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Disability Procedures


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ALL Agency Rules & Procedures Practice Materials

  Title Sort By Title, Descending Date
Word Document DES Functional Capacity Questionnaire7/21/2008
Word Document DES Mental Impairment Questionairre7/21/2008
PDF Document Disability Evaluations: FY04 Inter-Department Service Agreement Between DTA and UMass Medical

Contract between DTA and U Mass Medical describing the disability review tasks umass will do for TAFDC and EAEDC disability claims. Current for July 1, 2003 to June 30, 2004.

6/19/2003
PDF Document FYI: Completion of Disability Evaluation Services (DES) Medical Release Forms

Explains DES requirements for medical release forms, including that every individual provider at a particular clinic must be listed separately on a separate form. Case workers are responsible for contacting clients when additional release forms are needed. Missing or incorrectly completed release forms should not delay case worker processing of the disability claim or an application for benefits.

11/22/2006
PDF Document PS 98-01: Determining Disability for Applicants and Recipients Alleging Drug and Alcohol Addiction (DAA)

Revised December 13, 2005. This is the revised version.

7/15/1998
PDF Document PS 98-02: Establishing Onset Date of Disability 7/15/1998
PDF Document PS 98-03 Establishing Duration (Review) Dates

Revised January 19, 2006. This is the revised version.

7/28/1998
PDF Document PS 98-04 Processing a Priority Case

Revised March 1, 2006. This is the revised version.

9/23/1998
PDF Document PS 98-05 Use of "Good Cause" related to CE appts.

Revised April 24, 2006 to comply with Thibault litigation. This is the revised version.

9/16/1998
Word Document PS 98-06 Determining Severity

This document was revised on March 1, 2006.  The revised version is posted here, as it replaces the one written in 1998.

9/24/1998
PDF Document PS 98-07 Clarification of Procedures Regarding the Assignment of Disability Duration

This PS is no longer in effect; it was superseded with the revision of Procedural Standard 98-3 dated January 19, 2006.

9/23/1998
PDF Document PS 99-01 Assessing the quality and adequacy of info in an EAEDC Med Rept and Supplmnt2/22/1999
PDF Document PS 99-02 Medical Equivalence for adults and children 2/22/1999
Word Document PS 99-03 Pursuit of supplemental information from a treating provider

This memo was revised June 2, 2008. Attached is the revised version.

6/2/2008
PDF Document PS 99-04 Role of Nurse Practicioners, PAs, and LICSW in CE Process3/10/1999
PDF Document PS 99-05 Consultative examinations by psychiatrist and psychologists - revision 9/20/1999
Word Document PS 99-06 Utilization of Interpreters for Consultative Examination Process

This document was revised in 2006; the revised version is attached.

6/30/2006
PDF Document PS 99-07 Documentation6/2/1999
PDF Document PS 99-08 Documentation Methods6/2/1999
PDF Document PS 99-09 Equivalencies for FVC, FEVl, Wt/Ht, Hct, PO2/PCO2, Renal Impairment6/9/1999
PDF Document PS 99-10 Determining conditions or diagnoses requiring additional information 7/14/1999
PDF Document PS 99-11 Unanticipated clinical finding during consultative examination

Revised January 11, 2005. This is the revised version.

8/24/1999
PDF Document PS 99-12 Reassignment of open cases to Team 1008/30/1999
Word Document PS 99-13 Procedure for processing prior approvals with time remaining

This form was revised in 2006.  The revised version is attached.

4/24/2006
PDF Document PS 99-14 Follow-up for applicant's complaint about CE Provider

This form was revised on April 24, 2006.  This is the revised version.

3/10/2000
PDF Document PS 99-15 Procedural Standard for Identifying fraudulent EAEDC Medical Reports8/31/1999
PDF Document PS 99-16 Procedure for Returning Cases to DTA Based upon MMIS DATA 9/30/1999
PDF Document PS 99-19 SSA Ruling: Revised Medical Criteria10/19/1999
PDF Document PS 99-20 Case File Order 11/16/1999
PDF Document PS 00-01: Voice Mail Message Log3/20/2000
PDF Document PS 00-03: Requesting Consultative Examinations5/30/2000
PDF Document PS 00-04: Release of Medical Information

This issuance is no longer in effect. See Procedural Standards PS 04-1, 04-2, and 04-3 for current language regarding similar issues.

9/9/1999
PDF Document PS 00-05: Incomplete Dictations of CE Reports and Multiple copies of CE Reports 6/15/2000
PDF Document PS 00-06: Disability determination on over 60 day cases7/6/2000
PDF Document PS 00-07: Threats of violence to self or others 8/2/2000
PDF Document PS 01-1: CommonHealth coverage for working disabled adults aged 65 and older3/7/2001
PDF Document PS 01-2: Medical Equivalence for Psychotic Depression4/7/2001
PDF Document PS 01-3 Preference Calls8/16/2001
PDF Document PS 01-4 Documentation of SSI/DTA criteria standards 11/14/2001
PDF Document PS 01-5 Determination of disability review date for vocational allowances 11/7/2001
PDF Document PS 01-6 Withdrawal of the DMA disability application

Revised November 14, 2005. This is the revised version.

