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Combined Manual


ISSUE DATE: 01/2014
Revision #8

Before people can receive any assistance benefits, they (or their authorized representative) must complete an application and meet eligibility requirements. See 0005.06 (Authorized Representatives), 0005.12.03 (What Is a Complete Application).

"Application" refers to the Combined Application Form (CAF) or ApplyMN application. See 0002.03 (Glossary: Agent Orange...) for the definition of application. Also see 0005.09 (Combined Application Form (CAF)), 0005.09.03 (When People Must Complete an Application), 0005.09.09 (When to Use an Addendum to an Application).

"Applicant household" means people who apply for assistance together. "Assistance unit" or "unit" means people who receive benefits together. People who apply as the applicant household on an application may be in separate assistance units. If you find 2 or more assistance units living in the same applicant household, each unit may choose to file its own or a joint application.

Certain people must sign the application. See 0005.12.06 (Who Must Sign Applications).

In some cases you cannot require an application but can require an addendum. See 0005.09.06 (When Not to Require Completion of an Application), 0005.09.09 (When to Use an Addendum to an Application).

Counties must have staff available during office hours to answer program questions and advise people of their right to file an application. See 0005.03 (Assistance Requests).

At client request, counties may evaluate a person’s circumstances (before he or she files an application) and predict eligibility. See 0005.03.03 (Predicting Eligibility).

Encourage people to apply for assistance in their county of residence. However, you must accept applications from residents of other Minnesota counties. Follow the instructions in 0005.12 (Accepting and Processing Applications) for handling applications from residents of other counties. Also see 0005.12.09 (Date of Application), 0006 (Determining Financial Responsibility).

The application process includes the following steps:

A person contacts the county agency.

The county agency advises the person of his or her right to file an application, tells the person how and where to apply, and, if necessary, assists the person with the application.

The county agency provides information on the kinds of assistance available, and other community resources which may be available. See 0005.03.03 (Predicting Eligibility).

A person files an application. The application process begins with the completion of page number 1 of the Combined Application Form (CAF) containing the name, address and signature of the applicant or the submittal of an ApplyMN application.

The county agency evaluates the application for emergency need and expedited service. See 0004 (Emergencies), 0005.09.15 (Emergency Assistance and Applications).

The county agency conducts an interview. See 0005.12.12 (Application Interviews), 0005.12.12.03 (Waiving In-Office Interviews).

The applicant provides verifications. See 0010 (Verification).

The county agency determines eligibility and the beginning date of eligibility.

The county agency notifies the applicant of eligibility or ineligibility. See 0026 (Notices).

For specific information on the date of application for a CAF or ApplyMN application, see 0005.12.09 (Date of Application)

People must meet program eligibility requirements within the application processing period. If the unit is not eligible by the end of the processing period, deny the application. See 0005.12.15 (Application Processing Standards), 0022.03.03 (Ineligibility in a Prospective Month - Cash), 0022.03.04 (Ineligibility in a Prospective Month - SNAP), 0022.18 (Suspensions), 0026.15 (Notice of Denial, Termination, or Suspension).

You must complete the application process within designated time frames. See 0005.12.15 (Application Processing Standards). Under certain situations, delays in application processing may occur. See 0005.12.15.03 (Delays in Processing Applications), 0005.12.15.06 (Determining Who Caused the Delay), 0005.12.15.09 (Delays Caused by the Applicant Household), 0005.12.15.12 (Delays Caused by the Agency), 0005.12.15.15 (Delays Caused by the Agency and Applicant).

People may withdraw an application for assistance either orally or in writing any time before you act on it. See 0005.12.18 (Withdrawing an Application). People may also rescind the withdrawal and have the application reinstated if they meet certain requirements. See 0005.12.21 (Reinstating a Withdrawn Application). For notice requirements, see 0026 (Notices).

Counties must use forms developed by DHS for the purposes of informing and advising clients about their rights and responsibilities, the status of an application or recertification, and ongoing eligibility for assistance. If DHS does not provide a form for a given purpose, the county agency may develop its own form; however, the form must meet the requirements in TEMP Manual TE12.02.01 (County Designed Forms).

Some applicants must apply for other potential benefits, such as Unemployment Insurance, Social Security benefits or Workers’ Compensation. Inform the applicants that assistance may be denied for failure to apply for appropriate benefits. See 0012.12 (Applying for Other Benefits).


The county agency must provide an orientation to MFIP. See 0005.12.12.06 (Orientation to Financial Services).


No provisions. See 0005.10 (Minnesota Transition Application Form (MTAF)).


Follow general provisions but in addition, when the county agency receives an application from a family for assistance under DWP, you must determine if the applicant may be eligible for other benefits. To assist the county in determining whether the family is eligible for DWP or should have eligibility determined for MFIP, the DWP/MFIP Screening Questions (DHS-4026) is available. This form is optional and can be used as part of the application packet or when a completed application is received by the county agency.

At the initial screening, explain to the applicant that modifications to the Employment Plan can be made if the participant is a victim of family violence.

Inform the applicant that timely processing of DWP applications is critical to the success of the program. Inform the applicant that any delay in submitting the application will reduce the benefits paid for the month of application. Also inform applicants that an application may be submitted before they have an interview appointment.

Discuss with the applicant the benefits/drawbacks of withdrawing the application until the 1st of the next month so that the family can receive 4 full months of DWP benefits, if a family applies for DWP during the last few days of the month. If the family decides to withdraw the application for the current month, obtain a written statement from the applicant stating that the application is being withdrawn for the current month, but the family wants cash benefits determined on the 1st of the next month. Do NOT require a new application. Do not delay an application for SNAP. If it appears that the applicant needs Child Care Assistance and has not completed a Minnesota Child Care Assistance Program Application (DHS-3550) or requested Child Care Assistance through an ApplyMN application, explain the advantages of completing an application for Child Care Assistance before the end of the interview.

Follow the MFIP notice requirements when issuing a notice confirming the withdrawal. See 0026 (Notices).


Combined Application Forms (CAF) are also available at Social Security Administration offices. Clients may submit a CAF at the Social Security Administration.


Follow general provisions.

© 2018 Minnesota Department of Human Services
Updated: 1/2/14 6:16 AM