Common use of Disability Determination Process and Tools Clause in Contracts

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. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary Other process Local district TA eligibility worker will inquire whether the applicant/recipient has a physical or mental health condition which would limit his/her ability to participate in work activities. Such inquiry will be made at application, recertification or when there is reason to believe an applicant/recipient has an impairment. When an applicant/recipient claims to have a mental health or physical impairment, he/she will be given written notification that he/she has ten calendar days, from the date of written notice, to present medical documentation from his/her health care practitioner. The documentation must include a specific diagnosis, specify work limitations and specify the length of time the condition will prevent the applicant/recipient from taking part in work activities. The district will not assign the applicant/recipient to work activities while waiting for medical documentation or while the district is conducting a review of the medical documentation. The district will assess the information submitted by the applicant's/recipient's health care practitioner and determine if the applicant/recipient is disabled, work-limited or not disabled. Written notice of the results of the determination and the right to a fair hearing to contest the determination will be provided to the client, via the LDSS 4005 and 4005(a) forms.

Disability Determination Process and Tools. a. The district’s process for determining an individual’s disabilities and/or work limitations must be is 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 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 necessary. Other process Local district TA eligibility worker (please describe): District utilizes County Nurse Practitioner to assist with medical reviews. An applicant or recipient who claims to be unable to work or who has limitations regarding employment or participation in work-related activities will inquire whether be issued an LDSS- 4526 to be completed by all his/her treating health care provider(s) and to be returned to the agency within 10 days. Upon receipt of the completed medical report(s), the agency will determine the applicant/recipient has a physical or mental health condition which would limit his/her recipient's ability to participate in work activities. Such inquiry will be made at application, recertification or when there is reason to believe an applicant/recipient has an impairment. When an applicant/recipient claims to have a mental health or physical impairment, and any limitations he/she will be given written notification that he/she has ten calendar days, from the date of written notice, might have with respect to present medical documentation from his/her health care practitioner. The documentation must include a specific diagnosis, specify work limitations and specify the length of time the condition will prevent the applicant/recipient from taking part employment or participation in work work-related activities. The district will not assign LDSS staff may decide if the applicant/recipient to work activities while waiting for recipient's medical documentation is sufficient to make a decision. The worker will send either an LDSS-4005 or while a DSS-4005(a) to the district is conducting a review client notifying him/her of the medical documentation. The district will assess the information submitted by the applicant's/recipient's health care practitioner and determine if the applicant/recipient is disabled, work-limited or not disabled. Written notice of the results of the disability determination and the right to request a fair hearing hearing. The LDSS staff may refer individuals either who claim to contest have a physical or mental impairment or who it suspects of having a physical or mental impairment to IMA for a determination of the individual's medical condition. 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: District utilizes County Nurse Practitioner to assist with medical reviews. The TA/Employment Supervisor and/or staff designated by the TA intake TA/Employment Directors can review all available medical documentation and make the determination of status. Phone calls will be provided made by the worker who requested the medical report to any of the client, via treating physicians to request any additional documentation that may be required. The LDSS staff may refer individuals either who claim to have a physical or mental impairment or who it suspects of having a physical or mental impairment to IMA for a determination of the LDSS 4005 and 4005(a) formsindividual's medical condition. Refer to nurse practitioner for questions to assist with determination.

