M E M O R A N D U M

IM-6  1/12/01  PERMANENTLY DISABLED INDIVIDUALS (EXEMPTION CODE 06)
TEMPORARY ASSISTANCE MANUAL REVISION #2


SUBJECT:
PERMANENTLY DISABLED INDIVIDUALS (EXEMPTION 06)
TEMPORARY ASSISTANCE MANUAL REVISION #2
 
DISCUSSION:
Per State Rule 13 CSR 40-2.315 of May 1998, "Individuals who are permanently disabled if they have been determined to be eligible for Old Age Survivor's and Disability Insurance (OASDI), Supplemental Security Income (SSI), or employer-sponsored disability insurance are exempt from work activities.  Individuals are exempt from work activities while an application for the aforementioned is pending unless or until an unfavorable determination is made."  This memorandum will clarify the existing policy for permanently disabled individuals currently being given the exemption code of (06) "Permanently Disabled". 

A Permanently Disabled Individual

Individuals are exempt from work activities if permanently disabled as determined by OASDI, SSI, or employer-sponsored disability insurance.  Individuals are also exempt from work activities while an application for any of the above is pending and until a final agency determination is made. 

Final Agency Determination Process

Effective with this memorandum, there will be a two step process to be followed for any individuals being coded (06) and having made application for OASDI, SSI, or employer-sponsored disability insurance.

Step One
Participant is exempt and coded (06), with the application of OASDI, SSI, or employer-sponsored disability insurance.  If the decision of this application is rejected, proceed to step two. 
Step Two
Worker sends the information from the disability application listed in Step One, through the Medical Review Team (MRT) for a decision on the disability.  This information should be sent on our forms using as necessary, the IM-60 (Medical Referral and Authorization), IM-60A (Medical Report Including Physician's Certification/ Disability Evaluation), IM-61 (Social Information Summary), and the IM61B (Disability Questionnaire). 

If MRT rejects the disability claim, the participant will be changed to mandatory status unless s/he meets another exemption, as of the date of the MRT decision.  The worker will take appropriate action to engage the participant in a work activity.

If MRT shows the individual disabled for a short period of time, move that individual to "Temporarily Disabled Individual", exclusion code (4).  Re-evaluate this exclusion as appropriate based on the anticipated length of the disability.
This does not mean to imply that the participant cannot appeal the decision made from the original disability application through the proper channels.  However, they will not be exempt during that appeal process or at any subsequent application for SSI/SSA disability.
 
NECESSARY ACTION:
  • Review this memorandum with appropriate staff.

    •  
  • Review cases being coded 06 for consideration in the two step process.
  • Begin using the two step process for individuals coded 06 immediately.
  • File the revised Temporary Assistance Manual pages.
DC/GZ
Distribution #6
Attachments available on hard copy.


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