3.1 — Reviewing eligibility

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December 2021

Summary of Policy

To determine ongoing eligibility, a recipient is required to provide information regarding new or changed circumstances which may affect eligibility or the amount of income support received. Some examples include changes in disability or membership in a prescribed class, the receipt or disposition of assets, and the receipt or expected receipt of income or other financial resources, a change of address, shelter costs, utilities, living arrangements, family composition, assets, income and hospitalization.

The Director may require a member of a benefit unit to provide monthly reports respecting income, annual reports respecting business assets and income from the operation or interest in a business, and any other conditions relevant to determining eligibility.

The Director may request a visit to the home of a person receiving income support in order to verify ongoing eligibility for income support.

Legislative Authority

Summary of Directive

Information update reports include the:

Employment Training and Income Report (ETIR)
Update Report

Required documentation must be either:

Visually verified and noted on the Social Assistance Management System (SAMS), or copied and placed on the master file
Failure to provide required information may result in a decision of ineligibility or cancellation of income support, provided that staff have followed all policy conditions

Intent of Policy

To ensure that a recipient provides information required to determine ongoing eligibility for income support.

Application of Policy

Standards

Eligibility for ODSP income support is based on individual circumstances. Changes in financial or other circumstances which may affect eligibility or the amount of income support received must be reported by a recipient or trustee.

Monthly Reporting Requirements: Earnings and Changes in Circumstances

Earnings from Employment or Training

Earnings from employment or a training program are to be reported on a monthly basis by all members of the benefit unit with reporting requirements.

The income reporting period for earnings from employment or training is from the first day to the last day of a calendar month. Earnings received during this period are used to calculate income support for the following month.

Earnings are reported on the Employment/Training Income Report (ETIR). The ETIR is sent monthly to all recipients, enclosed with the income support cheque or statement. Earnings which must be reported include wages, salaries, vacation pay, commissions, tips, gratuities, casual earnings and training allowance income. Child care and disability- related employment expenses may be deducted from earnings from employment or training. The ETIR must be received at the local ODSP office by no later than the 7th day of the month following the income reporting period.

In unusual or special circumstances, alternative reporting arrangements may be appropriate. For example, a recipient with a visual impairment could report earnings information over the phone with verification to follow, or earnings could be submitted by the employer with the recipient's consent. Direct deposit statements and/or a signed declaration could also be considered as acceptable verification of earnings. However, it is essential that earnings are accurately entered into SAMS on a monthly basis.

Exceptions to monthly reporting of earnings from employment or training

The following are not required to submit an ETIR each month:

Self-employed persons as they have annual reporting requirements (see Directive 5.4 Self-Employment Income, Directive 5.6 Private Home Day Care Providers, and Directive 5.7 Farm Income).

Recipients who only receive Assistance for Children with Severe Disabilities (ACSD) as this program has its own specific requirements.

Recipients participating in supported employment programs whose earnings are unchanged from month-to-month. (Note: appropriate verification of the monthly earnings must be on file for audit purposes.)

There is no requirement to report earnings of dependent children.

Reporting Changes

Recipients are required to report all changes in circumstances. A recipient is responsible for reporting changes in circumstances which may affect eligibility or the amount of income support received. A change in circumstance includes a change of address, shelter costs, utilities, living arrangements, family composition, assets, income and hospitalization.

Verification of the change is required to confirm ongoing eligibility and to ensure that the correct amount of income support is provided. Information can be reported by email, in person, mail, on-line etc.

Financial Eligibility Reviews

Eligibility Verification Process

The Eligibility Verification Process uses a risk-based approach to review ODSP recipients’ ongoing eligibility for income support.

The Eligibility Verification Model (EVM) will identify cases in which there is a high likelihood that there has been a change in the recipient’s financial eligibility, which has not been reflected in the amount of assistance issued. Each month, a percentage of the cases (3%) identified as high risk will be assigned to staff for review.

Caseworkers will analyze third party consumer credit and EVM output information against information on the recipient’s file to determine if the recipient continues to meet eligibility requirements. The Caseworker will also determine whether the amount of income support being issued is correct and will make the appropriate adjustments.