Disability Determination Process and Tools. a. ‌ The district’s process for determining an individual’s disabilities and/or work limitations must be is 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 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 necessary. Other process Local district TA eligibility worker will inquire whether (please describe): - A physical examination is required prior to any JOBTRAK assignment. Physicals are conducted by the applicant/recipient has a physical or mental health condition which would limit his/her ability Allegany County Health Department unless the client chooses to participate in work activitiesgo to their primary care provider. Such inquiry will be made at application, recertification or when there is reason to believe an applicant/recipient has an impairment. When an applicant/recipient - Any individual who claims to have a mental health limitation or physical impairment, he/she will disability must provide the agency with the name(s) of his or her medical provider(s) and sign a release of information. - A participant claiming a limitation or disability may be given written notification that he/she has ten calendar days, from the date of written notice, required by ACDSS to present medical documentation from make an appointment with his/her health care practitionerprovider(s) to obtain current information abouth the person's xxxxxx.Xx is the client's responsibility to provide documentation of this to the agency. The documentation -If it is determined by the health care provider that the individual has no limitations, or can work with limitations, the individual will be assigned to appropriate work activities regardless of whether the individual has applied for SSI - If it is determined by the health care provider that the individual is unable to work, the district may refer the individual to a health care provider for a second opinion, and/or may require that the individual apply for SSI. - When it is indicated that an individual has a limitation or is temporarily disabled but, with treatment, is likely to improve his or her medical status, the individual will be notified that s(he) must include a specific diagnosisenter into the recommended course of treatment and that failure to comply with the recommended course of treatment will be cause for case action, specify work limitations and specify the length of time the condition including sanction. These individuals will prevent the applicant/recipient from taking part in work activities. The district will not assign the applicant/recipient only be assigned to work activities while waiting that are determined to be within the person's limitations. Noncompliance for an exempt individual results in ineligibility for the individual. - If there are no work activities that can safely accommodate the individual's limitations and/or plan of treatment, a person with medical limitations may be offered the option of proposing a community service plan as his/her work activity. However, if the individual is unable to arrange for community service, no negative action will be taken. - An individual with documentation of permanent and/or total disability will be assisted through ACDSS's DCAP program and Legal Services, to pursue SSI. Such an individual will also be provided information regarding ACCES-VR services and the ADA, and will be encouraged to seek assistance for becoming self-supporting. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or while work limited is as follows: District directs the district is conducting 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: Employment worker reviews and determines employment status. For individuals who are exempt the caseload examiner receives a review copy of the medical documentation. The district will assess the information submitted by the applicant's/recipient's health care practitioner doumentation and determine if the applicant/recipient is disabled, workresponsible to follow-limited or not disabled. Written notice of the results of the determination and the right up at certain intervals to a fair hearing to contest the determination will be provided to the client, via the LDSS 4005 and 4005(a) forms.obtain updated medical information

Disability Determination Process and Tools. a. The district’s process for determining an individual’s disabilities and/or work limitations must be is 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 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 necessary. Other process Local district TA eligibility worker will inquire whether the applicant(please describe): When an individual indicates that they are unable to work due to medical/recipient has a physical or mental health condition which would limit his/her ability reasons, they are requested to participate in work activitiesprovide documentation of such limitation by having their health care practitioner or medical provider complete a statement (preferably the LDSS-4526). Such inquiry will be made at applicationIf the health care practitioner's or medical provider's statement is not complete, recertification or when there fails to provide sufficient information, the Employment Unit case manager may contact the health care practitioner or medical provider directly for clarification. If the individual does not have a health care practitioner or medical provider or has provided a health care practitioner's or medical provider's statement that is reason to believe an applicant/recipient has an impairmentquestionable, a referral for a consultative evaluation is made. When an applicantindividual indicates that they are unable to work because they are needed in the home to care for a disabled/recipient claims incapaciated household member they are requested to have a mental health or physical impairment, he/she will be given written notification that he/she has ten calendar days, provide documentation from the date of written notice, to present medical documentation from his/her health care practitioner. The documentation must include a specific diagnosis, specify work limitations and specify the length of time the condition will prevent the applicant/recipient from taking part in work activities. The district will not assign the applicant/recipient to work activities while waiting for medical documentation or while the district is conducting a review of the medical documentation. The district will assess the information submitted by the applicant's/recipienthousehold member's health care practitioner or medical provider that the impairment exists and that the household member is in need of care by completing the Caretaker Medical Information Employability Assessment (Attachment J). The local process for reviewing the medical documentation to determine if the applicantindividual 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/recipient medical staff or unit reviews and determines status (described below) Other: The Employment Unit case manager reviews the documentation provided and if completed fully will submit the documentation to the Employment Unit Medical Review Team for review and determination of status. The decision is disabled, work-limited or not disabled. Written notice based primarily on the “Functional Limitations” as listed by the physician in section IV of the results LDSS-4526 (if that form has been presented) and/or whatever additional information the physician has written either on the form or in a separate letter indicating their opinion as to the employability of the determination and individual. If the right documentation fails to provide sufficient information to render an employability determination, a fair hearing to contest call is placed by the determination will be provided Employment Unit case manager to the clientphysician to clarify their position. If the Employment Unit case manager is unable to make contact with the physician, via or needs further information, the LDSS 4005 individual is referred for a consultative evaluation to receive a medical report that may provide additional information needed to make an employability code determination (all medical documentation received by the Employment Unit case manager is sent to the consultative evaluator for consideration). Through the CNS (Client Notice System) the Employment Unit case manager issues the Notice of Temporary Assistance Work Requirements Determination (LDSS-4005 or LDSS-4005a) notifying the individual of the agency’s decision including an employability determination of exempt or non-exempt and 4005(a) formsany limitations that have been indicated.

