209.01 Verification: APTD SR 13-35 Dated 10/13

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Verify all APTD eligibility requirements at the initial eligibility determination, redeterminations, and whenever questionable.

Verify disability at the initial eligibility determination and during subsequent review months established by DDU.

For APTD medical determinations, send the following forms when forwarding the request to DDU:

. DDU Form 177, Non-Medical Evaluation of Disability, completed by the individual or authorized representative;

. DDU Form 915, Medical Evaluation Initial, completed by a licensed physician or doctor of osteopathy, if DDU has provided this form as part of a review; and

. a separate DDU Form 900, Authorization for Release of Protected Health Information, for each provider listed on DDU Form 177.

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 DDU such as additional evaluations, consultations, or second opinions.

References: He-W 606.69, He-W 642.03, RSA 167:3-j, RSA 167:6,VI, 20 CFR 404.1574(b)(2), 20 CFR 416.976, 20 CFR 416.1112(c)(6), 42 CFR 435.4, 42 CFR 435.540, 42 CFR 435.541, 42 CFR 435.914, 45 CFR 233.10(b)(2), 45 CFR 233.80, 42 USC 1382c