5000-5 INCOMPLETE VERIFICATION
5000-5 A. CIRCUMSTANCES FOR WHICH VERIFICATION MAY BE WAIVED
Eligibility may be found for the first two calendar months without complete verification if all of the following conditions are met and documented in the case file:
The eligibility
factor that is not fully verified requires documentary evidence;
The necessary
documents are not in the possession of the applicant and he or she
cannot easily obtain them;
The documents
have been requested and cannot be reasonably expected to be received
within the 30 days allowed for the caseworker to make a final eligibility
decision;
At least one
collateral contact has been made, which verifies the factor of eligibility
is met;
There is no
reason to doubt the applicant’s statement about the factor in question;
The caseworker
requested a supervisory review of the case situation and the supervisor
approves a temporary finding of eligibility; and
The case is placed in a suspense system to assure that the documents are received and the factor is fully verified at least 10 days before the end of the second month.
5000-5 B. CIRCUMSTANCES FOR WHICH VERIFICATION CANNOT BE WAIVED
Social Security Enumeration: Verification requirements for Social Security enumeration applications cannot be waived with the exception of Newborn Coverage (see Section 5330). Applicants must have a Social Security Number or apply for one as a condition of eligibility for Medicaid. (For more information on applying for a Social Security number, see Section 5014 and the Administrative Procedures Manual.)
U.S. Citizenship and Eligible Alien Status: Verification of U.S. citizenship and identity cannot be waived unless exempt. See Section 5011 for exceptions to this requirement.
Caretaker Relationship: If the caseworker is unable to verify the child’s relationship to his or her possible caretaker relative, the child will not be considered a household member for Family Medicaid purposes. (This restriction does not apply to any other Medicaid category.) See Section 5120-1.
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