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Issue Alert - 12-12-01

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Date:

Dec 14, 2012

Program Area:

Food Assistance Program (FAP), State Disability Assistance (SDA), Medicaid (MA)

Issue Summary:

Clients who have a disability including blindness must complete an Activities of Daily Living Form for the medical determination in their case.

Persons Affected:

All FAP, SDA, and MA applicants or recipients who claim a disability including blindness.

For More Information:

Center for Civil Justice 320 S. Washington, 2nd Floor Saginaw, MI 48607 (989) 755-3120, (800) 724-7441 (989) 755-3558 Fax E-mail: info@ccj-mi.org Michigan Poverty Law Program 611 Church Street, Suite 4A Ann Arbor, MI 48104-3000 (734) 998-6100 (734) 998-9125 Fax


Background

When disability is an issue in a FIP, SDA, or MA case, a determination by the Medical Review Team (MRT) may be required.  The MRT uses medical evidence submitted by the applicant or gathered by the DHS caseworker to evaluate disability.

What's Happening?

DHS’s October Bridges Policy Bulletin 2012-015, effective October 1, 2012, makes a slight change for medical determinations involving disability including blindness in FIP, SDA, and MA cases.  Now, the DHS-49-G Activities of Daily Living Form “must” be completed for the medical determination on initial application.  The form also can be used for verification at redetermination.  However, the Policy Bulletin also states that if the client does not return the form to the DHS caseworker, the rest of the medical packet should STILL be forwarded to the MRT for a medical decision.  This change affects Bridges Administrative Manual (BAM) 815 and Bridges Eligibility Manual (BEM) 260.  However, this new provision has not yet been added to the current BAM or BEM. 

 

It does not appear that the revised DHS-49-G form has been uploaded yet to the public website. 

What Should Advocates Do?

1.            Educate clients and community organizations about this slight change. 

2.       Help initial application and redetermination clients work with their specialist to submit the Activities of Daily Living form.  Advocate for clients to make sure their medical packets still get forwarded to the MRT, even if they do not submit the form.

3.       If you or your clients need help with this, and the client lives in Genesee County, please call or refer clients to Center for Civil Justice at our Flint office Family Economic Security Project (for FIP), at 1-810-244-8044, and our Healthcare Eligibility Law Project at 1-810-238-8053 (for MA).

4.       Remember that clients can always request hearings on public benefits disputes especially when they receive a Notice of Case Action.  Should clients be denied clients be denied FIP, SDA, or MA because they did not complete the form, help them request a hearing and find legal advice for the hearing (see below).


 

What Should Clients Do?

1.            When applying for FIP, SDA, or MA, or at redetermination, be sure your DHS caseworker has you fill out the DHS-49-G Activities of Daily Living Form, and return it to the caseworker.  This is so it can be sent to the Medical Review Team that will look at your records of disability and make a decision on it.

2.            Always return forms to DHS on time, and keep a copy of what you turn in.  If you do not know the deadline or have any other questions about turning in forms, ask your caseworker or the supervisor.

3.            Be aware that even if you do not return the Activities of Daily Living Form to your caseworker, your caseworker STILL has to forward your medical records to the Medical Review Team for a decision on your case.

4.            If you need help with these issues, and you live in Genesee County, please call Center for Civil Justice at our Flint office Family Economic Security Project (for FIP), at 1-810-244-8044, and our Healthcare Eligibility Law Project at 1-810-238-8053 (for MA).

5.      Remember that  you can always request a hearing on a dispute you have with DHS, especially when you receive a Notice of Case Action.  If you are denied FIP, SDA, or MA because you did not complete the Activities of the Daily Living form, find legal advice if you want to request a hearing (see below).

Finding Help

Most legal aid and legal services offices handle these types of cases, and they do not charge a fee. You can locate various sources of legal and related services, including the free legal aid office that serves your county, at MichiganLegalAid.org. You can also look in the yellow pages under "attorneys" or call the toll-free lawyer referral number, (800) 968-0738.