Documentation/Verification of Deprivation 400-19-45-70-20

(Revised 6/1/10 ML #3218)

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IM 5422

 

 

Death

The death certificate is the primary verification for this element.

Document or other record available from the client or other sources

  • Death Certificate
  • OASDI Record of Lump Sum Death Payment
  • Veteran’s Record of Widow or Survivor’s Benefits
  • Veteran’s Administration Death Payment Correspondence
  • Insurance Company Death Settlement Correspondence
  • OASDI Survivor’s Benefit Notices
  • Vital Statistics
  • Newspaper death notice
  • Insurance company records
  • Social Security records
  • Funeral Director
  • Veterans Administration
  • Hospital records
  • Institutional records
  • Military service records
  • Church Record
  • Tribal Record

 

Incapacity/Disability

Document or other record available from the client or other sources

  • Disability Certification by Social Security Administration
  • Medical Examination Report
  • Medical Statement from doctor, hospital, or clinic
  • Physician’s Records
  • Hospital Records
  • Clinic Records
  • Veterans Administration Records
  • Rehabilitation Centers’ Records
  • Psychological Tests
  • Psychiatric Records
  • State Review Team

 

Continued Absence from the home

Document or other record available from the client or other sources

  • Divorce Papers
  • Separation Papers
  • Military Record Papers or Induction Notice
  • Annulment Papers
  • Contact with absent parent
  • Shelter Record of absent parents, lease, or rent receipts, etc.
  • Post Office Record of Address
  • Motor Vehicle Registration
  • Driver’s License
  • Court Records
  • Correctional Institution records
  • Statements from reputable sources in the community
  • Union Records
  • Law Enforcement Officials
  • Employer Records