Eligibility Review

Effective: September 1, 2024

An eligibility review is an administrative process to determine the accuracy of information used to determine current and past eligibility. An eligibility review updates the information on a recipient’s case or contact. It includes examining and analyzing information on a recipient’s case and comparing it to information obtained from third-party checks and documents provided by the recipient, gathering additional information, recording outcomes, and if necessary, adjusting the amount of assistance and/or identifying, calculating, and recording overpayments. Recipients are notified of any changes or debts. 

Eligibility reviews are conducted according to the principles of administrative fairness to ensure the recipient is made aware of eligibility issues and has an opportunity to respond to identified issues. The ministry may determine whether the recipient is required to complete the review “in person” in the ministry office, over the telephone, or by the recipient completing the review form and submitting it to the ministry office.

Recipients are required to provide shelter, financial, identification, and any other required documents to verify their information and ensure that they continue to be financially eligible for assistance.

At each interview with a recipient, including an eligibility review, ministry staff should review all aspects of the recipient’s case, including their employment status, obligations, and progress (if applicable). 

See the Employment and Assistance/Employment and Assistance for Persons with Disabilities review (HR0080R) form here

A follow-up interview may be required to develop or review an employability plan activity. For more information, review employability plan.

Effective: December 1, 2003

The requirement to complete an eligibility review when requested is a condition of continued eligibility and is not appealable. A family unit ceases to be eligible for assistance if the recipient, and dependent spouse, where applicable, fail to attend the review when required or to complete a review form when requested

Effective: September 30, 2014

Eligibility reviews may be conducted annually, or for Persons with Disabilities and adults in special care facilities, every two years. In addition, eligibility reviews must be conducted when a spouse is added to a case. Eligibility reviews may also be conducted in other situations where ministry staff have questions about a recipient’s eligibility, such as when a person requests assistance after a two-month absence and their circumstances are not known.

Where a recipient’s prior eligibility for a period of more than three months is in question or fraud is suspected, assess current eligibility and complete a referral to Prevention and Loss Management Services (PLMS) for review of the other information.

Effective: September 24, 2014

At the eligibility review, documents and information provided by the recipient are to be verified for accuracy. This may require further documentation from the recipient or through third-party checks.

Third-party checks must not be run unless valid consent is on the case. If consent is on the case, they are run after the recipient submits documents, but prior to the interview. If consent is not on the case, they are run after the HR0080R is signed.

Mandatory third-party checks for all eligibility reviews are:

• BC Online – BC Assessment (address verification and name search)
• BC Online – Personal Property Registry
• Equifax Consumer Credit Report
• Insurance Corporation of BC (ICBC)
• Canada Revenue Agency (CRA) (only for recipients aged 19 and over)

Note: Some recipients may not have filed an income tax return for previous years. Filing an income tax return is not a condition of eligibility. However, recipients should be encouraged to file an income tax return annually in order to receive exempt tax credits and benefits, such as the family bonus, GST credit, B.C. low income climate action tax credit, B.C. sales tax credit, and working income tax benefit.

Other third-party checks that may be required, depending on circumstances, include (but are not limited to):

• WEB AOB link
• Warrant check
• MHR-EI common claimant report in the report to web folder

Effective: November 1, 2007

When the Eligibility Review is completed and the recipient has signed the Employment and Assistance Review Form (HR0080R), the recipient will be requested to complete the voluntary Aboriginal Self-Identifier form (HR3187), if one has not already been completed. Review the BCEA application – stage 1 for more information.

Effective: January 1, 2020

Recipients of medical services only (MSO) who are requesting income assistance, disability assistance or hardship assistance may apply for assistance as follows:

• If they have not received income assistance in any of the preceding six months, complete an application by using the eligibility review process and signing an HR0080R
• If they have received income assistance in any of the preceding six months, and their file is open, the ministry has discretion to use either the streamlined reapplication process, or where needed, the eligibility review process and signing an HR0080R

For more information, review BCEA streamlined application returning within six months

Recipients of MSO who left disability assistance due to employment income (exhausting their annual earnings exemption) may again be eligible for disability assistance at any time during the year if their financial circumstances change due to a loss of employment or a reduction in income or at the beginning of the new exemption year, as they may be eligible for assistance with a new annual earnings exemption limit.

For detailed information on verification review information and verification.

Note: Recipients who leave disability assistance because of employment income and become eligible for MSO can continue to submit their Monthly Report (HR0081) monthly to automatically re-establish eligibility for disability assistance when they become financially eligible. MSO recipients who do not continue to submit their HR0081 monthly will be required to complete a reapplication.

