Disability Determination Process and Tools a. The district’s process for determining an individual’s disabilities and/or work limitations must be in accordance with 18 NYCRR 385.2(d). Indicate below what the district’s process is for determining an individual’s disabilities and/or work limitations. (Select all that apply, and describe the process) District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. X District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary Other process Niagara County will adhere to the disability program requirements set forth in 18 NYCRR 385.2(d). The disability procedure will be followed whenever the applicant/recipient claims an inability to work, a work limitation or whenever the district worker suspects that an inability to work or a work limitation might exist. If the applicant/recipient has his/her own health care provider, he/she will be provided ten (10) calendar days to submit evidence in support of the claim to be unable to work or work-limited. In instances where it is not possible for the documentation to be provided within ten (10) calendar days, an extension may be granted at the discretion of the local district. It is understood that an individual's health care provider may not be a physician or certified psychologist. However, the District reserves the right to require additional documentation from the individual when the documentation on file is insufficient for the district to make a determination on exempt/non-exempt status. NCDSS staff will review any documentation submitted by the individual to support his/her claim for exemption from work program requirements. The individual's past medical history, work limitations, prior work history and the availability of "light duty" worksites will be factors in determining the individual's exempt/nonexempt status. Niagara County will utilize the LDSS 4005 or 4005(a) to notify individuals of the District's determination regarding whether the individual is exempt, work-limited, or non-exempt. The individual retains the right to request a fair hearing should the issue not be resolved to his/her satisfaction.
b. Described below is the district’s procedure for notifying an individual of their exempt/non-exempt determination whenever an individual alleges to be unable to p...
Disability Determination Process and Tools.
a. The district’s process for determining an individual’s disabilities and/or work limitations must be in accordance with 18 NYCRR 385.2(d). Indicate below what the district’s process is for determining an individual’s disabilities and/or work limitations. (Select all that apply, and describe the process) District participates in the OTDA managed contract for independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary Other process Self Sufficiency staff, temporary assistance examiner staff, or contracted assessment staff may review medical documentation and make determinations on whether individuals are exempt, nonexempt, or work-limited and complete the LDSS-4005 (Notice of Disability Determination) accordingly. In situations where the individuals have previously been coded exempt and are being re-evaluated, the medical statements and determinations will be handled by the designated Self Sufficiency Examiner staff. In situations that are complex or an individual is contesting the determination, MCDSS may request additional testing or evaluations from IMA or from another appropriate community resource in order to make a determination.
b. Indicated below is the process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited and describe the process by which the determination is made. (Select all that apply) District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below). Other Self Sufficiency staff, temporary assistance examiner staff, or contracted assessment staff may review medical documentation and make determinations on whether individuals are exempt, nonexempt, or work-limited and complete the LDSS-4005 (Notice of Disability Determination) accordingly. In situations where the individuals have previously been coded exempt and are being re-evaluated, the medical statements and determinations will be handled by the designated Self Sufficiency Examiner staff. In situations that are complex or an individual is contesting the determination, MCDSS may request additional testing or evaluations from IMA or from another appropriate community resource in order t...
Disability Determination Process and Tools. The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): The Welfare Employment Representative meets with the individual and gives them the LDSS- 2642 (documentation requirements) followed by the LDSS-4526 (medical examination for employability assessment, disability screening, and alcoholism/drug addiction determination) to be completed and returned to the Welfare Employment Representative within 10 business days. The district has contracted with St. Mary's Hospital for physical, mental health and drug/alcohol evaluations. Individuals are generally referred to the contracted provider for an evaluation when they do not already have a treating practitioner. The Welfare Employment Representative can also accept medical documentation from the individuals practioner. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: The Intake Worker, makes the initial employability determination during the application process. At this time it is determined as to whether the individual is employable or needs medical documentation. The Intake worker will make the appropriate referrals at that time (drug and alchohol evaluation, etc.). The Welfare Employment Representative reviews the appropriate referrals as well as the medical documentation and determines whether the individual is exempt, non-exempt, or work limited based on the evidence provided and in accordance with NYCRR guidelines. Once the determination is made the Welfare Employment Representative will notify the individual of the determination in writing with the LDSS-4005 and 4005a, Notification of Temporary Assistance Work Requirements Determination (Exemp...
