Obtaining Required Medical Information for Applications
In general, applicants to Medicaid and SSI/SSDI will need to provide contact information for physicians who provided physical and/or mental health care as well as records from such physicians that outline clinical diagnoses to substantiate claims of disability. State Medicaid agencies will usually offer a standardized form for physicians to fill out that more specifically solicits the type of information needed to substantiate such claims.[1]
State Disability Determination Services (DDS), which evaluate disability claims for applicants for Social Security disability benefit programs, are responsible for gathering medical documentation to support claims of disability. However, when applicants provide medical documentation of disability in an application, it can significantly reduce the time it takes to review these claims. In addition, when DDS staff have insufficient medical evidence to make a determination, they will order an independent consultative evaluation (CE) of an applicant.[2] CEs can add considerable lag time to the processing of applications.
Officials in prisons and jails may wish to take a number of steps to make it easier for staff assisting with benefits applications to gather required medical documentation for SSI/SSDI and Medicaid applications. Particularly in the case of jails, officials may develop information-sharing agreements with local community behavioral health care providers to identify incoming inmates who may have received medical services at these community providers (see Cook County IL Information Sharing Program). These providers may be able to provide some clinical evidence for disability claims.[3]
In addition, jail and prison administrators might initiate agreements with community behavioral health providers or medical staff working within jails or prisons to conduct clinical evaluations of individuals that can be used in applications to substantiate disability.
