Minnesota Minnesota

MFIP Employment Services Manual

MFIP Employment Services Manual


17.48 Documenting Conditions

ISSUE DATE: 09/2020

Qualified professionals can use DHS forms or their own forms or letters.

Medical opinion forms

The state provides a medical opinion form that employment services counselors may ask qualified professionals to complete: Request for Medical Opinion (DHS-2114) (PDF).
There is also a FSS Medical Cover letter, Family Stabilization Services Medical Cover Letter (DHS-5285) (PDF).

The information to be included whether qualified professionals use a DHS form or their own forms:

  • · The professional’s name.
  • · Date of most recent exam.
  • · Diagnosis.
  • · The length of time the condition is anticipated to last.
  • · Identification of any permanent physical or mental limitations.
  • · Indication of whether there is a treatment plan and whether the patient is following the plan.
  • · Information about any limitations on the type of work or amount of work the participant can do, including whether the participant can sustain 20 hours of work a week.

  • End dates and renewals of medical opinions.

  • · Request a new medical opinion form before the current form expires.
  • · Assume the condition continues until the end date the qualified professional has indicated in the medical opinion.
  • · If the medical opinion indicates that there is not an end date for a condition, that opinion is valid for a year from the date the professional signed it.
  • · Request a new medical opinion form each year in order to assess the participant’s ability to work at least 20 hours a week if the participant’s condition is permanent. A new diagnosis of the condition itself is not necessary if the condition is permanent.

  • Information on these conditions is medically protected information.

  • · There must be a signed release from the participant to seek a medical opinion from a qualified professional.
  • · For policies on handling medical information in case notes, see Chapter 04 (Participants' Rights).
  • · For policies on handling information about someone’s mental health, chemical dependency or experience with family violence, see Chapter 04 (Participants' Rights).
  • · Participants have the right to see most of the private medical information about themselves, see Chapter 04 (Participants' Rights).
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