Verification Charts

Verification Chart - Acceptable Forms


Revised March 10, 2016


Acceptable Forms of Verification Chart

 

The following table is a suggested list of reliable sources of verification for each eligibility factor.  Any source, including verbal, written, and email statements, can be used as long as it meets the "Criteria for Evaluating Verification".

 

WHAT TO VERIFY

ACCEPTABLE VERIFICATION

Alien Status (For all non-citizen AU members)

See tables in NILC Guide for documents used to verify alien status

Child Support Obligation

  • Court papers
  • SEMS data
  • Statement from custodial parent
  • Receipt

Citizenship and Identity for Medicaid

Citizenship for Cash, ABD and state funded medical assistance (Only if questionable)

  • Birth Certificate
  • Naturalization Papers
  • Passport

Dependent Care Expenses

  • Statement from the provider
  • Bills or receipts
  • SSPS data

Disability

  • Award letter from SSA
  • DDDS disability approval
  • Collateral contact with SSA
  • Collateral contact with VA
  • Decision from disability program specialist (ABD cash)

Emergent Medical Condition

  • Hospital bills
  • Statement from the provider

Household Composition

  • Statement from landlord
  • Rental agreement
  • Collateral contact

Identity (for Cash and Food)

  • Driver's license
  • State ID card
  • Birth certificate
  • Passport
  • School records
  • Current Alien Registration Card
  • Collateral Contact outside the client's household
  • SOLQ

Incapacity

  • Doctor's statement
  • Medical records
  • Decision from disability program specialist

Income

  • Pay stubs
  • Employer statement by telephone or in writing
  • SEMS data
  • ACES Interfaces
  • Bank statement that shows direct deposits (many deposits show the net amount, you may need additional information that shows the gross income)
  • Collateral contact
  • SOLQ

LAM (Living Above Means)

  • Alternate Income Verification
  • Bills/Receipts
  • Collateral contact
  • Bank Statement

Medical Expenses

  • Bills/Receipts
  • Statement from the provider
  • Mileage log or receipt for medical transportation costs

Pregnancy

  • Medical records or statement from a licensed medical practitioner (for TANF/SFA/PWA)
  • Client's statement that she had a positive result from a pregnancy test (for Pregnancy Medical, Family Medical, and Children's Medical only)

Residency

  • Rental or lease agreement
  • Statement from landlord
  • Mortgage papers
  • Utility company records or bills

Resources - including those of an immigrant's sponsor

  • Bank statements
  • Insurance documents
  • Vehicle registration
  • Stock certificates
  • Courthouse records
  • Property tax statement

Shelter Costs

  • Landlord statement
  • Current lease
  • Rent or mortgage receipt
  • Utility bills
  • Collateral contact

SSN Application

  • Collateral contact with SSA
  • SSA printouts or documents
  • Birth document that states SSN was applied for

 

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Verification Chart - Cash and Basic Food


Revised March 10, 2016


Verification Requirements Chart - Cash Assistance and Basic Food

 

WHAT TO VERIFY

CASH ASSISTANCE

BASIC FOOD

Alien Status

X
For all non-citizen AU members*

X
For all non-citizen AU members*

Child Support Obligation

X

X

Only if questionable

(Continue to check SEMS for cases through DCS)

Citizenship

X

Only if Questionable

X

Only if questionable

Dependent Care Expenses

(Including transportation costs)

 

X

Only if questionable

(Continue to check WCAP for WCCC copays

Disability

X

X

Emergent Medical Condition

   

Household Composition

(Includes Purchase & Prepare arrangements)

X

Only if questionable

X
Only if  questionable

Identity

X

For all AU members

X

For applicant or both the Head of Household and Authorized Representative

Incapacity

 

X

Income

X

X

Recertification:

·     If source has changed; or

·    If amount has changed over $50.

NOTE:  There is no requirement to verify

             income-in-kind for BF.

LAM (Living Above Means)

X

Only if Questionable

X

Only if questionable

Medical Expenses

 

X
Only for elderly persons or persons with disabilities:

  • At initial application if expenses are more than $35 monthly; and
  • At recertification or change of circumstances if expenses have changed by more than $25.

 

Pregnancy

X
Including Estimated Due Date

 

Residency

 

X

Households that are not Categorically Eligible (CE) for Basic Food

Shelter Costs

X

Only if questionable

X

Only if questionable

SSN Application

X

X

Questionable Information

X

X

* Persons who are here without documentation are not required to verify that fact.

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Verification Chart - Medical


Revised April 29, 2013


Verification Requirements Chart - Medical Assistance

 

WHAT TO VERIFY

FAMILY MEDICAL, PREGNANT WOMEN, ALL CHILDREN'S MEDICAL PROGRAMS

SSI RELATED MEDICAL (AGED, BLIND AND DISABLED)

LONG TERM CARE MEDICAL

Alien Status and Entry Date

X
For all non-citizen AU members

X
For all non-citizen AU members

X
For all non-citizen AU members

Child Support Obligation

 

Deduction Not Allowed

X
Only if income is garnished

Citizenship

X*

X*

X*

Dependent Care Expenses

 

 

 

Disability

 

X

X

Emergent Medical Condition

 

 

 

Household Composition

 

 

X
Spousal and dependent deeming cases only

Income

X ***

X

X

Medical Expenses

 

X
For spenddown only

X

Pregnancy

X **

 

 

Residency

 

 

 

Resources

X *****

X (Except HWD)

 X

Shelter Costs

 

 

X
Spousal and dependent deeming cases only

SSN Application - when no number or number is unknown

X******

X

X

 

* Citizenship and identity will be verified using the SSA citizenship data match.  If unable to verify with the SSA match the Citizenship Central Unit (CCU) will work with the client to verify.  

** For a woman who had a positive pregnancy test either at home or at a medical office, we can accept her statement that she is pregnant as well as the EDD (which includes the month, day and year of the expected delivery date). 

***   Emergency Medical Condition applies only to the Alien Emergency Medical Program F09 and S07.
****  The income a minor receives from her parents does not need to be verified for pregnancy medical.

***** Resource verification is a requirement for family medical and pregnancy medical under the medically needy program only. It is NOT required for children's medical programs or CN medical coverage for pregnant women.

****** A newborn as described in  WAC 182-505-0210 (1) is eligible for CN medical without meeting the SSN requirement until the baby's first birthday.