Verification is the use of documentary evidence, collateral contacts, or home visits to establish the accuracy of statements on the application.
The worker shall verify the following information prior to approval for clients initially applying:
For Working Healthy (WKH) recipients, communication with the Working Healthy Benefits Specialist is necessary to determine when employment ended and whether a Temporary Unemployment Plan (TUP) is needed. See 2664.7.
The agency may not request verification of non-citizen status from the applicant or recipient if that information can be verified through an available resource. The agency shall make every effort to verify non-citizen status through those resources.
NOTE: If the individual already has a DCF-verified record that results in a qualifying alien/immigration status and does not reflect a change in immigration status, this would be considered a Tier 1 verification per 2146.6.
If the agency is unable to verify non-citizen status, verification shall be waived and a three (3) month reasonable opportunity period for the individual to provide the information shall be applied. If otherwise eligible, the applicant may be approved for assistance. The individual shall be contacted to provide verification and notified of the reasonable opportunity period. See 2146.6.
When an applicant fails to provide an SSN or proof of application for an SSN, they may qualify for a Good Cause exception, see 2133.
A copy of the Social Security Card is not required, and assistance cannot be denied for failure to provide the Social Security card when a number has been provided.
Identity for persons claiming to be non-citizens is accomplished through documentation provided under the requirements of 2146. All documents used to verify identity must be retained in the case file indefinitely per 1711(9). For persons exempt from the requirement due to SSI or Medicare status, verification of such status is required.
The Reasonable Opportunity to Provide Documentation requirements of 2145.4 are also applicable to requests for identity verification.
Acceptable documents and the hierarchical protocol for obtaining acceptable documents are described in the A-1, Non-Citizen Qualification Chart and as follows:
The signature of the parent, legal guardian, or caretaker relative made under penalty of perjury in the presence of a witness. When a declaration is used to establish identity, the original must be retained in the case file indefinitely.
Any document which reasonably establishes identity shall be accepted and no requirement for a specific type of document, such as a birth certificate, will be imposed. If no such document is available, a collateral contact shall be made and documented in the case file.
Multiple documents can only be used for identity if a second or third level of citizenship has been provided.
NOTE: The balance of a Direct Express electronic debit account used for the deposit of federal benefits (Social Security, SSI, VA, Civil Service Annuities) need not be verified if the only monies in the account are from Social Security or SSI benefits, or the value of all countable resources, including the account, are not within $300 of the applicable resource limit.
Documentation of U.S. citizenship is required for each individual requesting medical assistance as described in 2145.2.
The agency may not request verification of citizenship from the applicant or recipient if that information can be verified through an available resource. The agency shall make every effort to verify citizenship through those resources.
If the agency is unable to verify citizenship, verification shall be waived and a three (3) month reasonable opportunity period for the individual to provide the information shall be applied. If otherwise eligible, the applicant may be approved for assistance. The individual shall be contacted to provide the information and notified of the reasonable opportunity period. See 2145.4.
The following information shall be verified prior to a determination of the benefit amount for households initially applying or when an ongoing recipient reports a change. Failure to provide verification of these items is not grounds for denial or discontinuance, rather the determination would be completed without considering the reported information.
Expenses direct billed to the fiscal agent by the medical provider are considered verified but are subject to review by KDHE-DHCF.
In addition, non-medical household expenses used to determine the excess shelter deduction for spousal impoverishment income allocation 8144.2 (1) (b) and 8244.2 (2) shall be verified.
When verification of resources is requested, the agency shall also provide notification that information not provided will not be included in the CSRA determination. In addition, the agency is also responsible for notifying the individual of any unverified resources not included in the CSRA once the allowance has been established. Applicants have until the later of 45-days from the date of application or 12-days from the date notification of the outcome of the CSRA was sent to provide unverified resource verification.
NOTE: Information provided in this section does not absolve the individual from the responsibility to provide verification of any resources owned at the time the long term care arrangement began when the information is being used to determine eligibility. The information provided in this section only allows the eligibility worker to complete the CSRA. Any other reason for the eligibility determination, such as the determination that a transfer of property occurred, a determination of whether the resource is producing income, or the determination of the countable or exempt status of the resource, would require verification of the resources.
The worker shall verify all other factors of eligibility prior to approval only if they are questionable and affect the household's eligibility or benefit level. To be considered questionable, the information on the application must be inconsistent with other information on the application or previous applications or inconsistent with information received by the agency. When determining if information is questionable, the decision shall be based on each household's individual circumstances. Also see 1310 and 1320.
At application and review, when verifying resource information through the Asset Verification Solution (AVS) as outlined in 1322.4(2) and 9333 respectively, if unreported bank accounts are found, additional verification shall be requested of the consumer if the account balance (in combination with all other countable, non-exempt resources) exceeds the applicable resource limit. Otherwise, contact with the consumer is not required to verify the unreported account and the AVS value is accepted.