Application for Assistance (Part 1) Updates

The Application for Assistance under the Ontario Disability Support Program Act, Part 1, is used as both an Application form and an Update Report. It is a financial assessment tool used to determine initial and ongoing eligibility.

Any changes in financial or other circumstances, which may affect eligibility or the amount of income support received, are to be reviewed on an ongoing basis to ensure ongoing eligibility.

Caseworkers may determine if a complete file review and update report is necessary based on their knowledge of the case file and assessment of eligibility risk factors such as duration since last complete review, duration since date of grant and previous eligibility-related issues.

The review and update report can be completed:

in person, which can take place in the office, community, or in the recipient's home, based on the recipient's needs and the office's capacity
over the phone and then signed and commissioned during a follow-up interview, which can take place in the office, community, or in the recipient's home, based on the recipient's needs and the office's capacity
over the phone, reviewed verbally and then sent to the recipient with instructions to sign and return them

The purpose of the file review is to become familiar with issues related to eligibility and entitlement and to identify issues that require follow up.

The file review will focus on confirming current eligibility and current entitlement
Only documentation/verification related directly to determining eligibility and/or the accurate amount of income support is required
If the review of current eligibility raises concerns about previous eligibility and/or entitlement, additional verification can be requested on an “as needed” basis only
Appropriate third party checks are completed for each review as required
The electronic and/or master files are reviewed with third party information
Outstanding information requirements are requested by sending the Advance List to the recipient or a letter outlining what is required to assess eligibility for the period under review
Each section of the update report must be reviewed and updated. Any changes must be verified with the required documentation
Confirm the eligibility for a Special Diet Allowance, where it is in pay, if the EVP review precedes the expiry date of the Special Diet Allowance. A Special Diet Allowance that has been approved as indefinite is reviewed at the time of the recipient’s EVP review.
If completed during an in-person interview, the update report is commissioned by reading each section of the statutory declaration and witnessing signatures. The Caseworker then signs the update report and affixes their commissioner stamp by their signature.
The general Consent to Disclose and Verify Information and Canada Revenue Agency Consent to Disclose and Verify Information are completed and signed
The Rights and Responsibilities form (Form 2865) is reviewed. A signed copy is retained on the master file, and a copy given to the recipient.
Other forms are completed as required such as an Assignment and Direction Form if the recipient has applied for certain incomes, a Declaration of Support/Maintenance (Form 2212) if there are issues related to support obligations, and a Declaration (Form 0311) if a written declaration is required etc.
For telephone interviews where there is no follow-up interview with the recipient, the update report cannot be commissioned after it is returned as the Caseworker has not reviewed the statutory declaration with the recipient in person and witnessed their signature
For these cases, a line should be drawn through the commissioner’s signature section before the form is mailed to the recipient. The consent forms and Rights and Responsibilities form should be reviewed verbally and then sent to the recipient with instructions to sign and return them.

Note: Where the Declaration of Support/Maintenance (Form 2212) is completed over the telephone and mailed to the recipient, a line should be drawn through the commissioner’s signature section before the form is mailed. A Declaration (Form 0311) cannot be completed by mail.

Third Party Verification

Eligibility reviews include third party checks, which are completed to verify eligibility related information provided by a recipient.

Third party checks include requests from the following:

Ministry of Transportation - obtained where there has been a history of vehicle ownership or changes in address
Equifax (credit check) - obtained for asset verification - mandatory
Family Responsibility Office (FRO) - obtained for spousal support payment information
Canada Revenue Agency (CRA) - obtained for income verification and other eligibility-related information - mandatory
Employment Insurance (EI) - obtained where there has been a history of employment and potential eligibility for EI benefits

Additional requests may be made, as required, to obtain or verify eligibility-related information on behalf of the recipient or any other member of the benefit unit.

Home visits should be conducted in accordance with the following guidelines:

For purposes of completing an update report, the recipient is notified in advance of the visit to facilitate information gathering prior to the update interview
Home visits are to be conducted during normal business hours
While in the home, only objects in plain view can be noted. There is no authority to look in places or areas that are not in plain view (i.e. cupboards or drawers)
Plain view includes assets such as vehicles, confirming residency and accommodation arrangements, etc.
The right to protection against inappropriate search of the person extends to one's home. Entry into a person's home for the purposes of investigating the person or their home would require a search warrant
If the recipient refuses entry to the home, the reason for the refusal must be obtained. Valid reasons for refusing entry may include an illness in the home, mourning, religious observance and/or visitors in the home where privacy is of concern to the recipient.

