9.2 Absence from Ontario
Sections 7(1), (3) and (4) of the Act.
Section 5 of Regulation 134/98.
Where a request for approval of an absence of more than seven days has been made prior to or after the absence, the request, receipts, reasons for the decision and the relevant dates are documented and on file.
Where a participant is absent in excess of seven days without approval from the Administrator and financial assistance is cancelled or reduced, information is documented and on file to support the decision.
Random file reviews are completed to ensure that all requirements are met.
Application of policy
A person who is absent from Ontario for a period greater than seven days is not eligible for assistance unless the absence is approved by the Administrator as necessary for reasons of health or exceptional circumstances.
A recipient who is absent from Ontario for a period of seven days or less must keep receipts in order to verify the dates of any and all absences should the duration of their absence need to be verified.
The Administrator should ensure that:
- the recipient understands that absence from Ontario for more than seven days without approval from the Administrator can result in ineligibility for assistance commencing on day eight of the unapproved absence
- recipients are aware of the rules, responsibilities and expectations with respect to the seven day absence rule by reviewing, signing and receiving the Rights and Responsibilities form
- when a recipient is not eligible for assistance because of an unapproved absence from Ontario and the recipient is part of a benefit unit with additional members, the financial assistance available to the benefit unit will be reduced, on a prorated basis, by the recipient’s amount for the period of their ineligibility
- any recipient who is not eligible for assistance because of an unapproved absence from Ontario must reapply for assistance and agree to meet participation requirements
- where a recipient has requested an approval for an absence of more than seven days, the Administrator provides a response to the recipient within a reasonable period of time
A recipient should ensure that:
- the delivery agent is informed of any absence from Ontario for more than seven days
- if they are absent from Ontario for a period of seven days or less, receipts are kept to verify the dates of absence from Ontario should the duration of their absence need to be verified
Absence in excess of seven days
The Administrator has the discretion to approve an absence from Ontario in excess of seven days where the absence can be verified as necessary for the recipient’s health or because of exceptional circumstances. These may include family or cultural events.
Some of the factors the Administrator may consider when making a decision about whether or not to approve the extended absence request include:
- the impact of the absence on meeting participation requirements
- the need for the recipient to attend to urgent family matters outside the province, such as serious illness, injury or death of an immediate family member
- the purpose for the absence is to receive necessary medical treatment outside the province or out of country that is prescribed by a physician and is covered by the Ontario Health Insurance Plan (OHIP) Out of Province or Out of Country Health Services
Note: The absence may only be approved if the recipient provides a letter from the Ministry of Health and Long-Term Care confirming that the out of province or out of country service is insured by OHIP
Where an absence is approved, all members of a benefit unit are eligible for financial assistance for the period of time that has been approved by the Administrator.
Verification of dates
Recipients may be asked to produce verification of their absence if the duration of their absence is questioned. A recipient should be informed, before they leave, that they are responsible for keeping receipts to verify dates of the absence from Ontario.
An affidavit signed by the recipient may be considered if the verification provided is not satisfactory.
Unapproved absence in excess of seven days
Where an absence is not approved, a single person’s financial assistance is cancelled for each day absent from Ontario, commencing on day eight. The financial assistance can be reinstated (prorated from the date of request) when the person re-applies and is eligible for assistance as a resident of Ontario.
An overpayment is charged if it is determined after the fact that the recipient was absent from Ontario without approval for more than seven days. The overpayment is prorated for the days absent starting on day eight and up to the time that they receive assistance while absent. Assistance should not be reinstated until the recipient re-applies.
A single recipient leaves Ontario for 14 days without approval. An overpayment is charged for days 8-14 (7 days total) and effective day 8, assistance is cancelled and cannot be reinstated until the recipient re-applies (see Directive 6.13: Calculating reduced assistance and Directive 9.3: Recovery of overpayments for more information).
Recipient who is a member of a benefit unit with additional members
Where an absence is not approved for a member of a benefit unit, financial assistance available to the benefit unit will be reduced, on a prorated basis, by the absent member’s amount, for the period of time commencing with day eight of the absence until the participant has returned to Ontario and has re-applied or requested reinstatement of assistance.
During the period of a temporary absence that has not been approved, a remaining spouse must continue to meet all of the requirements of eligibility (e.g., participation requirements, reporting absent recipient’s income), if the absence is for a reason other than a breakdown in the relationship with no reasonable prospect of reconciliation. Failure to meet these requirements would result in ineligibility for the remaining spouse.
If at any time during this period there is a breakdown in the relationship with no reasonable prospect of reconciliation, a remaining spouse may re-apply as a single applicant or sole-support parent (see Directive 6.13: Calculating reduced assistance and Directive 9.3: Recovery of overpayments for more information).
The benefit unit consists of two adults and two children under age 12. The benefit unit is eligible for $1,250 ($494 Basic Needs + $756 Shelter) without deductions. One of the adult participants leaves Ontario for three weeks without approval. The budgetary requirements for the benefit unit is reduced by the basic needs rate reduction amount and the adult participant’s portion of the shelter amount ($238 Basic Needs Rate Reduction + $59 Shelter = $297).
The financial assistance for the benefit unit is reduced by the absent participant’s amount for each day absent from Ontario commencing on day eight up to and including day twenty-one, for a total of 14 days.
$1,250.00 - Current eligibility for the benefit unit
-$138.60 - Subtract participant’s portion prorated for 14 days ($297 / 30 days × 14 days)
$1,111.40 - Reduced assistance amount for the benefit unit
More than one member of the benefit unit
The same principle applies when there is more than one member of the benefit unit absent from Ontario for more than seven days without approval. Financial assistance for the benefit unit is reduced, on a prorated basis, by the absent members’ amount for the period of time commencing with day eight of the absence until the members have returned to Ontario and have re-applied or requested reinstatement of assistance.