Disability Determination - Concurrent Disability / Incapacity Determination Process

Created on: 
Dec 01 2015

Summary

  1. Under the concurrent process, the Department first attempts to obtain medical evidence necessary to determine eligibility for ABD cash assistance identified in WAC 388-449-0015.                                                                                                                                                   
  2. If the applicant does not meet ABD disability criteria outlined in WAC 388-449-0001 or fails to provide the medical evidence necessary for the Department to determine ABD eligibility within the 45 day standard of promptness, the Department will consider eligibility for the HEN Referral program.
  3. Medical evidence necessary to determine HEN Referral eligibility is outlined in WAC 388-447-0005 and WAC 388-447-0010.

Worker Responsibilities

  1. Review available records and approve ABD when the applicant meets any of the non-SEP criteria outlined in WAC 388-449-0001.
  2. If available records are not sufficient to approve ABD, complete a social service intake assessment and review available records to determine what additional evidence is necessary to determine ABD disability.
  3. Request medical records from within the past 5 years associated with any potentially disabling impairment(s).
  4. Request a mental health or physical evaluation from an ABD acceptable medical source identified in WAC 388-449-0010 only when current medical records are insufficient to determine ABD eligibility or when the impairment has not been established by an ABD acceptable medical source within the past 5 years.
  5. If sufficient medical evidence necessary to determine ABD eligibility is not received within the 45 day standard of promptness or the applicant does not meet ABD disability criteria, consider eligibility for the HEN Referral program.
NOTE: See #3 of the When HEN Referral Eligibility Ends section for information regarding when a new SEP is conducted for an active HEN Referral recipient.
NOTE: A social service intake assessment is not required to determine ABD disability. If the applicant fails to complete a social service intake assessment, review available evidence to determine if the applicant meets the approval criteria detailed in WAC 388-449-0001. If the applicant meets the approval criteria detailed in WAC 388-449-0001, approve ABD. If the applicant does not meet the approval criteria detailed in WAC 388-449-0001, deny ABD for no medical evidence.