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

Section 385.2 – Page 37

Rev. 4/2025 A.21 Each program has a different definition and a different process for determining whether an individual is considered disabled. The process for determining Medicaid eligibility and exempt status for employment purposes are not the same. Districts should coordinate medical information and review processes to ensure as complete a medical file as possible for each program determination and for evaluation of any work limitations. An individual determined to be disabled for Medicaid would be exempt from TA/SNAP employment requirements if they are disabled and currently unable to work. Q.22 An individual discloses an impairment and submits medical documentation; however, the district requires that the individual be examined by the district’s practitioner. What are the consequences if the individual refuses to comply with the examination by the district’s practitioner? A.22 An individual who alleges an impairment and who does not comply with the district’s requirement to be examined by the district practitioner without good cause is subject to case denial/closure. Even though the individual has provided medical documentation, the district has the authority to accept the documentation or to send the individual to the district practitioner for an evaluation. Q.23 What happens if an individual does not follow a treatment plan? A.23 18 NYCRR 385.12 states that if an individual is potentially employable and fails to comply with health care or rehabilitation to restore themselves to self-sufficiency, the individual is ineligible for assistance (removed from the case) until willing to comply. When determining if an individual had good cause for failing to comply with treatment, districts must consider if the individual’s condition caused the failure. Additionally, the district may only assign an individual to a treatment activity when an appropriate health care professional has determined what specific activity is necessary to restore the individual to self-sufficiency. For example, the district may not require an individual to participate in mental health counseling without first having an appropriate health care professional evaluate the individual and recommend such counseling. Q.24 What must a district do to protect an individual’s confidentiality regarding protected health- related information? A.24 The district must have the individual’s signature authorizing it to obtain medical information from health care practitioners. The State medical form (LDSS-4526) contains an authorization the individual signs allowing the release of information to the district. If the district has obtained the individual’s authorization, the Health Insurance Portability & Accountability Act of 1996 (HIPAA) does not impose any additional requirements for the provider to release medical information to the district. Q.25 May TANF funding be used for medical evaluations? A.25 TANF funds may be used to assess the ability of an applicant or recipient to participate in work activities for those individuals who are eligible to receive TANF services. TANF funds