Approval Individual Information WC Mandatory Registrant Form 354 Medical Expense LUW Persons Demographics for everyone Total countable gross Exempt Timely Stages of Intake Person Demographics PI Gross income test UCM DOL Stages of pplication Registration 30th day DIS 29th day Form 74 Total shelter costs Homeless shelter cost Scheduling Net Income Limit test Stages of Screening RSDI Total Net FS income eDRS Adequate Medicare claim LUW UART SSI Applicant Group Address 100% VA Net test VR Disability LUW Application Registration Form 859 11th day ABAWD No Income limit test Approval Individual Information WC Mandatory Registrant Form 354 Medical Expense LUW Persons Demographics for everyone Total countable gross Exempt Timely Stages of Intake Person Demographics PI Gross income test UCM DOL Stages of pplication Registration 30th day DIS 29th day Form 74 Total shelter costs Homeless shelter cost Scheduling Net Income Limit test Stages of Screening RSDI Total Net FS income eDRS Adequate Medicare claim LUW UART SSI Applicant Group Address 100% VA Net test VR Disability LUW Application Registration Form 859 11th day ABAWD No Income limit test
(Print)
Approval
Individual Information
WC
Mandatory Registrant
Form 354
Medical Expense LUW
Persons Demographics for everyone
Total countable gross
Exempt
Timely
Stages of Intake
Person Demographics PI
Gross income test
UCM
DOL
Stages of pplication Registration
30th day
DIS
29th day
Form 74
Total shelter costs
Homeless shelter cost
Scheduling
Net Income Limit test
Stages of Screening
RSDI
Total Net FS income
eDRS
Adequate
Medicare claim LUW
UART
SSI
Applicant Group Address
100% VA
Net test
VR
Disability LUW
Application Registration
Form 859
11th day
ABAWD
No Income limit test
