209.13 Family Services Specialist (FSS) Determines Incapacity SR 13-04, 02/13 (FAM-A)

The *Family Services Specialist (FSS) makes the determination of incapacity.

The child or children are automatically considered to be deprived of support or care due to a parent’s physical or mental incapacity when the applicant:

• is currently receiving SSI or SSA based on disability or is eligible but not receiving it due to recoupment;

• returns DFA Form 720, Determination of Incapacity Status, on which a physician, physician’s assistant (PA), advanced practice registered nurse (APRN), or psychologist certifies the individual as incapacitated for at least 30 continuous days from the date of application for assistance, or that the individual was incapacitated for at least 30 days in the 90-day period prior to the application date;

• has been previously determined to be permanently disabled or blind by the Disability Determination Unit (DDU);

• reapplies within 90 days of being denied or terminated from a case in which their incapacity has already been established, provided the reason for the denial or termination was not related to incapacity or earnings from employment.

Exception: If DFA Form 720 was originally submitted to document the incapacity, FSS must also refer to the expected incapacity end date information provided on the originally submitted DFA Form 720 to ensure that the incapacity still exists and will continue to exist for at least 30 days from the new date of application. If the original DFA Form 720 does not conclusively provide this information based on the new application date, deprivation is not automatically confirmed and a new DFA Form 720 must be completed;

• is convalescing after being treated in an institution for the mentally ill, or was discharged within 90 days prior to applying for assistance; or

• is needy and mentally retarded, has resided in a state-operated ICF/MR, and was officially discharged within 90 days of applying for assistance. Require documentation of congenital mental retardation confirmed by a psychological evaluation at any time after age ten, or a psychological evaluation before age ten confirming an IQ of 40 or less.

If the incapacity meets the 30-day minimum time period but no longer exists or ends before an application can be processed within time frames, the case may be eligible for medical and financial assistance for the month in which the determination was made and for the next full calendar month unless the client requests an earlier termination of assistance or refuses, or fails, to submit medical records and the forms necessary for the medical eligibility determination.