Disability Determination Process and Tools. a. ‌ The district’s process for determining an individual’s disabilities and/or work limitations must be is 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 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 necessary. Other process Local district TA eligibility worker (please describe): The TA/Employment Unit is assisted by the BILT team which employs staff who assist applicants and recipients in the process of applying for disability benefits. This process is initiated once a medical statement indicating a long-term disability has been received from one or more of the above entities and the District agrees with the medical statement. Referral to IMA for an independent evaluation will inquire whether be made when an individual indicates that they do not agree with their physician’s evaluation; the agency’s determination and/or when no other medical provider is available to do an evaluation. Upon receipt of medical verification, the applicant/recipient has a physical or mental health condition which would limit his/her ability to participate in work activities. Such inquiry will be made at applicationreferred to the Disability Advocate in the BILT Unit if the medical review indicates, recertification or when there in the agency’s judgment, that an application for SSI is reason to believe an applicant/recipient has an impairment. When an applicant/recipient claims to have a mental health or physical impairment, he/she will be given written notification that he/she has ten calendar days, from the date of written notice, to present medical documentation from his/her health care practitioner. The documentation must include a specific diagnosis, specify work limitations and specify the length of time the condition will prevent appropriate for the applicant/recipient from taking part recipient. Form LDSS-4005 or LDSS form 4005(a) will be sent to all applicant/recipients anytime there is a change in work activitiestheir employability code. The district will not assign local process for reviewing the applicant/recipient to work activities while waiting for medical documentation or while the district is conducting a review of the medical documentation. The district will assess the information submitted by the applicant's/recipient's health care practitioner and to determine if the applicantindividual 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/recipient medical staff or unit reviews and determines status (described below) Other: As noted above, the Employment Unit is disabled, work-limited or not disabled. Written notice assisted by members of the results BILT Team to assist in determining employability status. Meetings are scheduled between the units for case review as needed. A course of action which best suits the determination and the right to a fair hearing to contest the determination will be provided to the client, via the LDSS 4005 and 4005(a) formsindividual’s needs is then determined.

Disability Determination Process and Tools. a. ‌ The district’s process for determining an individual’s disabilities and/or work limitations must be is 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 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 necessary. Other process (please describe): Local district TA eligibility worker workers will inquire whether the applicant/recipient has a physical or mental health condition impairment which would limit his/her ability to participate in work activities. Such inquiry will be made at application, recertification or when there is reason to believe that an applicant/recipient has an impairment. When an applicant/recipient claims to have a mental health or physical impairment, he/she will be given written notification that he/she has ten calendar days, from the date of written notice, to present medical documentation from his/her health care practitioner. The LDSS-4526 is provided to the client and must be fully completed to determine the extent of the limitation(s). Any other medical documentation must include a specific diagnosis, ; specify work limitations limitations; and specify the length of time the condition impairment will prevent the applicant/recipient from taking part in work activities. The district will not assign the applicant/recipient to work activities while waiting for medical documentation or while the district is conducting a review of the medical documentation. The district will assess the information submitted by the applicant'sapplicant’s/recipient's ’s health care practitioner and determine if the applicant/recipient is disabled, work-limited or not disabled. Written notice of the results of the determination and the right to a fair hearing to contest the determination will be provided to the client, via the LDSS 4005 LDSS-4005 and 4005(aLDSS-4005(a) forms. In the event the medical documentation submitted by the applicant’s/recipient’s health care practitioner is insufficient to make a determination, the applicant/recipient may be required to obtain additional documentation from their health care provider. 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: Employment Unit staff reviews and determines status with the assistance of the Administrative Assistant in the Medicaid Unit when necessary. TCDSS continues to review the options of utilizing an Independent Medical Examiner (IME) to review certain disability cases.

