720-3          DETERMINATION OF INCAPACITY FOR A TWO-PARENT FAMILY

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 partial medical or part-time medical (PM) exemption allows the maximum payment standard for two-parent families and exempts the household from the two-parent seasonal reduction. See ATAPAlaska Temporary Assistance Program MS 780-6 B & 720-2 A.

720-3 A.      ELIGIBILITY FOR SSISupplemental Security Income, SSDISocial Security Disability Insurance, OR APAAdult 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 HEALTH STATUS REPORT FORM (TA 10)

When a two-parent household claims incapacity, due to a reason not listed in ATAPAlaska Temporary Assistance Program MS 720-3 A, it 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 physician or other health care practitioner, and must describe the nature, extent, and expected duration of the condition.

Note:

The TA 10Health Status Report Form is allowable but not required for single parent households. Other acceptable verification for this type of household can be found in ATAPAlaska Temporary Assistance Program MS 730-2 under "medical reasons."

The caseworker should ensure required verification of a medical exemption for either a two-parent or single parent household is received before adding the exemption coding to the case. All other exemptions do not require a Work Services case manager to provide verification, to support a request to impose or remove a penalty. The caseworker should be following the direction provided by the Work Services case manager's email.

720-3 C.      THE INCAPACITY DECISION

The eligibility caseworker will make the finding of incapacity based on the completed Health Status Report Form (TA 10). This finding is valid until circumstances change. The finding must be reviewed when eligibility is re-determined.

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

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

Note:

Regardless of the date a completed TA 10Health Status Report Form is received at DPADivision of Public Assistance, it is necessary for the work activity exemption due to incapacity to begin the first full month after the doctor signs and dates the form. This also holds true for acceptable documentation of incapacity provided for a single parent household.

Example:

On 07/03/2019 DPADivision of Public Assistance receives a completed TA 10Health Status Report Form for Betty, dated by her doctor on 05/21/19. The form confirms Betty is not able to work full or part-time for 3 months. The assigned caseworker enters the appropriate work exemption coding for the months of 06/2019, 07/2019, and 08/2019.

720-3 D.      EXCEPTION TO VERIFICATION REQUIREMENT

The eligibility caseworker may temporarily waive the completion of the TA 10Health 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 a 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 ATAPAlaska Temporary Assistance Program benefits using the higher payment standards may be authorized while the form is being completed and submitted.