Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: UPDATE TO MEDICAL REPORT INCLUDING PHYSICIAN’S CERTIFICATION/DISABILITY EVALUATION (IM-60A) AND INSTRUCTIONS
FORM REVISION #
IM-60A
INSTRUCTIONS
DISCUSSION:
The purpose of this memorandum is to inform staff of updates to the form “Medical Report Including Physician’s Certification/Disability Evaluation” (IM-60A) and the corresponding instructions.
The IM-60A now uses current medical information regarding mental disorders. It was also reformatted to remove outdated Family Support Division (FSD) processes and language.
The IM-60A Instructions were updated to reflect the changes made on the IM-60A and provide clear instructions regarding which sections are to be completed by FSD staff and which sections are to be completed by medical professionals.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Begin using the updated version (revised 02/2021) immediately.
- Destroy all outdated versions of this form.
KE/cj