Page 12 - Louisiana

Proof of Eligibility:
Guidelines and Examples

• Supplemental Security Income (SSI)
o Benefit Letter issued by the Social Security Administration (SSA) with the consumer’s
name, date, claim number, and payment amount
▪ USAC understands that consumers may request a beneficial verification letter
via my Social Security account. This letter may also be referred to as “my Social
Security Benefit Verification Letter,” a “budget letter,” a “proof of income
letter,” or a “proof of award letter.”
▪ To be acceptable, documentation must show supplemental security income
payments, not Social Security benefits.
o Notice of Award issued by the SSA with the consumer’s name, award date, claim
number, payment amount, and term dates
o Benefit Summary letter issued by the SSA with the consumer’s name, date, claim
number, description of payment assistance, and term date
o Notice of Change in Payment issued by the SSA with the consumer’s name, date, claim
number, description of change in payment assistance, and effective date
• Veterans Pension and Survivor's Benefit
o Pension Grant letter issued by Veterans Benefits Administration (VBA) with the
consumer’s name, address, benefit information or entitlement amount, and effective
date
o Cost of Living Adjustment (COLA) letter issued by VBA with the consumer’s name,
address, benefit information or assistance amount, and effective date
o Survivors Benefit Summary letter issued by the Department of Veterans Affairs (VA)
with the consumer’s name, address, description of benefit, and effective date
o Survivors Pension COLA issued by the VA with the consumer’s name, address, benefit
information or assistance amount, and effective date

Tribal Program Documentation:

In addition to the programs listed above, consumers living on federally recognized Tribal lands can use
the following Tribally administered programs to qualify for Lifeline:
• Bureau of Indian Affairs General Assistance (BIA)
o Award letter issued to a beneficiary of the Bureau of Indian Affairs (BIA) General
Assistance Program receives an award letter from the national or regional BIA office.
o Benefit check stub from the BIA may also be submitted as proof of participation, if the
check stub clearly states the date and name of the beneficiary and that the benefit
received is BIA General Assistance.
o The beneficiary named on the BIA General Assistance documentation may be the
consumer, the consumer's dependent, or a member of the consumer's household.

• Tribally Administered Temporary Assistance for Needy Families (Tribal TANF)
o Award or Benefits letter issued by BIA or other Tribal Association which includes the
following information:
▪ Name of the program
▪ Name of beneficiary
▪ Address of beneficiary
▪ Date of the Award

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Proprietary and Confidential 1/20/2020