Disability Determination Process and Tools. a. ‌ The district’s process for determining an individual’s disabilities and/or work limitations must be is 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 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 necessary. Other process Local district TA eligibility worker (please describe): District utilizes County Nurse Practitioner to assist with medical reviews. An applicant or recipient who claims to be unable to work or who has limitations regarding employment or participation in work-related activities will inquire whether be issued an LDSS- 4526 to be completed by all his/her treating health care provider(s) and to be returned to the agency within 10 days. Upon receipt of the completed medical report(s), the agency will determine the applicant/recipient has a physical or mental health condition which would limit his/her recipient's ability to participate in work activities. Such inquiry will be made at application, recertification or when there is reason to believe an applicant/recipient has an impairment. When an applicant/recipient claims to have a mental health or physical impairment, and any limitations he/she will be given written notification that he/she has ten calendar days, from the date of written notice, might have with respect to present medical documentation from his/her health care practitioner. The documentation must include a specific diagnosis, specify work limitations and specify the length of time the condition will prevent the applicant/recipient from taking part employment or participation in work work-related activities. The district will not assign LDSS staff may decide if the applicant/recipient to work activities while waiting for recipient's medical documentation is sufficient to make a decision. The worker will send either an LDSS-4005 or while a DSS-4005(a) to the district is conducting a review client notifying him/her of the medical documentation. The district will assess the information submitted by the applicant's/recipient's health care practitioner and determine if the applicant/recipient is disabled, work-limited or not disabled. Written notice of the results of the disability determination and the right to request a fair hearing hearing. The LDSS staff may refer individuals either who claim to contest have a physical or mental impairment or who it suspects of having a physical or mental impairment to IMA for a determination of the individual's medical condition. 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: District utilizes County Nurse Practitioner to assist with medical reviews. The TA/Employment Supervisor and/or staff designated by the TA intake TA/Employment Directors can review all available medical documentation and make the determination of status. Phone calls will be provided made by the worker who requested the medical report to any of the client, via treating physicians to request any additional documentation that may be required. The LDSS staff may refer individuals either who claim to have a physical or mental impairment or who it suspects of having a physical or mental impairment to IMA for a determination of the LDSS 4005 and 4005(a) formsindividual's medical condition. Refer to nurse practitioner for questions to assist with determination.

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. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary Other process Local When an applicant or recipient declares a medical impairment, the local district TA eligibility worker will inquire whether issues a Physical/Psychological Assessment for Determination of Employability. This form also states that the following information is required: 1. A specific diagnosis 2. Any specific work limitations caused by this diagnosis 3. The expected duration of these work limitations/prognosis 4. The duration of the disability The local district has sole discretion in determining if the documentation provided is sufficient to make a determination of medical impairment. Submitting the required documentation is described above to determine the initial claim of impairment by an applicant/, or in evaluating the continuing claim of a recipient who has a physical or mental health condition which would limit his/her ability to participate been previously determined exempt from participation in work activities, shall be a condition of initial or ongoing eligibility for Temporary Assistance. Such inquiry will For SNAP, failure to document a disability causes the individual to lose exempt status. Additional documentation may be made at application, recertification or when there is reason to believe an applicant/recipient has an impairment. When an applicant/recipient claims to have a mental health or physical impairment, he/she will be given written notification that he/she has ten calendar days, from the date of written notice, to present medical documentation from his/her health care practitioner. The documentation must include a specific diagnosis, specify work limitations and specify the length of time the condition will prevent the applicant/recipient from taking part in work activities. The district will not assign the applicant/recipient to work activities while waiting for medical documentation or while the district is conducting a review required of the medical documentation. The district will assess the information submitted by the applicant's/recipientindividual's health care practitioner and determine if to evaluate an individual's ongoing claim of a mental or physical impairment. In these circumstances, such individual remains exempt until a final employability determination is made by the applicant/recipient is disabled, work-limited local district. If an individual has demonstrated an inability to successfully participate in work activities or not disabled. Written notice of the results of the determination employment and the right local district has reason to believe this is due to a fair hearing disability or work limitation, the local district shall require the individual to contest participate in a disability related screening and/or evaluation. Additionally, if an individual has demonstrated an inability to successfully function in a work setting and is determined through an evaluation or assessment to be exempt and in need to treatment, the determination will individual shall be provided required to the client, via the LDSS 4005 and 4005(a) formsparticipate in necessary treatment a condition of eligibility for temporary assistance.

