Page 26

Official source

(MRG) UPDATED: JUNE 2010 26 CATEGORICAL FACTORS SSI-RELATED AGE (65 OR OVER) Church records Baptismal Certificate Vital Records Office of the New York State Department of Health Municipal Local Registrar Records U.S. Passport Census records Immigration and Naturalization Service Records Records of birth maintained by SSA Physician’s statement Documentation: Sufficient to establish an audit trail: the date of birth, place and date of filing, identifying numbers of the available document, and the name of the official who signed the document. Disposition: Persons 65 or over are advised of benefits which may be available to them under the Supplemental Security Income (SSI) program. If they appear eligible and express interest they are referred to the local Social Security District Office for a determination of SSI eligibility. Application for SSI is not a condition of eligibility for Medicaid.

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Page 26

Official source

(MRG) UPDATED: JUNE 2010 26 CATEGORICAL FACTORS SSI-RELATED AGE (65 OR OVER) Church records Baptismal Certificate Vital Records Office of the New York State Department of Health Municipal Local Registrar Records U.S. Passport Census records Immigration and Naturalization Service Records Records of birth maintained by SSA Physician’s statement Documentation: Sufficient to establish an audit trail: the date of birth, place and date of filing, identifying numbers of the available document, and the name of the official who signed the document. Disposition: Persons 65 or over are advised of benefits which may be available to them under the Supplemental Security Income (SSI) program. If they appear eligible and express interest they are referred to the local Social Security District Office for a determination of SSI eligibility. Application for SSI is not a condition of eligibility for Medicaid.