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Chapter: 1800 Income Program: TCA 29 Acceptable forms of verification include, but are not limited to, the following:

1. W-2 forms and income tax returns for self-employed individuals, 2. wage receipts, 3. wage statements, 4. pay stubs, 5. employment verification form or written statements containing the required information, 6. collateral contact with employer, and 7. work calendar (for tips and daily cash payments).

Any document used to verify income must be copied and retained in the case record. All documents must be completed and signed by the appropriate individuals (for example, the employer, the recipient). Exceptions are as follows:

1. The individual’s statement that his income exceeds the income standard is sufficient to deny or close FS, TCA, and RAP benefits. However, medical assistance cannot be denied/closed without an ex parte determination of Medicaid eligibility. Verification of income must be pursued for these situations in which the individual/AG appears to be Medicaid ineligible. 2. When documentation/verification of income that makes the assistance group ineligible cannot be obtained prior to the advance notice deadline, the case manager must redetermine the assistance group's eligibility based on its statement to avoid overpayment. In this situation, the cost of child care can be disregarded without verification. 3. The individual’s statement regarding the begin date and amount of earned income is sufficient when authorizing transitional Medicaid. 1820.0209.01 Verification of Income (TCA) All non-exempt income must be verified at application and review unless otherwise specified.

Income can be verified through a telephone call or collateral contact with the employer or source of income. When verifying by this method the date and source of verbal verification and the date(s) and amount(s) of income received must be recorded.

The individual’s statement regarding the amount of earned income is sufficient when authorizing transitional Medicaid.

As a part of verifying last date of employment and last day of pay, any loss of income which occurred within the month of application must be verified when possible. Examples of circumstances that might make verification impossible are when a business closes or when a person for whom child care was provided moves and the new address is unknown. The individual’s statement is acceptable for any loss of income prior to the month of application.

If documentation or verbal verification is not provided within specified time limits, the assistance group must be determined ineligible for assistance. However, the eligibility specialist must submit a policy exception request to the Region or Circuit Program Office, or at the Region or Circuit’s discretion the unit supervisor, if the individual reports an inability to secure required documentation or verification due to factors beyond recipient control. The Region or Circuit Program Office or the unit supervisor, if authorized by the Region or Circuit Program Office, may grant or deny the exception. Refer to passage 1820.0207 for exception to documentation/verification of income that makes the assistance group ineligible.