WAC 388-448-0040 PEP Step I - Review of medical evidence required for eligibility determination

When we receive your medical evidence, we review it to see if it is complete and to decide whether your circumstances match GAU program requirements.

1. We require a written medical report to determine incapacity. The report must:

   1. Contain sufficient information as described under WAC 388-448-0030;

   2. Be written by an authorized medical professional; 

   3. Document the existence of a potentially incapacitating condition; and

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

2. If the information received is not clear, we may require more information before we decide your ability to be gainfully employed. As examples, we may require you to get more medical tests or be examined by a medical specialist.

3. We deny incapacity when:

   1. There is only one impairment with a severity rating less than three;

   2. A reported impairment is not expected to last ninety days (twelve weeks) or more from the date of application;

   3. The practitioner is not able to determine that the physical or mental impairment would remain incapacitating after at least sixty days of abstinence from alcohol and drugs; or

   4. We do not have clear and objective medical evidence to approve incapacity.