Verification Requirements

The following chart identifies verification requirements and whether the document is to be visually verified or whether a copy of the document is to be placed on the Master File. Some documents require both.

Verification of Documents	Visually verified and input into the SAMS	copy of Original placed on Master File
Social Insurance Number	✓
Health Number	✓
Proof of all Members Identity and Date of Birth		✓
Verification of Income	✓*
Verification of Assets	✓
Verification of Shelter Costs	✓
Participation Agreement for Non-Disabled Spouse and Dependent Adult	✓
Verification of Person's Status in Canada		✓
Information Regarding Debts	✓

* Exceptions include spousal support provisions where original documentation or a copy of verification of support or waivers for the pursuit of support, must be placed on the master file. For child support, visual verification is not required.

Note: when information is received and verified it should be recorded in the Notes section of the SAMS

Social Insurance Number (SIN) or other official documentation of the SIN (tax form) must be visually verified and noted in the SAMS. Once the SIN is verified and input electronically, copies are not to be placed on the master file.

Health Number (HN) can be collected and recorded for the purpose of providing provincially funded health services. The HN must be visually verified and noted in the SAMS for all members of the benefit unit. Other official documentation of the HN includes a letter from Immigration, Refugees and Citizenship Canada (IRCC). Once the HN(s) is verified and input electronically, copies are not to be placed on the master file.

Proof of the identity and date of birth of all members of the benefit unit must be photocopied and placed on the master file and the information recorded in the SAMS. Identity and date of birth can be verified with one of the following:

Birth certificate
Religious Records (Baptismal and/or Confirmation certificate on church stationary, Bible Record, etc.)
Naturalization certificate
Hospital record of birth
Statement of live birth
Confirmation by Registrar General of Notice of Registration of Birth
Passport (i.e., Canadian or foreign)
Landing Record
Marriage certificate
Military record
School record
National Registration File of 1940 held by Statistics Canada
Indigenous membership records (e.g. band membership cards, Huadenosaunee/Iroquois Passport, Métis Nation of Ontario (MNO) issued membership, etc.)
Indian Status card (formerly known as Certificate of Indian Status)
Immigration documents
Ontario Driver’s Licence
Ontario Photo Card

In the case of a child who is adopted, verification of the adoption as proof of identity is not generally required. However, in some circumstances, the adoption order may assist in providing further support regarding the person’s identity. For example, where the adopted child’s surname is different than the parents’ surname. In these cases, a copy of the adoption order with the identifying information related to the birth parents removed can be requested.

A photo health card issued by the Ontario Ministry of Health is acceptable documentation to verify identity and date of birth for adults for the purposes of social assistance. A Ministry of Health issued photo or non-photo health card may be used to verify the identity and date of birth of dependent children. In these cases, the identity and date of birth should be visually verified, and a note added to SAMS that visual verification was made. No copy of the health card should be made.

For a variety of systemic reasons, some Indigenous people may not have access to birth certificates or other forms of identification listed in the directive. In these relatively limited cases, there may be other documentation that is acceptable to verify an applicant’s identity based on individual circumstances.

Verification of Income: Other income is taken into account in determining eligibility for income support. All sources of income are reviewed and recorded in the SAMS.

Income tax information is used to verify total income reported for any period under review through EVP as well as the source of the income. It may also be used to verify additional information such as reported marital status and address. Please note that a mandatory third party check is obtained from CRA, however, a recipient may be requested to provide additional income tax information, such as the original Notice of Assessment or a printout of the electronic version, copy of income tax return, T4s, etc.
Earned income is visually verified and recorded in the SAMS through the monthly income reporting process. Any change in the amount of the income is recorded in the SAMS. The amount of income support is adjusted accordingly.
Other income sources such as Old Age Security, GAINS, Canada Pension Plan benefits and annuities etc. are input into the SAMS. Any change in the amount of the income is recorded in the SAMS. The amount of income support is adjusted accordingly.

