Self-Declaration

A self-declaration is a statement from the client, attesting to an expense amount or other circumstances of the case. There are three types of self-declarations:

• Verbal - a verbal declaration from the client with no signature; or
• Telephonic - a verbal declaration followed by the client providing a signature via the telephonic signature line; or
• DTA Connect – a signed and dated electronic statement from the client. A datasheet will be created and added to the Client Communication page in BEACON.
• Written - a signed statement from the client. Acceptable verification requirements for documents that usually require a signature are outlined here: Signatures on Verification.

There are a limited number of items that can be self-declared. Self-declarations must be accepted for these items. Once a self-declaration has been submitted for a qualifying item, you must not send a Verification Checklist (VC-1) for it unless the information reported is questionable .

Any signed document attesting to a self-declarable verification item must be accepted. This includes, but is not limited to, signed Applications, Interim Reports, Recertifications or Reevaluations, and any other written or typed correspondence from a client that contains their signature including a typed or digital signature.

Some eligibility factors do not require a written or telephonic self-declaration. For such items, DTA can rely solely on the client’s verbal attestation. The items that clients can verbally self-declare include, but are not limited to, the following:

• Date of birth
• SSN (DTA subsequently verifies this through the SSA)

• The purchase and prepare arrangement of household members
• Name(s) of child(ren) for whom Child Support payments are being made when verified through UI Online
• Report loss of food due to household misfortune
• Frequency over over-the-counter medications (unless questionable)

Only the following items can be verified using a telephonic or a DTA Connect self-declaration. Please note that not all of the following are available to be reported on DTA Connect. What can be reported on DTA Connect is marked with an asterisk “*”.

• Voluntary closure/withdrawal of their case
• Dependent care expenses*

TAFDC and EAEDC

• Cash on hand
• Information of people who have joined or moved out of a household
• Past due housing and utility costs
• Good cause for refusing a bona fide offer of employment or training for employment
• TAFDC housing type
• EAEDC living arrangements A, B, H and D
• Who they live with
• Where they live after Massachusetts Residency has been established

For other verification items needed to determine TAFDC and EAEDC eligibility and benefit amounts, regulations state that only when the client has taken all necessary steps to obtain verification through documentary evidence and collateral contact , and no verification is available, that telephonic verification may be accepted as verification for the following eligibility factors:

• Ownership of bank deposits
• Inaccessibility of joint bank accounts and securities
• Age
• Relationship
• Canadian-born Indian status
• Good cause for failure to cooperate with the Child Support Enforcement Unit
• Good cause for refusing a bona fide offer of employment or training for employment
• Paternity
• Temporary absence
• Health insurance coverage*
• Termination of employment

• Shelter expenses*
• Utility expenses*
• Medical expenses less than or equal to $190 per month*
• Mileage related to dependent care expenses*
• Mileage related to medical expenses*
• Non-receipt of room and board fee in foster care arrangement (if foster care arrangement verification indicates a fee for room and board, but the caregiver tells you that they do not charge for room and board)
• 40 work quarters
• Amount of combat pay made available to the household by deployed service member
• Opt-out of mandatory income averaging for Bay State CAP client with fluctuating income
• Opt-out of Bay State CAP reporting
• Opt-in to Bay State CAP reporting if client had previously opted out
• Student Eligibility/Meal Plan
• Address Change* (if a client who already verified Massachusetts residency reports a new address in Massachusetts).

Proof of address change is different from proof of residency. For program eligibility purposes, Massachusetts residency is not a self-declarable verification item .

If a client appears on the Out of State EBT Card Usage Match and their EBT usage patterns are not consistent with someone who resides near the Massachusetts border, they must reverify residency because their EBT usage patterns make their residency questionable. (However, Simplified Reporting households who appear on the match do not have to reverify residency during case maintenance—only during application, recertification or IR.)

The following items can be self-declared. Clients must submit a written and signed self-declaration for these items, including a digital or typed signature.

• Earned income must be verified with documentary evidence . If the client cannot obtain documentary evidence, you must assist the client by using collateral contact . Collateral contact attempts must be documented in the narrative. If verification via documentary evidence and collateral contact are not obtainable, a written/typed and signed self-declaration may be accepted as verification as a last resort.

You must attempt to verify earned income information using the Work Number at application, recertification, or Interim Report, prior to sending the client a VC-1. If the client disputes the income available in the Work Number a VC-1 must be sent.

• Unearned income must be verified with documentary evidence if it is not available through an external data source. If the client cannot obtain documentary evidence, you must assist the client by using collateral contact . Collateral contact attempts must be documented in the narrative. If verification via documentary evidence and collateral contact are not obtainable, a written/typed and signed self-declaration may be accepted as verification as a last resort.

Earned and unearned income are listed here as examples of verification elements that usually require documentary evidence, but for which a written self-declaration is acceptable as a last resort. Accepting a written/typed self-declaration as a last resort in lieu of documentary evidence and collateral contact is also allowed for most other verification elements.

• Household Misfortune requires a signed SNAP 9-B form or a written and signed self-declaration attesting to the loss of food purchased with SNAP benefits, including the reason for the replacement request and verification of the loss. Clients can continue to report the loss verbally. For more information, see Household Misfortune Procedures .

Other non-eligibility items can be verbally self-declared. These include (but may not be limited to) the following:

• Request for Heightened Level of Security
• Removal of Heightened Level of Security
• Military/Veterans Status
• Opting in and out of text messaging
• Blocking Online Services

Whenever you attempt to issue a VC-1, INT-1, or INT-2 for an item for which the preferred method of verification is a self-declaration you will receive a warning edit on the verification page of BEACON which states:

“Some of the verification items listed in the ECF Verification tab can be verified as Self-Declaration or using data from a trusted match. Please review the verification items that are not verified.”

If the verification items are questionable, select the Questionable button to complete your response before printing a VC-1.

The Questionable Verifications page reads: “A self-declaration is the preferred type for this verification. Do you have a self-declaration at this time?”. If No is selected no further action is needed on this page. If Yes is selected, the toggle buttons for “Is this information questionable” must then be answered. If the document is not questionable and you select No, you must verify the item as a Self-Declaration in the Verifications Tab. If Yes is selected, you must click the icon and submit a detailed note explaining why the document is questionable. This will copy into the Narrative.

If the client submits a written/typed and signed self-declaration for any self-declarable verification item, you must accept the verification. Do NOT direct the client to resubmit the self-declaration using the telephonic signature line.

If the client provided the Department with a self-declaration that is considered questionable the VC-1 that follows will not list self-declaration as a verification type that can be provided.

The warning edit and Questionable Verifications page will also appear whenever you attempt to send a VC-1 for a self-declarable item for which telephonic signature is preferable.