Family MO HealthNet (MAGI) Manual – Table of Contents

1805.040.10.15.10 Types of Evidence to Support Good Cause

IM-#97, November 9, 2015

Evidence to support a good cause claim may include the following:

      1. Incidents of domestic violence resulting in physical or emotional harm to the child, applicant, or participant.

        Types of Evidence:

        • Court, medical, criminal, child protective services, social services, psychological, or law enforcement records. These records or statements should indicate that the noncustodial parent may inflict physical or emotional harm on the child, applicant, or participant as a result of cooperation
        • Medical records including the emotional health history and present emotional health of the child, applicant, or participant. These may be in the form of a written diagnosis or prognosis from a mental health professional indicating the emotional health of the child, applicant, or participant. These records should indicate that emotional harm to the child, applicant, or participant would result from cooperating
        • Medical and court records indicating that the noncustodial parent caused physical or emotional harm to the applicant or participant as a result of domestic violenceWhen documentation is unavailable, accept statements of the child, applicant, or participant. The applicant or participant is responsible for providing enough information to establish good cause and explain why no evidence is available. Make efforts to corroborate the statements by someone familiar with the situation
      2. A child is conceived as a result of forcible rape or incest.

        Types of Evidence:

        • Birth certificates
        • Medical or law enforcement records indicating that the child was conceived as a result of forcible rape or incest.These records may include a written statement from the applicant or participant if formal documentation is not available.
      3. Adoption proceedings pending:

        Types of Evidence:

        • Court documents or other records to indicate that legal adoption proceedings are pending, including written statements from staff of a public/private adoption agency.
      4. Counseling regarding relinquishment:

        Types of Evidence:

        • Written statements from public or private social services agencies stating that the applicant or participant is being assisted to resolve the issue of whether to keep the child or relinquish the child for adoption. The good cause for counseling is limited to three months.
      5. All above situations (#1-4) with the exception of emotional harm:

        Types of Evidence:

        • Sworn statements from individuals other than the applicant or participant with knowledge of the circumstances on which the good cause claim is based. A statement given under oath to a notary public is the most common and most available type of sworn statement.
        • NOTE: If the applicant or participant needs a mental evaluation to prove emotional harm, the evaluation is paid the same as an examination to determine incapacity. The evaluation is valid for two years unless the mental health professional or Income Maintenance staff determines that another evaluation is needed.

Additional evidence may be requested when evidence provided by the applicant or participant does not provide enough information to make a good cause determination.

NOTE: DO NOT CONTACT THE NONCUSTODIAL PARENT UNDER ANY CIRCUMSTANCES.