1.
GENERAL
RULE
Certain financial and non-financial information must be
verified to ensure accuracy.
EXCEPTION: Categorically Eligible Households
(Section 444-8)
.
2.
MANDATORY
ITEMS
Any of the following items that are reported by the
household, must be verified:
A. Alien
Status (Section
111-2),
B. Identity (Section
111-3),
C. Maine Residency (Section
111-3),
D. Social Security Number (Section
111-4),
E. Current Earned and Unearned Income or lack
thereof (Section
555-2 and
555-3),
F. Utility Expenses if the household is not
eligible for a Standard Utility Allowance (Section
555-5),
G. Deductible Medical Expenses (Section
555-5),
H. Deductible Legally Obligated Child Support
Payments (Section
555-5),
I. Dependent Care Expenses (Section
555-5), and
J. Meeting the definition of "Individuals
with Disabilities" (Section
999-1)
.
3.
OPTIONAL
ITEMS
Information that is contradictory to information known to
or received by the Department and may affect eligibility or benefit levels,
including separate household status (Section
111-1(2)(D))
and the proration of lottery winnings (Section
444-12)
.
4.
SOURCE OF
VERIFICATION
A. Documentary evidence
is used as the primary source of verification for all items except residency
and household size. Some examples of documentary evidence are wage stubs, rent
receipts, and utility bills. Acceptable verification is not limited to any
single type of document.
B.
Whenever documentary evidence is insufficient to make a firm determination of
eligibility or benefit level, or cannot be obtained, a collateral contact may
be required. Generally, the Department shall rely on the household to provide
the name of any collateral contact. The household may ask for help in
designating a collateral contact.
When the collateral contact, designated by the household,
cannot provide an accurate third party verification, the Department shall do
one of the following:
(1) designate
another collateral contact;
(2) ask
the household to designate another collateral contact; or
(3) ask the household to provide an
alternative form of verification.
NOTE: The Department is responsible for
obtaining verification from acceptable contacts. A collateral contact is an
oral confirmation of a household's circumstances by a person outside the
household. The contact may be made by the Department either in person or by
telephone. The Department shall not require written statements by collateral
contacts as a condition of eligibility. Some examples of acceptable collateral
contacts include employers, lessors, social service agencies, and neighbors who
can be expected to provide accurate third-party verification.
Prior to making any collateral contact, the Department
shall inform the household of the proposed contact, what information is
required, and why the contact is needed.
Households must be provided a clear notice of their right
to withdraw their application if they do not want the Department to pursue a
collateral contact designated by the Department.
5.
DOCUMENTATION
The Department shall document evidence to support
decisions of eligibility and/or benefit levels, the reasons for questioning
non-mandatory items, the need to make collateral contacts, and the reasons for
not accepting an applicant's designated collateral contact.
6.
RESPONSIBILITY FOR PROVIDING
VERIFICATION
The household has the primary responsibility for
providing verification to support statements made on the application. The
Department shall assist the household in obtaining this verification. The
household is not required to present verification in person. The Department
shall accept any reasonable proof provided by the household and shall be
primarily concerned with how adequately the verification proves the statement
on the application form. When all other sources of income verification are
unavailable, the amount to be used must be based upon the best available
information.
7.
VERIFICATION AT OTHER TIMES
The same verification procedures that are used for
initial application are used in all subsequent eligibility and benefit level
decisions. The verification requirements at annual eligibility review are
detailed in Section
666-9(5).
The verification requirements for changes during the certification period are
detailed in Section
666-6.
8.
REFUSAL OR FAILURE
TO PROVIDE VERIFICATION
The Department will deny or close an application or case
when verification is not provided due to refusal or failure to provide
verification. For a determination of refusal to be made, the household must be
able to cooperate, but clearly demonstrate that they will not take actions that
they can take and that are required to complete the certification process. For
example, to be denied for refusal to cooperate, a household must refuse to be
interviewed, not merely fail to complete it. If there is any question as to
whether the household has merely failed to cooperate the household must not be
denied or closed based on refusal.
A.
If the household refuses or fails to provide verification, the Department shall
deny the application, unless there is good cause (Section
999-1) .
B. If the household is receiving benefits and
refuses or fails to provide verification, the Department shall close the case,
unless there is good cause (Section
999-1) .
C. The household is not ineligible based upon
a person outside the household failing to cooperate with a request for
verification. Individuals considered disqualified (see list at Section
444-4) and authorized
representatives (Section
222-3) are not
considered as a person outside the household.
D. If a household refuses to cooperate with a
Quality Control reviewer, the household shall be denied or terminated for
refusal to cooperate. The household is not eligible until they cooperate with
the Quality Control review or they reapply after the time limits described
below. This ineligibility applies to all households, including those eligible
for expedited service.
(1) If a household,
which has been terminated for refusal to cooperate with a State Quality Control
reviewer, reapplies after 125 days beyond the annual review period for that
Quality Control sample month, they may be found eligible, but each eligibility
factor must be verified, regardless of whether or not the information is
contradictory to information known to or received by the Department.
(2) If such a household reapplies after 125
days from the end of the annual review period for that Quality Control sample
month, and the household is eligible for expedited service, the household shall
be provided benefits based on the expedited service processing requirements,
including the provision that only identity must be verified. However, before
the household may receive an issuance not processed under expedited service
requirements, the household must provide verification of all eligibility
requirements.
(3) Verification of
all eligibility requirements refers to any household circumstance that could
affect eligibility. Required verification is not limited to those items
required at the time of initial application or at annual eligibility review.
Items such as household composition, citizenship or eligibility for a standard
utility allowance that would normally only be verified unless contradictory to
information known to or received by the Department, must be verified in these
cases.
(4) If a household which has
been terminated for refusal to cooperate with a Federal Quality Control
reviewer reapplies after 9 months beyond the annual review period for that
Quality Control sample month, it may be found eligible but each eligibility
factor must be verified.
NOTE: The annual review period refers to the
federal Quality Control review period and runs from October 1 through September
30.
E. Where
verification is incomplete, the Department shall provide the household with a
written statement of required verification and an offer to assist in obtaining
it. The Department shall allow the household at least ten days from the date of
the initial request for the particular verification to provide the missing
verification.
F. When information
from another source contradicts statements made by the household, the
Department shall give the household at least 10 days to resolve the
discrepancy.
G. When the household
fails to provide verification required to establish a deductible expense or
income exclusion, the Department shall determine eligibility without the
deduction or exclusion. The Department shall not deny or terminate benefits for
failure to provide such verification.
