WAG 02-07-00.
See policy memorandum dated 10/03/13 Verifications for Medical Programs.
See Medical Morsel dated 04/01/14 Electronic Verifications for Medical Programs.
Help the applicant obtain proof they qualify and to determine their benefit amount. Collect forms, statements, and clearances that support what the applicant claims on the application. Each benefit program requires verification, but not every program requires verification of the same things.
See PM Chapters 03, 07, 08, and 09 for policy on eligibility factors for each program. Use all available information and documents to establish proof of eligibility. Absolute proof may not always be needed if sufficient information exists to believe that the eligibility factor is met.
A home visit may be made to get information if questions might be answered by a visit. Tell the applicant that the Family Community Resource Center can help if they have trouble getting information. If the applicant fails to provide the needed verification, ask them if they can get it and if they want help. If they say they will not get the verification and will not let you get it for them, deny the application.
If someone applies for a resident of a long term care home, contact the resident prior to the eligibility determination to review case facts. However, do not contact the resident if the person who applied for them says they're not capable of providing information and there is no reason to doubt their word. If the Family Community Resource Center doubts their word, the determination of the resident's ability to provide case facts may be made by the Family Community Resource Center.
A contact with the resident may be by phone or by visit to the long-term care home. Review both financial and nonfinancial factors of eligibility, including any asset transfers. Make an entry in the case record that says case facts were reviewed with the resident or that the resident was incapable of providing information. See PM 07-02-20 for asset transfer policy.
If someone applies for a resident of a long term care home, request that a contact person be identified who has knowledge of the client's financial facts. Contact this person (if other than the person who made application) prior to the eligibility determination to review case facts. Contact may be made by phone. Review both financial and nonfinancial factors of eligibility, including any asset transfers. Follow up on any additional facts provided by the contact person. Make an entry in the case record that says case facts were reviewed with the contact person.
