720-3          DETERMINATION OF INCAPACITY

An individual is considered incapacitated (physically or mentally unable to perform gainful activity) when they have a physical or mental condition that will last at least 30 days and the condition is severe enough to prevent the individual from working full-time.  Incapacity may also exist if the condition discourages employers from hiring the individual or providing reasonable accommodations.

Note:  

A ‘PM’ (partial medical or part-time medical) exemption allows the maximum payment standard for two-parent families and exempts the household from the two-parent seasonal reduction. See manual sections 780-6 B. & 720-2 A.  

720-3 A.     ELIGIBILITY FOR SSI Supplemental Security Income, SSDI Social Security Disability Insurance, OR APA Adult Public Assistance

If an individual is eligible for Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), or Adult Public Assistance (APA) because of blindness or disability, verification of this eligibility is sufficient to determine incapacity.

720-3 B.     COMPETENT MEDICAL TESTIMONY USING THE TA 10 Health Status report Form FORM

All other claims of incapacity must be supported by competent medical testimony.  This may be obtained at a reasonable cost at the Division’s expense.  The medical testimony must be provided on the Health Status Report Form (TA 10) by a licensed medical or other health care practitioner, and must describe the nature, extent, and expected duration of the condition.

720-3 C.     THE INCAPACITY DECISION

The eligibility caseworker will make the finding of incapacity based on the completed TA 10 Health Status report Form form.  This finding is valid until circumstances change.  The finding must be reviewed when eligibility is redetermined.

When circumstances change that affect the incapacity finding, or when an eligibility review is due, a new TA 10 Health Status report Form form may be requested.  The eligibility caseworker will redetermine the incapacity finding based on the information provided on the new TA 10 Health Status report Form form.

Whenever a decision concerning incapacity is made, the eligibility caseworker will provide the appropriate case manager with the information and a copy of the TA 10 Health Status report Form for their use in self-sufficiency planning with the family.

720-3 D.     EXCEPTION TO VERIFICATION REQUIREMENT

The eligibility caseworker may temporarily waive the completion of the TA 10 Health Status report Form form if all three of the following conditions are met:

•  The individual resides in a remote rural area of Alaska; and

•  Due to their remote location, the individual has been unable to gain access to an appropriate medical practitioner within the previous three months or since the onset of the physical or mental condition (whichever is the shorter time); and

•  There is reason to believe that the individual will be unable to gain access to an appropriate medical practitioner within 30 days.

If medical evidence from a licensed medical or health care practitioner cannot be obtained, the individual must provide a written statement from a village health aide or other health care provider who knows of the individual's physical or mental condition.

If adequate testimony concerning the individual's physical or mental condition is obtained in this way, and the eligibility caseworker determines that one parent is incapacitated, two months of Temporary Assistance benefits using the higher payment standards may be authorized while the form is being completed and submitted.