.01 Date of Birth Verification - CA
The following documents are acceptable verification for date of birth for CA:
●Adoption records
●Baptismal certificate before age five
●Certificate of Indian Blood (CIB)
●Certificate of Live Birth signed by a hospital official and a parent
●Certified Birth Certificates issued by U.S., state, or a local Bureau of Vital Statistics
●CR600 AHCCCS Deemed Newborn report
●Hospital Birth Certificate
●Social Security records
●Tribal Census Card
●Completed Tribal Records Request (FAA-0061A) form
●U.S. Passport
●Workforce Investment Act (WIA) document assigning to an institution of higher learning
When the previously listed documents are not available, the following are acceptable forms of verification for date of birth for CA:
●Affidavits
●Child welfare records
●CLIS when the CLIS VR field displays V (verified)
●Court child support order
●Doctor's statement
●Family Bible record
●Federal or state census records
●Insurance policy
●Juvenile court records
●Minister's statement
●School records
●Voluntary social service agency records
At the interview, request that the PI provide date of birth verification for each CA participant when a participant's age could affect eligibility.
The PI may not have the verification with them at the interview. When this occurs, have the PI sign an Authority to Release Information (FAA‑1765A) form.
Send the appropriate forms to obtain the required information. (See
Requesting Verification of Birth or Death)
When written verification has not been received by the time the case is ready to complete, call the appropriate contact for the information.
When verification is not received by the processing deadline, deny, close, or do not allow the deduction, depending on the reason verification is needed.
When it is necessary to deny or stop benefits, key DI or OU in the PT field on SEPA next to the participant for whom verification is needed. (See
CA Nonparticipants and
CA Participants Keyed as DI)
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When keying DI requires a Denial or Closure Reason Code, do not use the G (age) Code. in the RSN field on SEPA. Key the reason the verification of date of birth was needed (e.g., dependent child, school attendance, etc.).
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