TN 73 (06-12)

SI 00835.040 Temporary Absence from a Federal Living Arrangement (LA)

A. When to use instructions to determine temporary absence from a federal LA

To determine whether an eligible or ineligible claimant is temporarily absent from a federal LA, unless the claimant qualifies for continuation of benefits because of temporary institutionalization for any portion of the same confinement; refer to instructions in SI 00520.140.

B. Definition of absence and permanent LA

1. Absence

An absence means being physically away from a permanent LA, whether that living arrangement is a household or an institution, for at least 24 hours.

2. Permanent LA

A permanent LA is the place where a claimant lives or, for purposes of this section, on rare occasions, it may refer to one or more members of an individual's household.

EXAMPLE: Mrs. Kay is temporarily absent from her home while in the hospital for three weeks. When she entered the hospital, her permanent LA was with her husband, son, and mother in an apartment her mother rented. While she was in the hospital, her husband and son moved to a new apartment. Mrs. Kay intends to join her husband and son when the doctor at the hospital releases her. Even though Mrs. Kay does not intend to return to the same physical residence, she still intends to return to her permanent LA; i.e., the home she shares with her husband and son.

C. Policy for temporary absence from a federal LA

1. Conditions for a temporary absence

a. General rule

A temporary absence exists if a claimant:

  • has been in his or her permanent LA for at least one full calendar month prior to his or her absence; and

  • intends to, and actually does, return to the permanent LA in the same calendar month he or she leaves or in the next month.

b. Exceptions

Under certain circumstances, there are no limits on the length of a temporary absence and the claimant is not required to return. The exceptions are:

  • temporary absence of a child from a federal LA due to school attendance, per instructions in SI 00835.042; and

  • temporary absence from a federal LA, due to confinement in a medical facility where Medicaid pays more than half the cost of care, per instructions SI 00835.043.

2. ISM during a temporary absence

During a temporary absence of ISM, we:

  • continue to value ISM as if a claimant were physically in his or her permanent LA; and

  • do not count ISM a claimant receives during the temporary absence.

Exceptions:

D. Procedure for development for temporary absence from a federal LA

1. Assumption of temporary absence

Assume, absent evidence to the contrary, that an absence was temporary if:

  • you learn of it after the claimant returned to his or her prior residence; and

  • the reported duration of the absence does not exceed a calendar month.

It is not necessary to document the allegations or your decision.

2. Assumption not applicable

If the sections in SI 00835.040D.1. do not apply, to determine whether an absence is, or was temporary; if it is material to your LA or ISM determination, refer to instructions in SI 00835.041 through SI 00835.043.

E. References

The following sections deal with temporary absences for purposes other than determining LA and ISM.