209.01 Verification: APTD SR 94-04, 04/94 (AAM-A)

Verify disability at the initial eligibility determination and subsequently during review months established by MAB.

Verification used to determine disability must include the following:

• Form 177, Non-Medical Evaluation of Disability, completed by the individual or authorized representative, and

• Form 915, Medical Evaluation Initial, completed by a licensed physician or doctor of osteopathy.

If the individual has a mental disability, a licensed psychiatrist, NH Board-certified psychologist, or certified associate psychologist must complete Form 920, Psychiatric Evaluation Initial.

Additional verification may include any of the following:

• medical records, provided they are no older than 2 years,

• any additional material which may bear on the decision, or

• supplemental information requested by MAB such as additional evaluations, consultations, or second opinions.