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VERIFYING DISABILITY/INCAPACITY - CASH

ISSUE DATE: 06/2018

Social Security Administration (SSA) determinations and benefits may be verified with the State Verification and Exchange System (SVES) interface between MAXIS and SSA. See TEMP Manual TE02.12.13 (SVES TPQY Interface) for more information on this interface.


MFIP:

Do not ask for proof of illness or disability you expect to last less than 30 days unless the claim is questionable.


For households extended under the Ill/Incapacitated category which you expect to last 30 days or more, types of proof are:

Social Security Administration (SSA) disability status.

A qualified professional’s or psychologist's report based on the results of a current medical examination or a current psychiatric evaluation (no older than 12 months). The medical statement must state the time period the disability will last. See 0011.39 (Qualified Professionals).

If the qualified professional’s or psychologist's report alone does not prove disability, get a vocational history for the last 5 years to supplement the medical statement.


When possible, the county agency should determine disability. When you cannot tell if the evidence proves disability, refer the case to the State Medical Review Team (SMRT).

Counties may submit a Referral to SMRT by Fax or SIR Email:
Fax to 651-431-7461 or 1-800-311-3137.
SIR Email to the SMRT Case emailbox at dhs.smrtcases@state.mn.us

All submissions must be in the following format:

Documents must be in a multipage format. Do not send individual documents.

Documents must be arranged in a portrait orientation. Do not use not sideways or upside down orientation.

Documents must be placed in the following order:

1.

State Medical Review Team Referral for Disability Determination (DHS-6123) (PDF).

2.

State Medical Review Team Authorization to Release Protected Health Information (DHS-6124) (PDF).

3.

State Medical Review Team Adult Disability Worksheet (DHS-6125) (PDF) or State Medical Review Team Children’s Disability Worksheet (DHS-6126) (PDF).

4.

Medical Documentation. Medical evidence from the last 3-6 months relevant to the disabling condition.


Submissions must not include copies of medical bills, health care applications, driver’s licenses, birth certificates, Explanation of Medical Benefits (EOMB), or other documents that are not medical records.

The county agency must pay for costs the client incurs for medical reports using MA administrative account funds.

Clients who do not cooperate in the process cannot use disability as a basis of exemption from Employment Services.

The SMRT returns its determination and the supporting evidence to the county agency. In some cases the SMRT must request additional information. A SMRT decision is binding on the county agency, although clients may appeal. See 0027 (Appeals).


DWP:

Follow MFIP, EXCEPT do not ask for proof of illness or disability you expect to last less than 30 days unless the claim is questionable.


SNAP:

See 0010.18.06 (Verifying Disability/Incapacity - SNAP).


MSA:

Verify blindness or disability by either:

Receipt of RSDI or SSI based on the person's blindness or disability.

OR

The person has SSA 1619B status as indicated on MAXIS. See TEMP Manual TE02.07.259 (1619 A and B Status).



GA:

Use any 1 of the following as proof of illness or disability/incapacity:

The Request for Medical Opinion (DHS-2114) (PDF) (for non-SMRT referrals) signed by a qualified professional. The DHS-2114 certification is valid for 6 months from the date of last examination unless a shorter or longer time frame for the condition is specified. See 0011.39 (Qualified Professionals).

The SMRT Determination of Disability

The person has SSA 1619B status as indicated on MAXIS. See TEMP Manual TE02.07.259 (1619 A and B Status).

Other medical certification. See MEDICAL CERTIFICATION in 0002.39 (Glossary: Lump Sum...).



GRH:

Follow MSA, for blind, aged, and disabled clients.

For all other adults, verify that a person has a disabling condition that limits the ability to work and provide self-support according to a person’s basis of eligibility as follows:

Permanent illness. See 0011.39 (Qualified Professionals).

- Request for Medical Opinion (DHS-2114) (PDF).
OR
- Group Residential Housing - Professional Statement of Need (DHS-7122) (PDF).

Temporary illness. See 0011.39 (Qualified Professionals).

- Request for Medical Opinion (DHS-2114) (PDF).
OR
- Group Residential Housing - Professional Statement of Need (DHS-7122) (PDF).

Requires services in residence. See 0011.39 (Qualified Professionals).

- Group Residential Housing - Professional Statement of Need (DHS-7122) (PDF).

Unemployable.

- Assessment by vocational specialist. See 0013.18.21 (GRH Basis – Unemployable).

Medically certified as having developmental disability or mental illness. See 0011.39 (Qualified Professionals).

- Request for Medical Opinion (DHS-2114) (PDF).
OR
- Group Residential Housing - Professional Statement of Need (DHS-7122) (PDF).

Application or appeal pending for Social Security Disability or SSI. See 0011.39 (Qualified Professionals).

- Request for Medical Opinion (DHS-2114) (PDF).
AND
- Proof of application or appeal to the Social Security Administration.

Advanced age.

- Assessment by vocational specialist. See 0013.18.21 (GRH Basis – Unemployable).
OR
- Proof of work history showing decreased occupational status. See 0013.18.30 (GRH Basis – Advanced Age).

Learning disability. See 0011.39 (Qualified Professionals).

- Request for Medical Opinion (DHS-2114) (PDF).
OR
- Group Residential Housing - Professional Statement of Need (DHS-7122) (PDF).

Drug/alcohol addiction. See 0011.39 (Qualified Professionals).

- Request for Medical Opinion (DHS-2114) (PDF).
OR
- Group Residential Housing - Professional Statement of Need (DHS-7122) (PDF).

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