposition dates may remain the same may be changed to the date the DSS 8124 is keyed or may be changed to the next workday depending on when the form is keyed and whether the notice indicator is Blank or Y 1 The DSS 8124 is keyed within the first five workdays of the month a The Disposition Date on the DSS 8124 is the previous month 1 The Disposition Date is the Disposition Date keyed when the notice indicator is Y Example The DSS 8124 is keyed on 03062006 The Disposition Date keyed is 02282006 The Disposition Date remains 02282006 The Disposition Date is the Disposition Date keyed when the notice indicator is Blank Example The DSS 8124 is keyed on 03062006 The Disposition Date keyed is 02282006 The Disposition Date remains 02282006 The Disposition Date on the DSS 8124 is any month prior to the previous calendar month EIS does not allow a date to be any month prior to the previou
20. or include an individual s who is not a member of an active case This application type is used only to a Add a Non standard Filing Unit Member s to AAF Add an Individual to RRF and SA S CD C Add a Standard Filing Unit Member s to a pending AAF application only Application Type 6 An Add an individual application is made to request assistance for an individual s who is not included in a pending application or an active case Use this application type to a Add a Non standard Filing Unit Member s to AAF b Add an Individual to RRF and SA SCD C Add a Standard Filing Unit Member s to a pending AAF application only WORK FIRST USER S MANUAL Change 2 2012 DSS 8124 SCREEN INSTRUCTIONS November 1 2012 When adding an individual to a pending application a second DSS 8124 is required In the Case ID field of the second DSS 8124 enter the application number and the G from the original pending application 3 For AAF R RF and SA an application can only be for the month of application forward However the applicant may be eligible for up to three consecutive months of Medicaid if applicable according to policy requirements during those months D The Process Menu produces the EIS FORM 8124 screen EJA003 EIS FORM 8124 FORM ID 0000000 G TYPE APP WORKER CO NO CO CASE DIST Al ADMIN TRANS CASE ID FOOD STP A2 INDS ON APP HOW APP RECEIVED BD FAM PLAN CITY ST ZIP A P C QI1 HLTH CH C H INCL DIS DE
21. r Number e CS e The Z Citizenship code e RS e The D Disabled code NOTE If the payee is not included in the case EIS may not have the correct CAP code For example EIS may calculate the individual to be a non cap individual when in fact the individual is a family cap individual If the individual should be a cap or cap exempt individual change the individual CAP code prior to application approval Changing the Caretaker 1 Deny the original application made by the previous caretaker WORK FIRST USER S MANUAL Change 1 2012 DSS 8124 SCREEN INSTRUCTIONS June 1 2012 WF800 04 A 2 Key an application for the new caretaker using the date the new caretaker requested assistance as the date of application Changing the Notice Override Indicator The notice override indicator may only be changed on the same day the denial or withdrawal of the application is keyed Correcting the Date Of Application If an application is keyed with the wrong date of application correct the date of application with the following instructions 1 Select RE ENTRY on the Application Process Menu 2 On the EIS FORM 8124 screen key Y in the ADMINISTRATIVE field 3 Select RE ENTRY for the same application on the Application Process Menu 4 Key a denial for the application See below 5 Key anew application with the correct application date Individual Should Not Be Included On Application If an
22. rom EPICS every time an 8124 is keyed DQ Values W Work First F Food Stamps B Both Work First and Food Stamps N None WORK FIRST USER S MANUAL Change 2 2012 DSS 8124 SCREEN INSTRUCTIONS November 1 2012 WF800 03 5 EIS displays Y Yes or N No for CLM Claim if there is a claim present in EPICS The form can be placed on hold and not processed by pressing the PF4 key or NOTE An application that has been placed on hold can be recalled from the Application Process Menu Press SCREEN PRINT before continuing from this screen This is the application the family is to sign Continue processing by pressing ENTER After the application is keyed the user is routed automatically to the automated Child Support Referral When an application is keyed a copy of the application information is generated on the DSS 81241I Application Turn Around Document MAKING CHANGES TO A KEYED APPLICATION From the Application Process Menu key Y in the RE ENTRY field and the application number including suffix of G of the pending application in the FORM ID field The application is displayed on the EIS FORM 8124 screen A The following are the only fields that can be changed on a pending application e Address e County Case Number e County Number e Food Stamp County Case No e District Number e Notice Override e Individual ID Number e C H Payee e Worke
23. s calendar month The Disposition Date on the DSS 8124 is the current calendar month 1 The Disposition Date is the Disposition Date keyed when the notice indicator is Y Example The DSS 8124 is keyed on 03062006 The Disposition Date on the DSS 8124 is 03032006 The Disposition Date remains 03032006 WORK FIRST USER S MANUAL DSS 8124 SCREEN INSTRUCTIONS June 1 2012 Change 1 2012 2 The Disposition date is the Disposition Date keyed when the notice indicator is Blank Example The DSS 8124 is keyed on 03062006 The Disposition Date on the DSS 8124 is 03032006 The Disposition Date remains 03032006 The Disposition Date on the DSS 8124 is any month prior to the previous calendar month EIS does not allow a date to be any month prior to the previous calendar month The Disposition Date on the DSS 8124 is after the first five workdays of the month a The Disposition Date on the DSS 8124 is the previous month 1 The Disposition Date keyed on the DSS 8124 is changed to the date the DSS 8124 is keyed when the notice indicator is Y Example The DSS 8124 is keyed on 03112006 The Disposition Date on the DSS 8124 is 02282006 The Disposition Date is changed to 03112006 The Disposition Date keyed on the DSS 8124 is changed to the date the DSS 8124 is keyed when the notice indicator is Blank Example The DSS 8124 is keyed on 03112006 The Disposition Date on the DSS 812
24. stent with SSA data D SSN is verified there is indication of death and the allegation of citizenship is NOT consistent with SSA data Change 1 2012 3 WORK FIRST USER S MANUAL DSS 8124 SCREEN INSTRUCTIONS June 1 2012 Two fields are displayed CS CAP and RS Reason EIS enters the value under CS and RS when appropriate for each child ren under 19 years old These two fields are not valid for any individual 19 years old or older CAP and Reason Values CAP Y Child subject to family cap N 1 Non family cap child when RS field is space 2 Child family cap exempt when a RS code is present Reason F Individual is excluded from family cap because of being the first child born to a minor O Individual is excluded from family cap because he is no longer with his parents or has been adopted S Individual is excluded from family cap because of rape sexual assault or incest T Individual is excluded from family cap because of custody legally transferred Valid CAP and Reason Change Combinations CAP Reason To CAP Reason Y Space N Exempt Code N Exempt Code Y Space N Space Y Space NOTE A warning message is displayed when changing from a Non cap individual CAP N and RS space to an individual subject to the family cap provision The following values are sent from EPICS to show whether a person has any disqualifications This data is not stored in EIS it is sent f
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