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 Local 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 TA eligibility worker will inquire whether suspects that an inability to work or a work limitation might exist. If the applicant/recipient has a physical or mental health condition which would limit his/her ability to participate in work activities. Such inquiry will be made at application, recertification or when there is reason to believe an applicant/recipient has an impairment. When an applicant/recipient claims to have a mental own health or physical impairmentcare provider, he/she will be given written notification that he/she has 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 date of written notice, individual when the documentation on file is insufficient for the district to present medical make a determination on exempt/non-exempt status. NCDSS staff will review any documentation from submitted by the individual to support his/her health care practitionerclaim for exemption from work program requirements. The documentation must include a specific diagnosisindividual's past medical history, specify work limitations limitations, prior work history and specify the length availability of time "light duty" worksites will be factors in determining the condition individual's exempt/nonexempt status. Niagara County will prevent utilize the applicant/recipient from taking part in work activities. The district will not assign the applicant/recipient LDSS 4005 or 4005(a) to work activities while waiting for medical documentation or while the district is conducting a review notify individuals of the medical documentation. The district will assess District's determination regarding whether the information submitted by the applicant's/recipient's health care practitioner and determine if the applicant/recipient individual is disabledexempt, work-limited limited, or not disablednon-exempt. Written notice of the results of the determination and The individual retains the right to request a fair hearing should the issue not be resolved to contest the determination will be provided to the client, via the LDSS 4005 and 4005(a) formshis/her satisfaction.

