Definitions

Term Definition Valid reason explaining why the medical records contradict what is being reported Based on the PAS Assessor’s knowledge and experience, a valid reason is a logical explanation of why the reported information conflicts with the medical records. Reasons may vary and could cover dozens of scenarios. For example: The customer is a 55-year-old female diagnosed with moderate intellectual disability and lives alone. She says that she can walk “just fine” with her cane. Recent medical records state the customer is an extreme fall risk, and EMS has been contacted by neighbors four times in the past 45 days. The PAS Assessor contacts the customer to ask about the falls reported in the records and the customer says she does not remember falling. The PAS Assessor does not find a valid reason to use the customer’s statement instead of medical records and explains why in the comments. A Clinical Autism Diagnostic Evaluation from six months ago indicates the customer was using a few words and making frequent eye contact with his parents. The customer’s mother reports that when her child was 12 months old, he was saying a few words and looking at her often. She explained that at 17 months of age he became completely non-verbal and no longer makes eye contact with anyone. The mother is extremely concerned and has scheduled an appointment with the licensed psychologist who evaluated her son six months ago. The PAS Assessor finds the explanation a valid reason to use the statement instead of medical records, explains why in the comments.