477.6 Client Verification Request Form (PA 162-VR)

The CAO will send a Client Verification Request Form (PA 162-VR) when an individual or his representative has not reported information appearing on the Income Eligibility Verification System (IEVS) or Workload Dashboard (WLD); or information conflicts with the individual's statements. The individual or his representative is advised on the PA 162-VR that he has 10 calendar days to respond to the request for information.

NOTE: The CAO will send the PA 162-VR to the LTC facility if a representative of the facility is acting on behalf of the individual.

After allowing the 10 day response period, if the individual or his representative refuses or fails to cooperate in resolving the conflict, the CAO will send an Advance Notice to close the case.  The CAO will verify the IEVS or Data Exchange information by use of third party contacts, if possible, to determine if an overpayment has occurred.

Issued May 1, 2012