Each calendar year, annual earnings exemption (AEE) is reset and covers qualifying income received from January 1 to December 31, for March to February assistance months. January is the earliest month a PWD MSO recipient who has exhausted their AEE limit for the year can begin the reapplication process for disability assistance under the next year’s annual exemption limit, if the recipient did not submit an HR0081 each month.

If the MSO recipient (due to employment income) submitted the HR0081 monthly, disability assistance will be reinstated if or when the recipient becomes financially eligible. If the MSO recipient is found eligible for disability assistance, the recipient should be reminded of the choice between the transportation supplement (TS) as a bus pass or as a monthly payment of $52. The TS will default to the current form of transitional transportation support (TTS) the MSO recipient is receiving review transportation supplement. 

Effective: September 30, 2014

Eligibility review (ER) interviews may be completed in person or by telephone. ER tasks may be done by one worker or the tasks may be shared. For example, one person may send the initial letter, another person may review the documents and conduct the interview.

Cases may be selected for ER based on various factors, including but not limited to:

• Eligibility review lists
• Adding a spouse to the case
• MSO recipient returning to assistance
• Missing consent: An ER must be completed as soon as possible if there is no valid consent on the case
• Reports: Eligibility review overdue reports
• Information or an allegation is received that may affect current eligibility
• Any other situation that leads the worker to determine that an ER is needed

Prior to proceeding, ministry staff will review for PLMS involvement.

• If there is any type of active PLMS Review Service Request on the case, do not proceed with the review.
• If there is an active Incident – Investigation Fraud on a contact, the ER may continue, with the following points:
  • Address current eligibility only. Do not take action on any overpayment identified. Provide information related to a potential overpayment to the ministry investigator
  • Do not inform the recipient of PLMS involvement. PLMS will inform the recipient

To initiate the ER, ministry staff will:

• Conduct a brief overview of the case to identify any areas of concern
• Create and send the eligibility review documents: first request lLetter (HR3582) either by my self serve (MYSS) messaging or mail
• Allow the recipient 2-3 weeks (3-4 weeks for remote locations) to provide the documents

A general guideline is to allow 2-3 weeks for documents for persons who reside in urban/suburban areas, 3-4 weeks for persons who reside in rural areas. Ministry staff will adjust as needed to avoid having the document’s due date during cheque issue week.

• Exception: if there is a clear eligibility issue (for example, EI common claimant report showing current undeclared income), no further assistance may be issued until eligibility has been re-established

If the recipient does not respond to the first request for documents, ministry staff will attempt to contact the recipient by phone or MYSS messaging, if they are a registered user, to discuss the request, and send a second request following the same timelines as for the first letter.

Note: Staff may offer assistance if recipients have difficulty obtaining documents. For example, if a recipient is unable to get to their bank, ministry staff should contact the bank and request the bank statements. Ministry staff should assist the recipient with obtaining documentation where possible, as an alternative to denial for not providing information. If the recipient does not respond to the second request, and ministry staff cannot obtain the documents, the recipient is no longer eligible. Review eligibility review non attendance for more information.

When the documents are received, ministry staff will:

• Create and send the eligibility review interview: first request letter (HR3584) either by MYSS messaging or mail

Ministry staff may telephone the recipient in advance of sending the letter to arrange the date and time of the appointment, but the phone call must be followed by the letter or MYSS messaging in order to give the recipient a written record of the appointment.

If the recipient does not respond to the first letter, the recipient is offered the opportunity to reschedule and ministry staff will:

• Create and send the eligibility review interview: second request letter HR3585

Ministry staff should attempt to contact the recipient by telephone to arrange the date and time, but the phone call must be followed by the letter or MYSS messaging in order to give the recipient a written record of the appointment.

Effective: September 30, 2014

Review all information provided by the recipient and obtained from third-party checks (Note: if consent is not on the case, the third-party checks cannot be run until after the interview has been completed and the HR0080R signed).

Review case information and identify any issues to discuss with the recipient, including but not limited to:

• Questions or anomalies resulting from documentation, third-party checks, or case information
• Employability planning

Review alerts and identify any specific requirements, such as an interpreter.

