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NYS Office of Temporary and Disability Assistance- TA and SNAP Employment Policy Manual

Section 385.2 – Page 19

Rev. 4/2025 medical evidence submitted by an individual or to send the individual to the district’s own health care practitioner for additional documentation. • Districts are mandated to use the LDSS-2642 Documentation Requirements form or approved local equivalent form for each TA and SNAP case in which the applicant or recipient is being asked to provide proof of an eligibility factor, including requests for medical documentation to support a claimed disability (see 93-ADM-20). If the district requires an individual to submit medical evidence of an impairment from their own health care provider, then the individual must be provided with the LDSS-2642 Documentation Requirements form or approved local equivalent form giving the individual 10 days to submit the evidence. There may be instances when the district determines that 10 days is insufficient and it may extend the time allowed for the submission of documentation. This may include, but is not limited to, instances where an individual is unable, through no fault of their own, to obtain an appointment with their health care provider within the 10 day period. • If the district sends an individual to its own health care provider for a medical exam, the individual should be directed to bring any medical documentation to the exam and must be given 4 business days after the examination to submit any additional medical information. The district must notify the individual and should ensure the individual understands their right to provide medical evidence within 4 days following the date of the examination. • The district’s practitioner is required to provide to the district a specific written diagnosis based on medically appropriate tests or evaluations conducted regarding the alleged impairment. If the district’s practitioner to whom the individual is referred issues an opinion that differs from the applicant’s treating health care practitioner, the district’s practitioner shall provide a written determination that specifies why the district’s practitioner disagrees with the applicant’s treating health care practitioner’s disability determination and present evidence that supports the opinion. The practitioner must also report to the district any other conditions discovered during the evaluations that would affect the individual’s participation in work activities. The district must provide the individual a copy of the district practitioner’s report. • The district must provide written notification of its determination. If the individual does not agree with the district’s determination of their exempt/ non-exempt status and any limitations, they have only 10 days from the issuance of the LDSS 4005 or 4005(a) to request a fair hearing. If the individual requests a fair hearing within the 10 days, the district may not require the individual to participate in work activities pending the fair hearing determination. However, if the individual agrees to the assignment, a district may assign such an individual to a work assignment consistent with any alleged limitations.