Although child support is exempt as income effective January 1, 2017, it is still reported. Verification is not required. However, if the client does provide verification, it should be visually verified. Where child support is in pay and the applicant/recipient reports the amount of support, this information should be input into SAMS.

Information regarding spousal support must be verified. Copies of verification must be placed in the master file. Verification of spousal support includes a support court order, a private agreement, and or a divorce settlement. At each review, a Declaration of Support and Maintenance (Form 2212) must be completed on each absent person who may have an obligation to provide spousal support to the recipient and placed on the master file. Waivers for the pursuit of spousal support including police reports, medical reports, or confirmation that the spouse is receiving social assistance are noted on the SAMS and copied to the master file. See Directive 5.15 Spousal and Child Support. Where spousal support is in pay, the amount of support must be input into the SAMS. Any change in the amount of support is recorded in the SAMS. The amount of income support is adjusted accordingly.

Information regarding sponsorship support must be verified. Information regarding length of the sponsorship undertaking and the name of the sponsor must also be verified. Copies of verification must be placed on the master file. Verification includes a private agreement for sponsorship support, the Request for Family Class Information (RFCI) form completed by IRCC, Record of Landing, etc. A Declaration of Support and Maintenance (Form 2212) must be completed on the sponsor and co-sponsor, if applicable, and placed on the master file. See Directive 2.5 Tourists, Immigrants, Refugees and Deportees. Where sponsorship support is in pay, the amount of support must be input into the SAMS. Any change in the amount of support is recorded in the SAMS. The amount of income support is adjusted accordingly.

Verification of Assets: Assets are taken into account in determining eligibility for income support.All assets are reviewed and recorded in the SAMS. For update purposes, bankbooks or statements for one month prior to the date of review should be verified to identify any unreported income sources. If there is reason to require additional information, any additional statements/bankbooks available to the recipient without incurring fees or charges will be requested. Where payment is required and the person is unable to cover the cost, alternate methods of verification should be explored, such as obtaining the information directly using the Consent to Disclose and Verify Information Form.

The reloadable payment card (RPC) is not a bank account and only social assistance funds can be loaded onto the card. Any remaining balance on an RPC should be treated as a cash asset. The balance should be confirmed at the time of update (i.e. bank machine receipt). Statements for previous periods are not required.

It is important to review bank balances in combination with other assets such as life insurance policies, funds held in trust and savings plans to ensure asset levels are within the prescribed amount. Once assets are verified and noted in the SAMS, a copy of the record is not required to be placed on the master file.

Verification of Shelter Costs: Accommodation costs are used to establish budgetary requirements and the amount of income support that the recipient will receive. Visual verification and electronic input of documentation related to shelter costs is limited to the minimum necessary to verify shelter costs up to the maximum. For example, if a single recipient pays rent of $500 per month plus utilities, only visual verification of the rent is required as it exceeds the maximum shelter allowance for a single person.

Once the information has been visually verified, and input into the SAMS, verification of the shelter costs is not required to be placed on the master file. The following are acceptable sources of verification:

Letter from landlord
Rent receipt with landlord’s name and number
Lease or rental agreement
Mortgage statement or agreement for payments of principal and interest
Loans for purchase of principal residence or necessary repairs of residence
Property tax assessment or proof of property tax payment
Premiums paid for dwelling and content insurance
Common expenses for condominiums or cooperative housing units
Statements or receipts for the payment of utilities, water, sewage and the rental of a furnace or hot water heater
Statements or receipts for the cost of heat.

In a situation where a recipient does not use the income support amount provided for shelter toward their accommodation costs, an overpayment is not established. Rather, pay direct or trusteeship may be options to investigate to ensure the recipient retains their lodgings. See Directives 6.2 Shelter Calculation, 10.1 Pay Direct and 10.2 Trustees.

Participation Requirements for Non-Disabled Spouses and Dependent Adults:

Unless they meet the criteria for a waiver, non-disabled adult members of an ODSP benefit unit must complete an Ontario Works Participation Agreement and comply with the employment assistance provisions in the Ontario Works Regulation as a condition of eligibility for ODSP. Non-disabled adults include:

a dependent adult; and
a spouse other than a spouse who has been adjudicated and found to be a person with a disability under section 4 of the ODSP Act, or who is a member of a prescribed class under section 4 of the ODSP Regulation.

