MASSACHUSETTS WELFARE DISABILITY DETERMINATION PROCESS
The state’s welfare disability determination process is used in two different situations. The first situation occurs when an adult with dependent children who is applying for or receiving TAFDC (Transitional Aid to Families with Dependent Children) has a disability that makes her unable to meet the TAFDC program requirements. If the disability is expected to last at least 30 days, she may be entitled to a TAFDC disability exemption, which makes her exempt from the TAFDC 24-month time limit and the work requirement, and increases her family’s monthly TAFDC grant by 2.75%. The second situation occurs when an adult with no dependents has a disability that prevents him or her from working. If the disability is expected to last at least 60 days, he or she may be eligible to receive EAEDC (Emergency Aid to the Elderly, Disabled, and Children) benefits. The Department of Transitional Assistance (DTA) uses the same criteria to evaluate disability for TAFDC disability exemptions and for EAEDC benefits. The disability determination process begins at DTA, but DTA does not evaluate the applicant’s disability. Instead, DTA contracts with the University of Massachusetts Medical School, Disability Evaluation Services (DES), to obtain and review medical records and to decide whether the applicant is disabled. Navigating this disability determination process can be daunting. Disability exemption applicants and EAEDC applicants must complete a 9-page Disability Supplement form that asks them to list all of their impairments (physical, psychological, and cognitive), describe how the impairments affect their ability to work, and list all of their medical providers. EAEDC applicants must also submit a 7-page “Medical Report” completed by a treating provider, indicating that the patient has an impairment that affects his or her ability to work and is expected to last at least 60 days. Note: the medical provider does not need to make the determination whether or not this person is “disabled”. For the purposes of this program that will be decided by DES. It is often helpful for applicants to supplement their disability claims with letters from their providers, and additional medical records and test results. Too often, treating providers decline to complete paperwork or provide supplemental information for the disability determination process because they do not understand the purpose of the process or because they do not understand the criteria DTA uses to evaluate disability. Too often, linguistic, cultural, and physical barriers make it difficult for patients to explain the disability determination process to their treating providers or to collect the necessary information on their own.
Many Massachusetts welfare applicants and recipients cannot comply with welfare program requirements because they have physical, cognitive, or emotional disabilities. These disabilities may also hinder their ability to earn income. To be found eligible for certain Masssachusetts subsistence benefits or to qualify for an exemption from the welfare program requirements, welfare applicants and recipients must be found disabled through the state’s disability determination process. [This process is entirely separate from the disability process used when one applies for federal benefits such as for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI).] Hospital-based social workers are in a unique position to help their patients who receive or are applying for benefits navigate this complicated process.
Hospital-based social workers are uniquely positioned to assist patients in navigating the disability determination process. They can help patients who are applying for EAEDC to connect with medical providers who can complete the Medical Report, and they can explain the disability determination process to medical and non-medical service providers who are reluctant to complete paperwork for their patients or clients. Social workers can also help patients gather supplemental information from their providers that may increase their chances of securing an exemption or benefits in order to support themselves and their families during a difficult time. -Contributed by Ambika Panday, Attorney/Equal Justice Works Fellow, Greater Boston Legal Services, Welfare Law Unit, our SEALS collaboration liaison.
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