WAC 182-508-0040 PEP Step I --Review of medical evidence required for eligibility determination.

When the agency or the agency's designee receives the individual's medical evidence, the agency or the agency's designee reviews it to see if it is sufficient to decide whether the individual's circumstances meet incapacity requirements.

(1)  The agency or the agency's designee requires medical information to determine incapacity.  The information must:

(a)  Contain sufficient information as described under WAC 182-508-0030;

(b)  Be written by an authorized medical professional described in WAC 182-508-0020;

(c)  Document the existence of a potentially incapacitating condition; and

(d)  Indicate an impairment is expected to last ninety days or more from the application date.

(2)  If the information received isn't clear, the agency or the agency's designee may require more information before the agency or the agency's designee decides the individual's ability to be gainfully employed.  As examples, the agency or the agency's designee may require the individual to get more medical tests or be examined by a medical specialist.

(3)  The agency or the agency's designee denies incapacity if:

(a)  There is only one impairment and the severity rating is less than three;

(b)  A reported impairment isn't expected to last ninety days or more from the date of application;

(c)  The only impairment supported by objective medical evidence is drug or alcohol addiction; or

(d)  The agency or the agency's designee doesn't have clear and objective medical evidence to approve incapacity.