The following special verification provisions apply in determining the countable value of reported income, resources, expenses, and deductions.
Also included as a payor source for purposes of this section are pay stubs, or other comparable documentation voluntarily provided by the employee or employer at the time of application or request for assistance, which are sufficient to determine the countable amount of earned income without request for further verification. To be considered sufficient, the information provided must meet one of the following:
If the information voluntarily provided is sufficient to verify earned income, no further verification is required. The information voluntarily provided shall be used to determine the amount of earnings. If insufficient to verify the earned income, the information voluntarily provided is not considered a payor source.
NOTE: If sufficient information as described above is not voluntarily provided at the time of application or request for assistance, eligibility staff shall not request pay stubs or additional information as part of the Tier 1 process. Verification shall proceed through the remaining Tiers 2 through 4, in order.
See also 7123 (2) (Reasonable Compatibility), 7123 (3) (Budgeting Method), and 7241 (Deductions for MDN, QMB, LMB, QWD, and Working Healthy).
In addition, the manual research shall progress through the following steps in the order listed:
Resource Verification - A four-tiered approach to verifying resources to determine eligibility shall be used. This method means the agency will try to verify reported resource information as much as possible before contacting the consumer for the information.
Tier 1 – Unlike income, there are no source interfaces to verify resources. Tier 1 verification consists of hard copy documentation of the resource voluntarily provided by the individual or directly from the source at the time of application, review, or reported change.
Tier 2 – Reported information is verified through the use of a secondary non-source interface – the Asset Verification Solution (AVS). This interface can only be used to verify bank account information in financial institutions. It is not available for all other real or personal property. The use of the AVS for verification purposes shall be employed as described in 5120 concerning resource compatibility between reported and interface resource values.
Tier 3 – Manual research by the eligibility worker is required. This may include review of the Medical and Non-Medical case files, reconciling information received from the Tier 2 interface, checking other available program information, and making collateral contacts. Any decision to verify reported information at this level must be thoroughly documented.
Tier 4 – As a last resort when the reported information cannot be verified through any other means, contact with the consumer is required. Normally a formal request for information will be sent to the consumer to provide verification. However, in some instances, a phone contact with the consumer may be sufficient.
Self-attestation – The value and status of resources may be accepted without further verification when the countable value of all resources exceeds the applicable resource limit for the medical assistance program. The thoughtful and deliberate use of prudent person (see 1310) should be employed in making this determination. See Policy Memo 2018-10-01, re: SSI Termination and Verification of Resources and PM2024-06-01, re: Potential Resources and Resource Compatibility Changes for additional guidance.
See also 1322.1 (9), 1322.3 (3), 9121.1, 9310.2 (3), and 9333 (2)(b).
Expense Verification - Since there are no interface sources for verification of medical expenses (i.e., health insurance premiums, medical bills) or household expenses used to determine the excess shelter expense for spousal impoverishment income allocation [8144.2(1)(b) and 8244.2(2)], those expenses shall be verified as described in 1322.2(2).
Prior Medical Period Verification - For all medical assistance programs except long term care (LTC), verification of income and resources in a prior medical assistance period shall proceed as follows:
No Change Reported - If an individual requesting prior medical assistance reports that there has been no change in income or resources in the prior months from the application month, income and resources verified in the current period are considered verified in the prior period as well and will be budgeted for each of those months.
Change Reported - If the individual reports that there has been a change in income and/or resources in the prior period, verification of actual income and/or resources for each of the prior months must be obtained as indicated above. The verified actual income and/or resource amounts will be budgeted for each month of the prior period.
NOTE: The applicant must answer ‘yes’ or ‘no’ to the prior medical questions. These answers cannot be assumed. If responses are not provided, the prior medical determination cannot be completed.
Verification of Pre-tax Income and Federal Deductions - When total reported income or federal deductions is over $300.00 per month, verification of deductions will be required for them to be used in the income determination. If proof is not received, processing may be completed without them, and the applicant advised by notice that the amount was not used. Eligibility may not be denied due to failure to provide proof of deductions.
NOTE: When multiple individuals have combined pre-tax or federal deductions that total $300, verification of pre-tax deductions is needed for both individuals.
Verification of pre-tax income and/or federal deductions will follow the tiered approach of earned income in 1322.4 (1) above. Information on hand, such as the case file and TALX records must be used if available prior to requesting the information from the consumer. Pay stubs must be no older than three months prior to the month of the application to be used. Collateral contact with the employer may also be used but is not required. If there is no available information on file, the information must be requested from the consumer as noted below:
Pre-tax income deductions – Pay stubs from the last 30 days or a statement from the employer.
Federal/IRS deductions – Corresponding tax form or most recent tax return
NOTE: If based on the consumer’s self-attestation of both wages and deductions, the income will exceed guidelines for all programs, it is not necessary to request proof of the deductions.