UPM P-2535.05 - Establishing Blindness

CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-88 Transmittal: UP-88-21 P-2535.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Blindness AABD _______________________________________________________________ Subject: Establishing Blindness ______________________________________________________________________________

P-2535.05 1. If disability is not established by receipt of SSI/SSA based on blindness as provided for in policy, obtain the information necessary for a determination of blindness by the Department's Medical Review Team (MRT). To accomplish this, use the procedures which follow.

2. Give the assistance unit the following forms:

° "Instructions for Form WR-3A";

° "Medical Examination Report", Form WR-3;

° "Social Information and Disability Report", Form W-176.

3. Explain to the assistance unit the use of Form WR-3 and encourage the unit to tell the examining physician the importance of returning the form in a timely fashion.

4. Advise the unit of the purpose of Form W-176 and emphasize the need for:

° returning the form to the Department within the specified time standards;

° filling in all the blank areas on the form;

° giving special attention to the completeness of the "Education" and "Work History" sections of the W-176.

5. Inform the unit that you will provide assistance upon request if a problem arises with obtaining information or completing the forms.

6. Set ticklers for the return of the forms.

7. When the forms are returned:

° arrange all of the medical information in chronological order, most recent first;

° complete and attach W-542 "Route slip to MRT,"

° submit the medical packet to MRT, Central Office.