8/8/2001
PDF Document PS 01-7 Reopening a DMA Pediatric case on or after the client’s 19th birthday. 11/14/2001
PDF Document PS 01-8 Processing a DMA case with an open DTA case in progress.12/14/2001
Word Document PS 02-1: SSI Revised Criteria

This Procedural Standard describes the SSI Revisions to criteria effective February 19, 2002, that were announced in the May, 2002 edition of Social Security eNews..

7/1/2002
Word Document PS 02-2: DMA Pooled Trust Applicants

The purpose of this memorandum is to inform DES employees of a category of DMA clients with pooled trusts who require disability determinations regardless of age.

7/29/2002
Word Document PS 03-01: Evaluation of Disability on the Basis of Mental Disorders

This Procedural Standard provides an overview of SSI and Department of Transitional Assistance regulations regarding the evaluation of disability on the basis of mental disorders.

2/26/2003
PDF Document PS 03-02: DES Data Protection Policies and Procedures

For the purposes of this policy Disability Evaluation Services (hereinafter referred to as DES) workforce shall include all DES employees as well as certain other personnel, such as contractors, consultants, interns, and volunteers, who perform services for DES, either on the premises of DES, or at some other remote location. All workforce members must follow these policies and procedures.

6/11/2003
Word Document PS 03-3: DES Data Protection Policies and Procedures

For the purposes of this policy Disability Evaluation Services (hereinafter referred to as DES) workforce shall include all DES employees as well as certain other personnel, such as contractors, consultants, interns, and volunteers, who perform services for DES, either on the premises of DES, or at some other remote location. All workforce members must follow these policies and procedures.

6/11/2003
PDF Document PS 04-01: Inadvertent Disclosure of Protected Health Info

For the purposes of this policy the Disability Evaluation Services (hereinafter referred to as DES) workforce shall include all DES employees as well as certain other personnel, such as contractors, consultants, interns, and volunteers, who perform services for DES, either on the premises of DES, or at some other remote location. All workforce members must follow these policies and procedures.

5/5/2004
PDF Document PS 04-02: Disclosure of Protected Health Info to Client/ Legal Rep.

The purpose of h s guideline is to insure the proper and timely release of medical recordscontaining protected health information (PHI) requested by clients, legal representatives andor eligibility representatives. This guideline should also insure properdocumentation of additional correspondence and exchange of information regarding cases. Additionally, this documentation will cover guidelines for documenting and responding to subpoenas. Page 5)

6/15/2004
PDF Document PS 04-03: Disclosure of Helath Information to Third Party

The purpose of this guideline is to insure the proper and timely release of medical records containing protected health information (PHI) requested by third parties. This guideline shouldalso insure proper documentation of additional correspondence and exchange of information regarding cases. Additionally, this documentation will cover guidelines for documenting and responding to subpoenas. (page 6)

6/15/2004
PDF Document PS 05-1: Determining Pregnancy-Related Disability Claims

DES procedural memo to its staff regarding how to determine when pregnant women meet the disability standards for EAEDC and TAFDC.

11/23/2005
PDF Document PS 06-01: Development of Medical and Other Informaiton in DTA-Originated Cases

Explains DES' procedures for handling DTA-originated cases where the available information is insufficient to determine that the individual meets SSI disability standards.

6/1/2007
Word Document PS 06-02: Reopening a Prior Determination

This memorandum summarizes the situations when reopening of a prior determination is appropriate and describes the procedures to follow in reopening and closing the case.

7/3/2006
PDF Document PS 07-1: DES Data Protection Policies and Procedures

Explains secure email procedures for communications between DES and other entities.

9/24/2007
Word Document PS 08-1: Review of Prior Application(s) in the Disability Review Process

DES must review all prior DES disability files of a recipient when making determinations on new claims. Memo provides procedures for doing this.

6/2/2008
Word Document PS 08-2: Weighing Medical Opinions

Treating source medical opinions are given controlling weight in the disability determination process unless they are not well-supported by objective clinical evidence or are in conflict or inconsistent with other medical and/or non medical evidence in the file. Such situations require a careful analysis of all available information and may involve numerous considerations including the quality, consistency and detail of the evidence provided as well as the specialty and expertise of the other medical sources. The file must contain a written explanation of the resolution of conflicting information as well as the reasoning for assigning weight to treating source or other medical opinions.

6/2/2008


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