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Published byJody Dalton Modified over 9 years ago
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Incapacity Deprivation
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There MUST be 2 parents of a common child in the home One of the parents (or both) allege that there is a condition of mind or body, which makes the parent physically or mentally unable to provide the necessities of life for his/her child. In Order to Use Incapacity Deprivation (Code 30 on KAMES):
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If one of the parents of a common child is alleging incapacity, DO NOT complete an Unemployed Parent case on this family. A determination of “Not Incapacitated” must be received before we can start looking at a UP case. Incapacity or Unemployment?
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Have lasted, or be expected to last, at least 30 days Be present at the time of application Be such that it eliminates or substantially reduces the parent’s ability to provide support and care for the otherwise eligible child. The Incapacity Condition Must:
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Homemaking and child care functions Consideration of the parent’s age, education, training and work experience. The “Ability to Support and Care” Includes:
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In some instances, a case worker or case manager can do a “field determination”, verifying the incapacity of the parent. If an individual does not meet field determination criteria, then a referral must be sent to the Medical Review Team (MRT). A caseworker/case manager can never say that an individual is NOT incapacitated. Leave that to the experts at MRT! Incapacity Field Determinations
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SSI benefits are received. SSI was received within the past 12 months, but was discontinued due to income or resources, and NOT an improvement in their condition. Individual is age 65 or over. Individual has a “K” adult medical case. Individual has a “M” adult medical case. Field Determination Reasons
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RSDI, Black Lung, or Railroad Retirement based on disability is received. “Notice of Favorable Decision” has been received from the SSA office, Bureau of Hearings and Appeals. Incapacity has been determined by MRT, hearing officer, Appeal Board, or Circuit Court with the decision stating no re- determination needed and there is no visible improvement in the condition. More Field Determinations
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Individual is hospitalized, or in an alcohol or substance abuse facility, on the date of processing the application, and a statement from the doctor indicates the period of incapacity has or will exceed 30 days. Receipt of 100% VA benefits. An individual is on approved sick leave from a job, and the employer is holding the job for their return. More Field Determinations
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An individual had surgery, which requires a period of time for recovery, as specified by a doctor’s statement. A field determination can be made for up to six weeks. An individual had an illness or injury, which requires a period of time for recovery, as specified by a doctor’s statement. More Field Determinations
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A woman is deemed to be in a high-risk pregnancy condition. This is verified by a doctor’s statement, and lasts through the pregnancy and the 6-week postpartum period. We do not expect that you memorize this list! These reasons are listed in Vol. III, MS 2381 More Field Determinations
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Use form PAFS-5.1 to refer individuals to the local Social Security Office, to apply for SSI/RSDI benefits, if they appear to have a disabling health condition. Do not delay processing the KTAP application, if the individual has applied for SSI/RSDI, and a determination is pending. An individual has the right to apply for KTAP or MA benefits even if they are denied or discontinued by SSI/RSDI. If Disability Benefits Are Not Received:
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