How to Request SMEU Verification

Follow the steps below to request a SMEU disability decision to verify blindness or disability.

Step 1 The DFCS Case Manager completes Form 184 SMEU Data Report in detail. Form 188 is obsolete effective 12/1/22. SMEU Data Report (Form 184) must be completed by DFCS Case Manager. Step 2 Obtain any of the following medical information applicable to the A/R: Form 115, Report of Eye examination (Dr. supplies this form) Hospital records, including discharge summary, if available Physician’s medical records Psychiatric and/or psychological examination reports Current therapy notes (speech, occupational or physical) X-ray and laboratory reports Death Certificate The above list is not all-inclusive. If medical information is not available and/or is incomplete, the A/R will need to obtain additional information from an examining physician or risk denial of disability based on insufficient medical reports. Step 3 Effective 10/11/22, the SMEU submission process has changed due to SMEU Automation. DFCS Case Manager gathers all necessary documents: Medical records SMEU Data Report (Form 184) SMEU Cover Letter (Form 245) Any other relevant documents to substantiate disability If SMEU requests additional information after original submission, send a checklist to the AR requesting the new information. If the AR fails to return the additional information, close the case for failure to verify and notify SMEU of the closure. DFCS Case Manager will submit SMEU request by email to smeu@dhs.ga.gov . The DFCS Case Manager who submitted the request, and their supervisor will receive automated email communications throughout the process, including: If initial submission has been accepted or returned for correction If additional information is needed, i.e., 90-day follow-up When decision has been made Step 4 DFCS Case Manager will receive a task when SMEU decision letter has been uploaded. Step 5 If paper medical records were received, after the Approval/Denial has been received from SMEU (for active cases at review), check with the A/R or authorized representative to see if the medical information used to determine disability should be returned to them or shredded. Shred the SMEU Data report. Do not retain or upload paper medical records.

A re-evaluation by SMEU may be required when an approval decision is rendered for only a specified timeframe per SSA guidelines.

Use the following chart to determine how to use a SMEU decision to verify disability or blindness:

Chart 2205.2 – Verifying Blindness or Disability with a SMEU Decision IF SMEU determines the A/R is THEN disabled or blind for any of the months requested the ABD requirement is met for these months. Proceed to other eligibility criteria. not disabled or blind for any of the months requested the ABD requirement is not met for these months. Deny the application for these months.

Use the following chart to determine when to begin verification of blindness or disability with the DAS procedures and when to begin with the SMEU procedure:

Form 71 no longer in use as of 09/2013, please use SSA Form 831.

Chart 2205.3 – When to Use DAS Vs. SMEU Procedures IF the AR THEN has an approved SSI application AND applies for Medicaid for any of the months immediately prior to the month of the SSI application follow the DAS procedures, if onset date is not available from current SDX information. has a pending SSI application AND applies for Medicaid for any of the months immediately prior to the SSI application follow the SMEU procedures. If potentially eligible for RSDI, refer to SSA to apply. Abide by SSA disability determination if it differs from SMEU determination. is potentially eligible for SSI and RSDI and has not applied AND requests Medicaid at DFCS for any of the months immediately prior to the current month follow the SMEU procedures. If potentially eligible for RSDI, refer to SSA to apply. Abide by SSA disability determination if it differs from SMEU determination. is financially ineligible for SSI for all of the months for which Medicaid is requested AND has a RSDI application pending or is potentially RSDI eligible, follow the SMEU procedures. If potentially eligible for RSDI, refer to SSA to apply. Abide by SSA disability determination if it differs from SMEU determination. is deceased AND has never filed an application for SSI AND the surviving spouse or another individual requests Medicaid to cover unpaid medical bills follow the SMEU procedures. has a pending SSI application AND dies prior to SSA’s approval of the SSI AND the surviving spouse requests Medicaid to cover any unpaid medical bills follow the SMEU procedures. Abide by SSA disability determination if it differs from SMEU determination. has a pending SSI application AND dies prior to SSA’s approval of the SSI with no surviving spouse AND the A/R’s personal representative requests Medicaid to cover unpaid medical bills follow SMEU procedures. has a denied SSI application AND requests Medicaid for any of the 3 months prior to the SSI application follow SMEU procedures. SSI application is denied due to failure to meet the disability criteria AND the A/R requests Medicaid ongoing through DFCS If the SSI denial is within 12 months of the DFCS application for ongoing Medicaid, deny the application and refer the applicant to SSA to reapply for SSI or request a reconsideration of the SSI decision (unless A/R reports a worsening of condition or a new condition, then follow SMEU procedures).