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
