The purpose of this policy directive is to provide focus on the MRT process used to establish disability and to provide information that will assist MRT and the counties in meeting the 90 day processing regulation.

On March 24, 1995, during a lawsuit filed because MRT was not in compliance with the 90 day time limit to process applications, a memo was sent to the counties which outlined the guidelines to ensure future compliance with the 90 day limit. When the lawsuit was settled, there were approximately 2,679 cases pending with 50% over 90 days old. Today there are approximately 1,064 cases pending with 6% over 90 days old. As you can see, we have made great strides in reducing the numbers.

We are continuing our efforts to further reduce the number of cases pending over 90 days and to reduce the processing time for the county office and MRT. The following guidelines are given to help workers in submitting the necessary information and forms to MRT for the disability determination. These guidelines will expedite processing cases by MRT and reduce the requests by MRT for additional information which necessitates repetitive handling of the cases by MRT and county workers.

Form DCO-108

Please complete the DCO-108 as the directions indicate. Every question on the DCO-108 should be completed in its entirety. The Medical Review Team needs all of the requested data on the DCO-108 for the disability determination. This information is used to provide MRT with the client’s background information needed to request medical records and to complete the educational and vocational aspects of the disability determination. If the form is completed by hand, please write or print legibly. The worker’s complete name should be included on page 1 of the social report in the block provided. The complete name will enable MRT to e-mail workers concerning social reports or information needed on pending cases.

The complete name and address of all physicians, clinics, and hospitals that the client has seen in the last year is very important. Please list physicians seen on an out patient basis but do not list physicians seen only in the hospital. The specific dates (e.g. , 9/14/98 to 9/20/98) of service are needed for requests for medical records. The correct addresses for the providers are very important for acquiring medical records for the disability determination.

Please be specific about the type of jobs the client has performed. General labor and odd jobs should be specified to the job actually done such as yard work, handy man, factory labor, etc.

The last day actually worked is essential to the determination process.

For clients who are employed at the time of application or review, the number of hours worked, hourly wage, and whether the number of hours worked has been reduced is necessary. Attached is a sample DCO-108.

2. Form DCO-108A

This form should be used for all active cases on which MRT made a decision on and required a re-examination. TEFRA cases with previous SSI eligibility and closure due to parental income that are being reviewed by MRT for the first time are considered a new case by MRT and will require the completion of a DCO-108.

3. Form DHS-81

Please send DHS-81s for every hospital, physician, and clinic listed on the DCO-108. Should a physician or clinic refer the client to another medical provider after the initial interview, an additional DHS-81 will be required. Please provide these additional forms as quickly as possible to prevent an overdue application.

The full names and addresses of the medical providers should be completed on the DHS-81s.

The client must sign the DHS-81 unless medically impossible or deceased. Please request the authorized representatives to include relationship to applicants who are deceased or medically unable to sign DHS-81s.

4. Form DCO-106

Please be sure the current DCO-106 (revised 8/95) is being used. This form is required for all Aid to the Blind and Disabled and TEFRA cases with countable income under the applicable SSI SPA. It is not required for disability based on AFDC guidelines (e.g. 2M).

If the applicant has applied for SSI, key appropriate information on WQRY for a WTPY response. Another WQRY should be keyed later in the application process to verify the current status of the SSI application when the first response shows a pending decision. Applicants denied by Social Security (as not disabled) will be denied by the county as soon as they have this verification.

Question #6 on the DCO-106 addresses if the applicant has a new and different disabling condition from the ones considered by Social Security in their previous determination. If the client claims a new and different disabling condition, please review this information thoroughly by reviewing the social report to see if this statement conflicts with information gathered for the report. Do not list impairments that have gotten worse in question #6. This will be addressed in question #7.

5. TEFRA CASES

Please include DHS-81s for the facilities providing physical, speech and occupational therapy, if the child is receiving these services. For those claiming developmental delays, DHS-81s will be needed for the facility where the most recent evaluation was completed.

If the child is receiving services through special education, a DHS-81 will be required with the full name and address of the school attended.

As mentioned above, the parent will need to show relationship on the DHS-81s.

6. WMRV SCREEN

Applications registered to WIMA with Ys keyed to the appropriate MRT fields transfer to the WMRV screen overnight. Applications registered incorrectly will not transfer and cause a delay in processing the case once received by MRT.

The WMRV screen is updated by MRT each time an action is taken by MRT, such as the date the case is received, the date medical is requested and received, the date the case is routed to a physician for review, and the date of the decision. This screen should be used by supervisors and workers in monitoring the progress of pending cases through the MRT process. Attached is a sample.

7. MEMOS

Please respond promptly to memos sent to the county requesting additional information, forms, or action taken. MRT is faxing memos and DCO-109s to the counties. To expedite the exchange of information, counties are encouraged to fax replies to memos or questions to MRT. The fax number for MRT is 501-682-1559.

Inquires to: Linda Nordin 501-682-8261

                   Carolyn Duncan 501-682-1561