Disability Determination Process and Tools. The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): The employment worker reviews the documentation submitted by the client. Additional information may be requested from the client and/or the client may be referred for an independent evaluation through either the OTDA managed contract or through a local contract with Xxxxxx Hospital. Upon receipt of all available information, a decision is made by the worker regarding the individual’s claim of disability. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other:
Disability Determination Process and Tools. The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If a client claims to be unable to participate in work activities due to medical and/or mental health barriers, the FIA worker at the Job Center will refer the client to the Wellness, Comprehensive Assessment, Rehabilitation and Employment (WeCARE) program for an assessment. HRA has been enhancing its efforts to identify clients with work limitations through our existing application and recertification processes. HRA will continue to work with its contractors to strengthen assessments in these areas in an effort to better identify and serve these clients based on their individual needs, including any needs for reasonable accommodations. HRA is increasing the portals of entry to the WeCARE program from the Job Centers. HRA will implement a process where HRA staff will review a client’s case for a history of federal Supplemental Security Income (SSI) applications and/or denial and a history of non-compliance. HRA will conduct a case review of all participants who were previously referred to WeCARE prior to implementing any adverse action. Physical and mental health issues that prevent someone from being successful in the labor market and/or lead to a history of non-compliance can go unnoticed by HRA staff. To address this problem and make a determination about whether a referral for additional services is required, HRA staff will review cases for SSI application history and non-compliance history and assess whether there is a previously unidentified physical and/or mental health limitation that may be contributing to non- compliance and whether the client could benefit from a referral for additional services. Additionally, HRA worker review of Social Security Application/Denial History will help to identify clients who may be potentially eligible for SSI. There will also be a review of history of non-compliance with HRA appointments to consider unidentified limitation/barriers. HRA is ...
Disability Determination Process and Tools. Section 6.2 Mental Health Screening and Assessment Section 6.3 Requirements for Exempt Temporary Assistance Participants (Reference 18 NYCRR 385.2 (e)) Amendments to this Plan: (To be completed by XXXX) Section 2 Administration
Disability Determination Process and Tools. The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: BCDSS staff and subcontracted Star Group staff review collected/submitted medical documentation, consult with physicians' offices and determine employability status for all TANF recipients claiming a medical/psychiatric disability. All contracted staff assigned to this project have experience as registered nurses or case managers for the mentally/developmentally disabled population. They may also make referrals for Functional Capacity Exams, Mental Health evaluations, or any other follow up necessary to make a solid determination of employability. The goal is always to move the recipient to self-sufficiency, by returning them to employability or assisting them in obtaining Social Security benefits. Clients are referrred for independent exams for mental health and physical issues. Cases are reviewed by the Medical Services Unit. Once documentation is collected and reviewed, BCDSS staff determines appropriate employment code and issue the LDSS 4005/4005a to the client.
Disability Determination Process and Tools a. The district’s process for determining an individual’s disabilities and/or work limitations must be in accordance with 18 NYCRR 385.2(d). Indicate below what the district’s process is for determining an individual’s disabilities and/or work limitations. (Select all that apply, and describe the process) X X District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. X District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary Other process Referrals to IMA are made for medical, psychological and intellectual evaluations when required or warranted.
b. Described below is the district’s procedure for notifying an individual of their exempt/non-exempt determination whenever an individual alleges to be unable to participate, or the individual otherwise participates in the employability disability review, including when an individual is notified that their status changes from exempt to non-exempt. Individuals are mailed the LDSS 4005 to inform them if their code goes to exempt status or if the code remains exempt. The LDSS 4005(a) is mailed to inform them when they go from exempt status to non-exempt status.
c. Described below is how the district notifies an individual of their exempt/nonexempt determination. Check one of the following: The district sends the LDSS-4005/LDSS-4005(a) and retains a copy in the case record. The district sends a local equivalent and retains a copy in the case record.
d. Indicated below is the process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited and describe the process by which the determination is made. (Select all that apply) X
Disability Determination Process and Tools. The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other:
Disability Determination Process and Tools. The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: The Employment case manager, TA eligibility examiner, TA undercare examiner, and/or supervisor(s) review the medical documentation and determine status. When the documentation, diagnosis, prognosis, or limitations are unclear, the worker may contact the physician for further clarification, a nurse employed by the District who may be able to offer some clarification, and/or the worker may make a referral to IMA for an Employability Determination (second opinion).
