808.45 Referrals to the Medical Exemption Unit (MEU) SR 10-40, 12/10 (FAM-A)

Refer individuals to the *Medical Exemption Unit (MEU) whenever an individual:

• claims an exemption from NHEP due to their own or a relative’s or assistance group member’s medical condition that is expected to last longer than 6 weeks;

• claims a limitation in NHEP participation due to their own or a relative’s or assistance group member’s medical condition that is expected to last longer than 6 weeks; or

• requests a FANF hardship extension due to their own or a relative’s or assistance group member’s medical condition.

If the medical situation is expected to last less than 6 weeks and the client is not requesting an exemption or a FANF hardship extension, do not refer the case to the *MEU; NHEP can monitor short-term impairments and place the individual in the Interim Activities activity. All approved activities must take into account the individual’s temporary limitations.

Individuals claiming an exemption from NHEP, a limitation in NHEP participation, or a FANF hardship extension due to their own medical condition, must complete a DFA Form 752 Medical Exemption packet containing:

• DFA Form 752a, Authorization for Release of Protected Health Information; and

• DFA Form 752, Physician/Clinician Statement of Capabilities.

Individuals claiming an exemption from NHEP, a limitation in NHEP participation, or a FANF hardship extension due to the necessary care of a household member’s medical condition, must complete a DFA Form 752 Medical Exemption packet containing:

• DFA Form 752a, Authorization for Release of Protected Health Information; and

• DFA Form 752HH, Physician/Clinician Statement of Necessary Patient Care for a Household Member.

Exception: For individuals requesting a FANF hardship extension only, if there is a DFA Form 752 or DFA Form 752HH on file that is less than 4 months old and the individual is still in exempt status for this medical condition, do not make the individual complete a new DFA Form 752 Medical Exemption packet. If current verification on file is more than 4 months old or the current verification is less than 4 months old but the exemption for the medical condition has expired, the individual requesting a hardship exemption must provide a completed new DFA Form 752 Medical Exemption packet.

The request for a FANF hardship extension or an exemption from or limitation in NHEP participation will be denied, if:

• the healthcare provider fails to return the DFA Form 752 or DFA Form 752HH, even after the *MEU attempts to help get the information; or

• the applicant fails or refuses to cooperate with the *MEU.

Participant Status After Referral to the *MEU

Applicants

Applicants claiming a medical exemption from NHEP work requirements will be considered exempt until the *MEU receives DFA Form 752 or DFA Form 752HH and is able to determine the individual’s ability to participate in NHEP. Applicants have 10 days from the date of referral to submit a completed DFA Form 752 or 752HH. If the applicant fails to provide these documents within the required time period, the MEU codes the applicant as a mandatory participant in NHEP.

Recipients

Mandatory or voluntary participants in NHEP who claim an exemption to work requirements due to a medical issue will retain their status of mandatory or voluntary during the period of time the *MEU is awaiting the return of needed documentation and making a determination on the recipient’s claim for exemption. Participants must continue to comply with NHEP. Failure to comply with NHEP during the *MEU determination process is cause for progressive sanctioning or denial or closure of the FANF hardship extension if the individual is applying for or in a FANF hardship extension.

Recipients who are currently exempt from participation requirements due to a medical issue will be referred to the *MEU at their next regularly scheduled redetermination and must redocument the medical condition if, at that time, the DFA Form 752 or DFA Form 752HH does not provide current medical information clearly documenting a current medical issue that requires an exemption.

Medical exemptions must be redocumented at least every 6 months unless otherwise indicated by the Physician/Clinician on the form.

Claim Status After Referral to the *MEU

If not requesting a FANF hardship extension, once the DFA Form 752 or DFA Form 752HH is returned to the *MEU and the healthcare provider has indicated that:

• the individual is partially or fully able to participate in work or work-related activities, the *MEU will enter this information into New HEIGHTS and the individual will be referred to NHEP if the individual is not currently participating in NHEP; or

• the individual is totally unable to participate in work program activities, the *MEU will enter this information into New HEIGHTS. *

Note: If this is at least the second time the individual is asking for an exemption for this condition or the Physician/Clinician indicates that this condition will last at least 12 months:

• Individuals making a claim about their own medical condition: The individual must provide proof to the Family Service Specialist (FSS) within 30 days that the individual has applied for other benefits for which the individual is potentially eligible, such as Supplemental Security Income, Social Security Disability Income, veteran’s benefits, Aid to the Permanently and Totally Disabled, or Aid to the Needy Blind.

• Individuals making a claim about the medical condition of a household member: If the household member is a member of the assistance group (AG), then the individual making the claim must provide proof within 30 days that the household AG member with the medical condition has applied for the other benefits for which the household member is potentially eligible.

See PART 317, DEVELOPING POTENTIAL SOURCES OF INCOME, for further information about the requirements on applicants, recipients, and assistance group members for developing potential sources of income as a condition of eligibility.

If requesting a FANF hardship extension due to a medical condition, the *MEU will determine the individual’s ability to participate in NHEP work activities based on the information provided by the healthcare provider and then forward the DFA Form 752 or DFA Form 752HH to the District Office Supervisor for a decision on the hardship request.