89 Ill. Adm. Code 10.410
Application for Assistance
Section 10
Section 10.410 Application
for Assistance
a) An application is a request for cash, medical or SNAP
assistance on a Department of Human Services (Department) form or a DHS web
application submitted electronically that has been completed to the best of the
client's knowledge and ability.
b) The application must contain a name, address, and signature
(or signatures).
1) The
Department's application for assistance captures the electronic signature on a
secure directory and places the electronic signature into a secure database.
2) An
electronic signature may be made by an applicant who checks a box and types his
or her name; by an applicant who telephonically records his or her voice,
constituting a telephonic signature; by an applicant who verbally assents by
telephone, constituting a telephonic signature; or by any other symbol that is
executed or adopted, using electronic means, by the applicant with the intent to
authenticate the record. The option for an applicant to verbally assent by
telephone, constituting a telephonic signature, will end upon the expiration of
the COVID-19 Gubernatorial Disaster Proclamations or the expiration of the
federal waiver permitting that option, whichever occurs first.
3) The
application, which includes the electronic signature, is sent to a secure
database with auditing capabilities that track the user when the application is
modified to ensure the integrity, security and confidentiality of the
electronic signature. This requirement does not apply to applications to which
an applicant verbally assents by telephone.
c) If
the application does not contain a name, address, and signature (or
signatures), the local office shall return the application to the sender to
obtain the missing information.
1) If a person is homeless, he or she may use the address of a
friend or relative, supervised shelter, church, halfway house, or similar
facility.
2) If a person is homeless and does not have a permanent address,
he or she may use the address of the local office where he or she applied or where
his or her case is currently active.
d) The application must be signed by the applicant with the
following exceptions:
1) When a conservator has been appointed for the applicant, the
conservator must sign the application.
2) When the applicant is physically or mentally unable to sign
the application, the application may be signed by someone acting responsibly on
behalf of the applicant.
3) When application is made on behalf of a child, the child's
caretaker must sign the application.
4) When the applicant has appointed an authorized representative
with the Department. (An authorized representative is a person authorized by
the applicant to act on his or her behalf.)
e) Application for medical assistance may be made on behalf of a
deceased person. In order for payment to be made by the Department for the
funeral and burial expenses of the decedent, the completed application must be
received in the local office not more than 30 calendar days after the
individual's death, excluding the day on which death occurred, unless delay in
receipt of the form occurred through no fault of the individual applying.
f) The applicant may be assisted by the Department and by
individuals of the applicant's choice in completing the application.
g) The date of application shall be the date a completed application
is received by any local office, with the following exceptions:
1) For applications completed by pregnant women and children
under age 18 at a disproportionate share hospital or federally-qualified health
center, the date the application is signed by the applicant shall be the date
of application.
2) When an application is faxed to a local office or a web
application is submitted and received over the Internet after 5:00 P.M. on a
workday, or on a weekend or holiday, the application date is the next workday
following the date the application is received in the local office.