The cooperation requirements are excused if good cause is established. Good cause includes, but is not limited to when:
The child was conceived as a result of incest or rape;
Legal proceedings for the adoption of the child are pending before a court;
The applicant/recipient is currently being helped by a public or licensed private social agency to decide whether to keep or give up the child for adoption, and the discussions have continued for less than 3 months;
Action to establish paternity or get child or spousal support would make it harder for the person or family member to escape domestic violence, or would unfairly penalize the violence victim or increase the risk of further violence.
Domestic violence is defined as a pattern of behavior when there is one or more of the following:
Physical acts that resulted in, or threatened to result in, physical injury;
Sexual abuse;
Sexual activity involving a dependent child;
Being forced as the caretaker of a dependent child to engage in non-consensual sexual acts or activities;
Threats of, or attempts at, physical or sexual abuse;
Mental abuse;
Neglect or depriving of medical care.
An applicant or recipient must give proof of the good cause claim within 30 days from the date the claim is made except when the applicant or recipient states that domestic violence is the reason for the good cause claim.
Use the Domestic Violence Verification Form PA 1747 for good cause requests based on domestic violence.
For a good cause request based on rape, incest, pending adoption, or discussion to consider adoption, complete the “Good Cause” Determination Based on Factors Other than Domestic Violence for Child Support or Paternity PA/CS 173GC form.
Types of verification include, but are not limited to:
Birth certificates or medical or law enforcement records showing that the child was conceived as the result of incest or rape;
Court documents or other records showing that legal adoption proceedings are pending or that an agency is actively working with a parent considering giving up the child for adoption, and discussions have gone on less than three months;
Official records such as medical, criminal, child protective services, social services, psychological, or law enforcement verifying domestic violence;
Medical records showing the applicant/recipient’s emotional health history and present emotional health status or those of the child whose support is sought or received, or written statements from a mental health professional showing a diagnosis or prognosis of the applicant/recipient or child’s emotional health;
Statements from other people who are aware of the circumstances for the good cause claim. For example, a medical, psychological or social service provider, law enforcement professional, friend, relative, neighbor or other person who is aware of the circumstances may sign the statement.
The CAO and applicant or recipient must fill out the “Domestic Violence Verification” form (PA 1747) (available on Docushare) for all good cause claims based on domestic violence in these circumstances:
To accompany the above acceptable verification given by an applicant or recipient (Block 2 of the form);
To grant good cause on the applicant/recipient’s written consent based on proof of the good cause claim given by a third party on the form (Block 3 of the form);
To grant good cause for up to six months when an applicant or recipient says he or she is at risk of domestic violence and cannot get other proof of domestic violence safely within the established time frame (Block 4 of the form).
NOTE: The CAO may not contact the putative father or non-custodial parent to verify good cause based on a claim of domestic violence.
When an applicant/recipient begins a good cause claim, the CAO must tell the applicant/recipient how to get necessary documents. The CAO must try to get documents that the applicant/recipient cannot reasonably get unless helped, if the applicant/recipient asks or if circumstances show that information should be given or discussed.
The CAO must determine whether there is good cause within 45 days from the date the applicant/recipient began the claim. The CAO may approve more days for completing the determination if the case record documents that the CAO needs more time to investigate or if the CAO grants the applicant/recipient more days to give evidence.
For an applicant, the CAO must authorize assistance no later than 30 days after application when the applicant is claiming good cause and verification is not easily available or is waiting to be received from a third party.
For a recipient, the CAO must continue assistance if verification is not given within 30 days and the delay is due to a third party.
After making the determination, the CAO must:
Give the applicant or recipient oral notice of the determination;
Give written notice using the PA 162, Notice to Applicant/Recipient;
Record the decision and supporting verification in the case record.
If the claim is denied, the notice must include:
The right to appeal and request a fair hearing;
What further evidence or information is needed to support the good cause claim;
The dates when information can and needs to be provided;
The choice to withdraw the application for assistance;
The choice to ask that assistance be closed;
The choice to cooperate in establishing paternity and getting support.
If the claim is approved, the DRS must not try to establish paternity or get support.
If the claim is denied, neither the Department nor the BCSE must try to establish paternity or get support for at least 30 days after the client has been told orally and in writing that the good cause claim was denied.
Give the BCSE a copy of the completed PA/CS 173-GC. If good cause is based on domestic violence, forward a copy of the PA 1747. See Appendix E, Bureau of Child Support Enforcement Area Offices.
The CAO must review good cause waivers at least every six months. This review may be face-to-face or by telephone. No other proof is needed if the good cause waiver was granted based on verification other than the client’s affirmation of domestic violence, unless the client’s circumstances have changed since the waiver was approved.
If the good cause waiver based on domestic violence was verified by affirmation, and the client is still unable to give proof besides the affirmation, the CAO must determine good cause based on an assessment of the client’s circumstances. If domestic violence continues to be a barrier, verification of the continued good cause waiver must be documented on the PA 1747 form. An individual who requests the good cause waiver to continue but who is unable provide verification under Sections 2 or 3 may re-affirm under Section 4 for an additional six months, and the CAO should refer the individual to legal services or a domestic violence agency for help in getting verification. See Chapter 108, Section 108.84 Six-Month Review/Redeterminations for verification at subsequent reviews.
Reissued: October 22, 2013 replacing January 31, 2012