Effective: September 30, 2014

To conduct an eligibility review, ministry staff will complete the following steps:

Update case/contact information:

• Review and update all tabs/fields to ensure all case and contact information is accurate (e.g., marital status, family unit composition, citizenship/immigration status, income, assets, address and shelter expenses, personal information such as spelling of names, AKAs, date of birth, SIN).
• Review all ongoing supplements to confirm eligibility
• Ensure appropriate documents to verify all case and contact information, and eligibility for supplements, is on the case. (Obtain from recipient if needed)

Complete the employment and assistance review form (HR0080R): 

• Ask all relevant questions, including question on warrants, assets, bank accounts, etc
• Enter a response to each question (do not leave fields blank). Update all assets, including bank names and all account numbers. If no bank account is declared, enter “no bank acct” in the bank name field.
    (This confirms the question was asked and answered).
• Explain the rights and responsibilities, including reporting responsibilities, to the recipient and record on the case that this was done. Explain the consents, notifications, and privacy information

Obtain recipient signature on the HR0080R – in-person appointment:

• If the appointment is in person, print two copies of the HR0080R. Obtain the recipient’s (and spouse’s, if applicable) initials on each page (and for any manual changes), their signatures on each place in the general consent and CRA consent sections. Ensure the location (city) and the dates are entered. Witness in all applicable places

Obtain recipient signature on the HR0080R – telephone appointment:

• If the appointment is on the phone, arrange for the recipient to sign the HR0080R, either later in the EAC, or at a trusted third party (TTP). In exceptional circumstances, where a recipient is unable to attend at an EAC or a TTP, the ministry may accept witness signatures from:
  • Other government staff, or
  • Prescribed professionals (as described in EAPWD Regulation section 2, 2
• Set a notification or the SR due date as a reminder to ensure the HR0080R is signed and returned within 20 business days
• Note: the role of the TTP or other non-ministry staff witness is solely to verify the person’s identity and witness their signature. In cases where the HR0080R is completed by phone, ministry staff, not the TTP or other witness, are responsible to advise the recipient of the information contained in the form, and explain their rights and responsibilities

Attach the completed HR0080R to the service request 

• For in-person appointments, provide one copy of the completed HR0080R to the recipient; scan the other copy to the Service Request. Ensure the document is profiled and labelled “Signed HR0080R”. Batch-file the original
• For phone appointments, when the form is received, review to ensure all required fields are initialed or signed, as applicable, and that locations and dates are entered, and that witness and recipient dates/locations match. If not complete, follow up is required. If complete, scan it to the service request. Ensure the document is profiled and labelled “signed HR0080R”. Batch-file the original

Review and confirm eligibility 

• Scan and profile all documents and third-party check printouts to the service request except do NOT scan the CRA/TXI printout – it must be batch-filed
• Complete any outstanding third-party checks that have not yet been completed
• Review all information, documents, and third-party checks, and assess financial ability
• Follow up if needed with the recipient on any outstanding documents or questions

Advise recipient of changes

• Notify the recipient in writing if assistance is reduced or discontinued, or if an overpayment is calculated
• Include a Reconsideration and Appeals brochure

Effective: September 30, 2014

Recipients who do not complete an eligibility review when required cease to be eligible for assistance. If a recipient or their spouse does not provide required documents, does not attend the interview, or does not sign the HR0080R:

• Notify the recipient in writing that they are no longer eligible, using the Eligibility Review Non-compliance letter (HR3586)
• Provide the reconsideration and appeals brochure
• Cancel all outstanding cheques and turn cheque production off
• Set a reminder to review after the reconsideration period (urban recipients four business days mailing plus 20 business days for reconsideration; rural recipients seven business days mailing plus 20 business days for reconsideration)
• If no contact from the recipient, close the case using the close reason “non-comply EA review” and/or “non-comply info request”, as applicable.

Effective: January 1, 2020

Recipients of medical services only (MSO) may apply for assistance as follows:

• If they have not received income assistance in any of the preceding six months, complete an application by using the eligibility review process and signing an HR0080R
  • The process for scheduling an appointment may vary, however, in all other aspects the eligibility review is conducted in the same manner as for any eligibility review.  View eligibility review: conducting the interview for more information. The recipient must provide all relevant documents to verify their eligibility, third-party checks are completed, and the HR0080R is completed and signed
  • If they have received income assistance in any of the preceding six months, and their file is open, the ministry has discretion to use either the streamlined reapplication process, or where needed, the eligibility review process and signing an HR0080R

Ministry staff will need to assess eligibility for disability assistance based on what the PWD  recipient is reporting each month on the stub while in receipt of MSO coverage as a result of employment income. Staff will need to manually reinstate PWD-designated recipients onto disability assistance if their income drops below the disability assistance rate before January income/March benefit month.

When the eligibility review is completed, advise the recipient of the outcome:

If the recipient is eligible for income assistance, hardship assistance, or disability assistance, update the case and initiate payment.

If the recipient is not eligible for income assistance, hardship assistance, or disability assistance:

• Offer to provide written substantive reasons for the decision. Inform the recipient of their right to request a reconsideration of the decision. Provide a copy of the reconsideration and appeals brochure
• Re-assess eligibility for medical services only. If the recipient is not eligible for medical services only, offer to provide written substantive reasons and provide the right to request a reconsideration of the decision. Provide a copy of the reconsideration and appeals brochure