Disability Determination Process and Tools. a. ‌ The district’s process for determining an individual’s disabilities and/or work limitations must be is 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 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 necessary. Other process Local district TA eligibility worker (please describe): At application, clients will inquire whether complete the applicantmedical section of the employment assessment form. Based on an interview with the individual and any additional information provided by the client, a member of the Employment unit will determine if a possible disability/recipient limitation exists. If it is determined at assessment that there is a possible disability/limitation, the LDSS will require medical documentation from the client to verify any claim(s). The client has a physical ten (10) days to provide this verification to the LDSS. All clients will be provided with the LDSS 4005 or mental health condition which would limit hisLDSS 4005(a), whichever is appropriate. This document will provide the client with notification regarding their work capability status. A client could be found “fully employable without exemptions,” “work limited-with exemptions but the work activity does not conflict with the documented disability/her ability limitations(s)”, or “not employable” – the disability/limitations(s) are to participate the point that most activities are contraindicated. Clients with partial or full limitations will still be required, consistent with the verified medical limitation and/or treatment plan, to continue to be engaged in work activities. Such inquiry will Based on the client’s current disability, there exists the potential to be made at applicationrestored to self- sufficiency. Examples of self-sufficiency activities could include involvement in medical/drug/alcohol treatment known to LDSS, recertification or when there is reason SSI/SSD application appeal known to believe an applicant/recipient has an impairment. When an applicant/recipient claims the LDSS, independent medical exams assigned by the LDSS, psychological counseling known to have the LDSS and prescribed by a mental health professional, and/or LDSS approved education/training as outlined in this Plan. If the LDSS is unable to make a determination based on an interview with client from the verification provided by the client or physical impairmentthe client refutes the LDSS’s determination, he/she will the agency can make a referral to a health care provider certified by the Office of Disability Determinations (ODD) for an independent medical examination (IME). Clients claiming disabilities’/limitations may submit their own medical documentation to the provider certified by the ODD for consideration. Any documentation available from the client’s practitioner must be given written notification that he/she has ten calendar days, submitted to the IME provider no later than four (4) business days from the date of written notice, the independent examination to present medical documentation from his/her health care practitioner. The documentation must include a specific diagnosis, specify work limitations and specify the length of time the condition will prevent the applicant/recipient from taking part in work activities. The district will not assign the applicant/recipient to work activities while waiting for medical documentation or while the district is conducting a review of the medical submit additional documentation. The district LDSS staff as the basis for work activity assignments will assess the information submitted by the applicant's/recipient's health care practitioner and determine if the applicant/recipient is disabled, work-limited or not disabled. Written notice of use the results of the determination IME. Clients who are verified as having disability/limitations must work with the LDSS staff to access education/training/rehabilitation necessary to remove or reduce the disability or limitations. They must provide medical documentation for determining the individual’s ability to recover and accept medical care to assist in recovery. Clients will be required to accept referrals to and enrollment in a treatment or rehabilitation program and provide evidence of participation in the assigned program. Clients must also work with LDSS staff to apply for SSI or SSD benefits, comply with all requirements of the application process, and exhaust all possible appeals in the process. At the point of placing a client with a documented limitation(s) on a worksite, the LDSS will send notice to the cooperating agency of the scope of limitations. A representative of the cooperating worksite and the right to agency’s Employment unit supervisor, (TA Director) must sign a fair hearing to contest statement acknowledging the determination limitation(s) an assuring that the work assigned will not exceed the specified limitations(s). On a quarterly basis, the cooperating agencies will be provided required to reaffirm their knowledge of the limitation(s) and assure that limitations have not been exceeded in a written statement to the LDSS. These statements will be kept in the client’s employment file, via kept at LDSS. Clients who meet one or more of the following categories will be exempt from work activities: • Sixty years of age or older; • Pregnant and within thirty (30) of medically verified delivery date; or • The single parent or caretaker relative of a child under age one for a lifetime maximum of twelve (12) months It is important to note that the LDSS 4005 does not provide, generally, the full twelve (12) month exemption at any one time for clients who are the single parent or caretaker relative of a child under age one. Because this exemption can only be given for a lifetime maximum of twelve (12) month, the LDSS: Offers this exemption for a lesser duration, generally three (3) months or less; May extend the exemption based on case-by-case circumstances up to the twelve (12) month lifetime maximum. 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 4005(adetermines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) formsOther: Please refer to the above description of the process as outlined in Section 6 of this Plan. Ultimately, based on all of the available medical documentation, the Employment worker determines the status.

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. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary Other process Local district TA eligibility worker workers will inquire whether the applicant/recipient has a physical or mental health condition impairment which would limit his/her ability to participate in work activities. Such inquiry will be made at application, recertification or when there is reason to believe that an applicant/recipient has an impairment. When an applicant/recipient claims to have a mental health or physical impairment, he/she will be given written notification that he/she has ten calendar days, from the date of written notice, to present medical documentation from his/her health care practitioner. The LDSS-4526 is provided to the client and must be fully completed to determine the extent of the limitation(s). Any other medical documentation must include a specific diagnosis, ; specify work limitations limitations; and specify the length of time the condition impairment will prevent the applicant/recipient from taking part in work activities. The district will not assign the applicant/recipient to work activities while waiting for medical documentation or while the district is conducting a review of the medical documentation. The district will assess the information submitted by the applicant's/recipient's health care practitioner and determine if the applicant/recipient is disabled, work-limited or not disabled. Written notice of the results of the determination and the right to a fair hearing to contest the determination will be provided to the client, via the LDSS LDSS- 4005 and 4005(aLDSS-4005(a) forms. In the event the medical documentation submitted by the applicant's/recipient's health care practitioner is insufficient to make a determination, the applicant/recipient may be required to obtain additional documentation from their health care provider. TCDSS has recently begun participating in the OTDA managed contract for independent medical evaluations (IME) and is in the process of establishing a district review team to review XXXx and determine status.