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(MRG) UPDATED: JANUARY 2012 51 CATEGORICAL FACTORS MEDICAID BUY-IN PROGRAM FOR WORKING PEOPLE WITH DISABILITIES Applicants for the MBI-WPD Program must provide proof of work activity. Acceptable proof of work activity includes the following:  A current pay stub(s), paychecks, or a written statement from the employer stating the hours worked and the wages paid;  A current income tax return, W-2 form, or records of bank deposits;  If the individual is not required to file an income tax return, work activity may be documented by pay stubs or a letter from the employer stating the hours worked and wages paid. If the individual presents a personal check as a “paycheck”, a statement from the employer is needed to document that the check is for work activity. If the recipient is in the Medical Improvement group, the letter must also include the number of hours worked;  A self-employed individual may present a worksheet of hours worked, for whom, and income earned from each client.