The Michigan DHS-4487 Unearned Income Notice is a verification form the Department of Health and Human Services (MDHHS) sends when an IRS data match flags income that isn’t reflected in your public assistance case. It lists the income source and amount the match identified and asks you to confirm, correct, or explain it. You have 10 calendar days from the date on the notice to return the completed form with supporting documents. Miss that window and your benefits can be reduced, denied, or closed.
Why the Notice Showed Up in Your Mail
MDHHS is required to cross-check recipient records against income that banks, pension administrators, and government agencies report to the IRS. That comparison runs at application and again before each redetermination. When the match turns up unearned income your caseworker doesn’t have on file, the DHS-4487 goes out to active recipients during the month before their redetermination is due.1Michigan Department of Health and Human Services. Bridges Administrative Manual – IRS Data Exchanges
The programs affected are the Family Independence Program (FIP), State Disability Assistance (SDA), Medicaid, and the Food Assistance Program (FAP, Michigan’s version of SNAP). The notice arrives partially filled in with the specific institution and amount the IRS match identified. Your job is to verify or clarify that entry so your caseworker can update your file.1Michigan Department of Health and Human Services. Bridges Administrative Manual – IRS Data Exchanges
What Counts as Unearned Income Here
Unearned income is money you receive that doesn’t come from a current job or self-employment. The IRS data match specifically catches income reported by third parties: bank account interest, lottery winnings, government subsidies, agricultural and military pensions, unemployment compensation, and annuity payments.1Michigan Department of Health and Human Services. Bridges Administrative Manual – IRS Data Exchanges
Michigan’s eligibility manual reaches broader than what the IRS match alone picks up. Categories you may need to report include:
- Social Security retirement, survivors, and disability benefits (RSDI), plus Supplemental Security Income (SSI)
- Veterans disability compensation and pension payments
- Pensions and annuities from former employers or retirement accounts
- Unemployment and workers’ compensation
- Interest and dividends from bank accounts and investments
- Child support, including arrears
- Cryptocurrency income once converted into U.S. dollars, including crypto mining proceeds
- Adoption subsidies, foster care payments, and educational grants
Report the gross amount, meaning the full payment before taxes, Medicare premiums, or other deductions are taken out.3Michigan Department of Health & Human Services. BEM 500 – Income Overview
Filling Out the Form
Compare the pre-printed information against your own records. The notice may reference income from a prior tax year, so the amount listed might not match what you’re receiving now. If the source has changed — a pension raised by a cost-of-living adjustment, or a bank account you’ve since closed — note the current status on the form. For any ongoing payments, write in the gross figure, how often you receive it (monthly, quarterly, or annual), and the date of the most recent payment.
If you can’t verify the information yourself, say because you don’t recognize the institution listed or no longer have records, your caseworker may ask you to sign a DHS-20, Verification of Assets. Signing that form authorizes MDHHS to request the information directly from the institution named on the notice.1Michigan Department of Health and Human Services. Bridges Administrative Manual – IRS Data Exchanges
Documents to Attach
The right proof depends on the income type:
- Social Security or VA benefits: a current award or benefit verification letter showing the monthly amount
- Pensions and annuities: a recent benefit statement or check stub showing the gross amount
- Bank interest or dividends: a recent bank or brokerage statement, or a 1099-INT or 1099-DIV from the prior tax year
- Unemployment compensation: a payment history printout from Michigan’s unemployment system or a 1099-G
- Child support: a printout from the Michigan State Disbursement Unit or court records showing payment amounts
Every document should be legible and show your name, the paying institution, and the payment date or period covered. If you’re uneasy sharing account numbers on a bank statement, black them out, but leave your name, the institution name, and the interest figure visible.
Lump-Sum Payments
One-time payments need a note of their own. A retroactive Social Security or SSI payment can temporarily push you over resource limits, so flag any lump sum on the DHS-4487 and mark whether it was a one-time event or retroactive. For SSI purposes, retroactive SSI or Social Security payments are excluded from countable resources for up to nine months after receipt. The SSI resource limit is $2,000 for an individual and $3,000 for a couple.4Social Security Administration. Understanding Supplemental Security Income SSI Resources Your caseworker needs the distinction between a lump sum and ongoing income to apply the correct exclusion rather than treat it as monthly income.
How and Where to Submit
You have 10 calendar days from the date on the notice. For FAP cases, there’s no extension. Once the deadline passes, the case moves toward denial.5Michigan Department of Health & Human Services. Bridges Administrative Manual – Verification and Collateral Contacts
MIBridges Upload
Uploading through the MIBridges portal at newmibridges.michigan.gov is the fastest option. Log in, go to the document upload section, and attach scanned copies or clear photos of the completed form and every supporting document. Accepted file types are JPG, JPEG, PNG, TIF, and PDF. If a file is too large, save it in a compressed format or convert a color scan to black and white. An “Upload Successful” screen confirms the submission, and you can verify it later on the View Documents page.6MI Bridges. Document Upload
Mail or Fax
You can also mail or fax the packet to the local MDHHS office handling your case. The office name and address appear on the notice itself. Keep copies of everything you send. If documents go missing, you’ll want proof of what you submitted and when.
What Happens After You Submit
Your caseworker reviews the form and documents and updates your case in the Bridges system. If the verified income changes your eligibility or benefit amount, MDHHS sends a Notice of Case Action by mail explaining the decision. FAP decisions typically take 10 days or less; Medicaid can run 45 to 90 days; cash assistance falls in a 30 to 60 day range.7MI Bridges. Application Response Timeframe Check the MIBridges message center for status updates. If more clarification is needed, you’ll get another request, and the 10-day clock restarts for that follow-up.
If You Don’t Respond
The notice itself warns that failing to provide the requested information can lead to denial, reduction, or case closure. For FAP, no extension is granted past the verification due date and the case is denied once the deadline passes. For Medicaid the process can take longer, but the result is the same: a negative action notice and an adjustment or termination of benefits.1Michigan Department of Health and Human Services. Bridges Administrative Manual – IRS Data Exchanges
Withholding income information carries legal exposure beyond the benefit loss. Under Michigan law, anyone who neglects or refuses to report income to MDHHS faces criminal charges. If the resulting overpayment is $500 or less, the offense is a misdemeanor; above $500, it’s a felony. Even without prosecution, MDHHS can recover the overpayment amount plus 5% annual interest.8Michigan Legislature. Michigan Compiled Laws Section 400-60 – Fraudulent Device to Obtain Relief
Appealing a Reduction or Termination
If MDHHS reduces or ends your benefits based on the income reported through this process, you can challenge the decision through an administrative hearing. You have 90 calendar days from the date on the Notice of Case Action to submit a written hearing request to your local MDHHS office, addressed to the Hearings Coordinator. For FAP, the request can be oral, and your caseworker will complete a DHS-18 hearing request form for you.9Michigan Department of Health & Human Services. Bridges Administrative Manual – Hearings
Timing changes what you get during the appeal. If your request reaches the local office within 10 calendar days of the notice date, MDHHS must reinstate your benefits to their previous level while the hearing is pending. File on day 11 and your benefits stay at the reduced level set by the notice; you’ll still get your hearing, but not the old amount in the meantime. For Medicaid, you must file before the effective date of the action to keep benefits during the appeal.9Michigan Department of Health & Human Services. Bridges Administrative Manual – Hearings
One tradeoff to weigh: if you ask for continued benefits during the hearing and lose, MDHHS can recover the benefits paid in that period as an overpayment. If you believe the income data is wrong or was already in your case, filing within the 10-day window protects you from a gap in assistance while the dispute plays out.