A non-disabled adult can have their referral to Ontario Works employment assistance waived under some circumstances. In order to have their referral to Ontario Works waived, the person is required to provide appropriate documentation to verify their circumstances. See Directive 2.8 Participation Requirements for Non-disabled Adults.

Verification of Status in Canada:

Documentation regarding status in Canada must be on file for all members of the benefit unit. This information should be recorded in the SAMS. If documentation is not on file, or if there has been a change of status in Canada, it must be provided at the time of the EVP review. Acceptable documentation includes one of the following:

Canadian Birth Certificate;
Certificate of Canadian Citizenship;
Indian status card (formerly known as Certificate of Indian Status);
Temporary Confirmation of Registration Document;
valid Canadian passport;
Confirmation of Permanent Residence (IMM 5292 or 5509);
Permanent Resident Card;
letter issued by IRCC verifying permanent residence status;
proof of application for permanent residence status;
Determination of Eligibility for refugee status (IRCC form IMM1442 or IMM5292);
Refugee Protection Claimant Document (IMM-1442);
Acknowledgement of Claim and Notice to Return for Interview Form;
Entry for Further Examination or Admissibility Hearing Form;
Acknowledgement of Conditions Form (IMM-1262);
Temporary resident document (IMM1442 or IMM1263); or
other acceptable document that confirms status in Canada status in Canada (such as the Request for Family Class Information (RFCI) form or the Acknowledgement of Claim and Notice to Return for Interview Form completed by IRCC).

Ontario has an information sharing agreement with IRCC. Under this agreement the nearest IRCC office may be contacted for confirmation of an applicant’s status in Canada ((This process is not applicable when confirming a person’s Indian status). The agreement permits ODSP staff to provide information to IRCC to administer and enforce federal immigration legislation only when IRCC requests it.

Note: where the recipient is a sponsored immigrant, verification of the length of the sponsorship undertaking and the name of the sponsor must be on file (i.e. RFCI, etc.)

Information Regarding Debts:

Information regarding debts owed by the recipient is recorded in the Notes section in the SAMS. The information may be used to verify a recipient’s debts and repayment requirements. Information sources of debts include the following:

Credit Card statements
Loan agreements and outstanding balances
Letters of promise to pay individuals who have loaned the recipient money on the condition of repayment
Letter from credit counselling agency

Once the amount has been visually verified and the information recorded in the Notes section regarding the origin, date and amount of the debt, ensure that this Note is printed on the Application for Assistance, Part 1. A copy of the debt is not to be placed on the master file.

Note: Information related to an amount owed by a recipient may assist in determining eligibility at a future date if a situation arises regarding disposition of assets where the debt is paid using assets or income received by the recipient.

Suspension of Income Support

Where required information and documentation continue to be outstanding without reason, income support may be suspended. Suspension of a recipient’s income support may only be imposed after all of the following conditions are met:

the information and/or documentation requested is essential for the determination of eligibility or the accuracy of the entitlement
the recipient has been given notice of what information and/or required documentation is outstanding
the information and/or documentation is within the ability and power of the recipient to obtain

Persons with disabilities may require additional time to obtain or access the necessary information required to verify eligibility for ODSP. Wherever possible, requests for additional time to obtain information should be granted. A test of reasonableness should be applied to determine the amount of additional time allowed to obtain the necessary information.

Where a recipient encounters barriers to obtaining the required documentation or is required to pay to get documentation and is unable to cover the costs, alternate methods of verification should be explored. Alternate methods could include obtaining the information directly from the source using the Consent to Disclose and Verify Information Form.

If a recipient whose income support has been suspended has made reasonable efforts to obtain the necessary information/documentation, they have met eligibility requirements and income support should be released.

The following scenarios outline when it is appropriate/inappropriate to suspend/cancel income support:

Scenario #1

Recipient notifies the Caseworker that their rent has increased and is asked to provide verification of the new rental amount. Recipient is already receiving the maximum shelter allowed under ODSP and rent was previously visually verified and noted in the SAMS.