NURSE PRACTITIONERS NOW QUALIFY AS EAEDC/TAFDC “COMPETENT MEDICAL AUTHORITY.”

The Department of Transitional Assistance (DTA) has added “Nurse Practitioner” to the list of treating providers deemed a “competent medical authority” (able to sign various TAFDC and EAEDC program forms).¹ Expanding the definition of a “competent medical authority” should help individuals secure TAFDC disability exemptions or EAEDC benefits.

A Brief Overview of the Disability Determination Process

TAFDC

TAFDC is specifically for individuals with dependent children. An individual  who is subject to the TAFDC work program requirement or the 24-month time limit for benefits , and whose disability prevents them from complying with the work program rules or with the time limits, may qualify for a disability exemption of these requirements/limits.  To apply for an exemption, an individual must fill out a “Disability Supplement.” If someone has previously been denied a disability exemption, then they must also submit a “Good Cause Medical Statement” ² To be protected while their claim is under review, These forms are submitted directly to DTA. The Department then forwards the paperwork to Disability Evaluation Services (DES) at the University of Massachusetts Medical School, which evaluates the individual for disabilities.

EAEDC

Adults with disabilities who do not have children may be eligible to apply for EAEDC benefits. EAEDC applicants must complete a disability supplement as well as a “Medical Report.” As in the TAFDC disability determination process, the EAEDC disability supplement and “Medical Report” are submitted to DTA, which then forwards the paperwork to DES. DES is responsible for evaluating whether the applicant has a disability.³

Obtaining the Signature of a “Competent Medical Authority"

The TAFDC “Good Cause Medical Statement” and the EAEDC ““Medical Report”” both require the signature of a “competent medical authority.” Until now, DTA has only accepted a physician’s or psychologist’s signature on a TAFDC “Good Cause Medical Statement” and EAEDC “Medical Report.” This has made obtaining EAEDC benefits or a TAFDC disability exemption extremely difficult for many individuals who do not have a treating physician to sign the forms. These applicants and recipients (many of whom are treated by nurse practitioners in neighborhood health clinics) would be forced to spend significant amounts of time find a physician, explain the disability determination process to him/her, schedule an appointment with the physician, and get the forms signed.⁴ Too often, the daunting task of locating a willing physician discouraged an individual from proceeding with her request for EAEDC or a TAFDC disability exemption—sometimes jeopardizing the individual and/or her family’s livelihood.

The Department’s expanded definition of “competent medical authority” to include nurse practitioners (the backbone of many neighborhood health clinics frequented by low-income individuals and families) should make it easier for individuals to secure TAFDC disability exemptions and EAEDC benefits.

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¹1 DTA Public Notice dated November 28, 2008

² For more detailed information about the disability determination process and TAFDC, please refer to the MGH Community News article, June 2008.

³ For more detailed information about the disability determination process and EAEDC, please refer to the MGH Community News article, June 2008.

⁴ A TAFDC applicant/recipient may apply for a disability exemption at any time and she or he may also apply for the exemption more than once. A first time disability exemption applicant is considered “presumptively exempt” and is not subject to the work program requirement, time-limit, or 2.75% reduction in benefits while her request for a disability exemption is pending. If, however, the individual is denied a disability exemption within the 60 months prior to an application for an exemption, she is no longer considered presumptively exempt. To avoid being subject to the work program requirement, time limit, and 2.75% reduction in benefits while DES reviews their request for an TAFDC disability exemption, applicants must submit a Good Cause Medical Statement along with their disability supplement.

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