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Division/Section Family Support Chapter No./Name 04 – Economic Stability (ES) Part No./Name C – Case Processing Section No./Name C-1500 FITAP Incapacity Determination/SNAP Disability Document No./Name C-1510-FITAP Incapacity Determination Effective Date January 1, 2019

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If the local office continues to disagree with the FITAP/STEP Program Consultant’s incapacity decision, the local office may request a review by the Economic Stability Section. Obtain approval from the ES Manager and submit the form OFS 90 packet to the Economic Stability Section with a cover memo giving the reasons for submission.

III. FORMS AND INSTRUCTIONS

OFS 090 Form/Instructions Medical Evaluation-Physician’s Report

OFS 090A Form/Instructions Referral for Medical Information on Incapacity

OFS 090AD Form/Instructions Medical Evaluation Addendum - Physician’s Report

OFS 090D Form/Instructions Request to Physician or Medical Facility for Medical Data

OFS 090DDS Form/Instructions Request to DDS for Medical Information

OFS 090L Form/Instructions Request for Verification of the Need for Full Time Care

OFS 090S Form/Instructions Social Information

OFS 090X Form/Instructions Cover for Submittal of Social and Medical Information

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SSI 003 Form/Instructions Information-Referral Form

IV. REFERENCES

Personal Responsibility and Work Opportunity Reconciliation Act of 1996

LAC 67:III.1247