Eligibility Online Manual
M903 Determining Best Estimates
Purpose: This section provides information on determining best estimates of prospective income.
Current Policy Effective Date: August 1, 2008
Date Last Reviewed: July 29, 2008
Previous Policy:
POL M903: DETERMINING BEST ESTIMATES
Aged, Blind and Disabled Programs
1. Income May Need To Be Estimated
Complete a best estimate of prospective gross countable income when an applicant’s income is irregular. Use the applicant’s individual circumstances to determine the best approach for anticipating prospective gross countable income and determining the best estimate.
2. Best Estimates Include Actual and Estimated Income
Best estimates are determined by:
Counting actual income received during month of application.
AND/OR
Using the best estimate of any income the applicant expects to receive.
3. Second Month Income Estimate May Be Zero
The second and subsequent benefit month income estimates will be zero when both the following are true:
Applicant’s income ceases during the month of application for benefits.
Applicant does not expect to receive additional income.
4. Existing Income History Must Be Used
When possible, use an applicant’s income history to determine the best estimate of future income.
Verified income history of at least 30 days, but not exceeding 60 days, may be used.
5. Best Estimates Must Be Reviewed
The best estimate of a client’s income must be reviewed when any of the following occur:
Client experiences a change in circumstances.
Client reports a change in circumstances.
Client is scheduled for a periodic review/recertification.
Reference:
Income: 20 CFR 416, Subpart K
Defining Group: 42 CFR 435 Subpart G
Clarifying Information:
Best Estimate is defined as a Benefit Specialist's best determination based on knowledge of past, current, and future case circumstances, which accurately reflects all facts known to the benefit specialist at the time.
Worker Responsibilities:
Determining Best Estimate of Applicant’s Gross Countable Income
1. Determine earned and unearned income.
2. Verify past income with pay stubs when applicant has pay stubs covering at least a 30-day history of income.
2A. Do not exceed 60 days history.
3. Require an employer’s statement or other verification of past income when applicant does not have at least a 30-day history of income or if the history is not indicative of the future.
4. Estimate tips, commissions, overtime, differential pay, or other source of income when applicant’s employment indicates that applicant may receive income from one of these sources.
5. Count self-employment income representing the months for which applicant is applying for benefits.
5A. Deduct allowable business expenses from self-employment income.
5B. Refer to Section M902 for information on self-employment income and deductible business expenses.
6. Count irregular income representing months for which applicant is applying for benefits.
7. Prorate or average income from self-employment, contractual employment or intermittent income unless income is not indicative of future months.
7A. Examples of intermittent income are income received quarterly, semi-annually, or annually.
8. Count number of paychecks normally received by applicant in cases where a problem with payroll or mail causes the applicant to receive fewer or additional paychecks.
9. Document in applicant’s case record method used to determine best estimate.
10. Document rationale for choosing the method.