A-2310, Notice to Applicants

Revision 22-3; Effective July 1, 2022

All Programs

Eligibility Determination Group (EDG) disposition produces the person's notice of eligibility status. At the close of the interview or during processing of the application or renewal form, the EDG is pended, certified, sustained or denied. After disposition, provide one or more of the following notices, as applicable:

  • Form H1020, Request for Information or Action (PDF), tells the applicant the:
    • reason the case is pending;
    • action the applicant or staff must take;
    • date by which the applicant or staff must take action; and
    • date staff must deny the application or EDG if the person does not take action, if applicable.

      Note: For those who are Spanish-speaking only, ensure all comments provided are in Spanish. See Form H1020 instructions for translation of common pending phrases.

  • Form TF0001, Notice of Case Action
    • If benefits have been approved, the notice informs the person of:
      • the date benefits begin or Medicaid effective date;
      • the amount of benefits; and
      • the length of certification for Supplemental Nutrition Assistance Program (SNAP) EDGs.
    • If benefits have been denied, terminated or reduced, the notice informs the person:
      • the reason for the denied the application, denied EDG or reduced benefits;
      • that a protective payee is required for Temporary Assistance for Needy Families (TANF);
      • the effective date of the action;
      • the person's right to appeal;
      • the address and phone number of free legal services available in the area; and
      • that staff used a credit report, if its use resulted in fewer benefits than the person would have otherwise received.

If an application is denied because a person failed to keep an appointment or furnish information, inform the person through the notice what they must do to reuse the application.

Note: Eligibility for multiple programs is determined independently. Do not deny an application for one program based solely on the denial of another program unless the household fails to meet the eligibility requirements.

Related Policy 

Reuse of an Application Form After Denial, B-111
Denied for Missed Appointments, B-122.3.1
Denied for Failure to Provide Information/Verification, B-122.3.2