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

Section 385.2 – Page 20

Rev. 4/2025 Collection of Medical Evidence Rather than relying solely on an individual’s practitioner to determine to what extent an individual can participate in work activities, districts may find it advantageous to employ or contract with someone qualified to interpret medical evaluations provided by individuals’ health care practitioners, or to contract with a provider to examine individuals directly and make a determination. It is beneficial to both the client and the district to have a medical professional consult on determinations and to identify any necessary treatment or accommodations. The examining professional should be made aware of the purpose of the evaluation and how the district will use the results. A district may want to: • attach a cover letter to the medical form that explains what information the district needs and how it will be applied; • contract with a specific provider who is aware of the district’s goals and intent; • speak with the individual’s examining professional directly if the medical documentation requires clarification or is inconsistent with your observations. See Appendix A of the manual for a sample cover letter to accompany the request for medical information. Misrepresentation of a Disability If the local district has reason to believe an individual does not have a claimed disability or limitation, and such belief is based in fact upon medical or other evidence, the district must provide the individual written notification that a TA sanction may be imposed if the medical evaluation process results in a determination that the individual does not suffer from a limitation. Districts should then impose a sanction if the medical evidence indicates there was no basis for the individual’s claim and the district determines that the individual intentionally misrepresented their medical condition. Regardless of whether the household has dependent children or not, the sanction period is 90 days for the first sanction, 150 days for the second, and 180 days for the third. (See Section 385.12 of this manual for specific information regarding a sanction for misrepresentation of a disability.) This sanction notice is supported by the automated client notices system. Relationship Between Disability Review Procedure and Assessment Requirements A determination of exempt/non-exempt status is distinct from the assessment requirements outlined in Sections 385.6 and 385.7 of this manual and 18 NYCRR 385.6 and 18 NYCRR 385.7; however, a district may choose to fulfill both requirements at the same time. Districts have the option to make the determination of an individual’s exempt/non-exempt status either before conducting an employability assessment or in conjunction with the assessment process. However, the information obtained about the individual when determining exempt/non-exempt