Client’s statement is acceptable for those factors coded “Yes,” unless questionable or inconsistent with known facts.
| Number | Eligibility factors | Accept client statement | Policy cite | Commonly-used documentation to verify client’s statement if questionable or required | |
|---|---|---|---|---|---|
| 1 | Residency | Yes | 340:10-7-1 | References, employers, landlords | |
| 2 | Relationship | Yes | 340:10-9-1(b) | Birth certificates, hospital certificates, baptismal records | |
| 3 | Age | Yes | 340:10-5-1 | Birth certificates, hospital certificates, Date Exchange, driver’s license | |
| 4 | Living in home of relative payee | Yes | 340:10-3-56 | Seeing child in the home, school records | |
| 5 | Minor parent living in home of relative | Yes | 340:10-3-56(p) | Statement from an adult knowledgeable of the family situation | |
| 6 | SSN | Yes | 340:65-3-1(e) 340:10-12-1 |
SSN card, ADM-101 completed by SSA, W-4, other OKDHS case records, Data Exchange | |
| 7 | Citizenship | No | 340:10-15-1 340:65-3-1 317:35-5-25 |
Birth certificate, SAVE | |
| 8 | Alien status | No | 340:10-15-1 | SAVE, Immigration documents | |
| 9 | Income (Earned) | No | 340:10-3-31(3) 340:10-3-58 |
Pay stubs, copy of checks, tax records, employer’s statement, ADM-94 | |
| 10 | Income (Unearned) | No | 340:10-3-39 | Award letter, copy of checks, Data Exchange, verbal verification of benefits from agency, provider | |
| 11 | Resources | Yes | 340:10-3-2 | Bank statement, court house records, Data Exchange | |
| 12 | Deprivation | No | 340:10-10 | ||
| Death | No | 340-10-10-1 | Death certificate, notice of death | ||
| Incapacity | No | 340:10-10-2(c) | Medical documentation from provider and decision by OHCA | ||
| Unemployed parent | No | 340:10-10-3(c) | Data Exchange, employer’s statement, SSA records | ||
| Absence | No | 340:10-10-4(b) | AP address, landlord’s statement, AP statement, interview with collateral source | ||
| 13 | School attendance | No | 340:10-13-1(a) | School documents, ADM-96 | |
| 14 | Immunization | No | 340:10-14-1(a) | Shot records, doctor statement | |
| 15 | Third party insurance* | Yes | 317:35-5-43 340:10-3-5(e) |
Insurance policy, policy owner statement, client’s employer | |
| 16 | Mandatory drug screening | No | 340:10-4-1 | Documentation from the substance abuse treatment provider verifying the SASSI, ASI and/or UA results | |
*This is not a factor of eligibility, but is required information.
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