Page 1174

West Virginia Income Maintenance Manual Chapter 13

West Virginia Income Maintenance Manual Page 21 Chapter 13 Determining Disability, Incapacity, and Blindness

If the client was in a West Virginia mental hospital, the Worker sends a memorandum to the Human Services Mental Health Coordinator in the county in which the hospital is located. ➢ Veterans Affairs (VA) Hospitals and Clinics If the client has been in a VA hospital and/or is currently receiving, or has recently received, medical services from a VA clinic, the Worker sends the request for a copy of medical reports to the appropriate facility. The letter is addressed as follows: • For VA hospitals and outpatient clinics located in a VA hospital, write to Chief, Medical Information Services. • For VA clinics located outside of a VA hospital, write to Chief, Medical Administration Services. ➢ Private Hospitals, In-State and Border Facilities Form DFA-RT-9 is used to request reports from private hospitals. Special instructions for completion of the forms are as follows: • The county office determines person to whom the form is addressed. • There are spaces on the form to enter the applicant's hospital ID number, the dates the applicant was in the hospital, and the name of his physician. Entries are made as follows: o If the applicant cannot provide all the required information, the Worker completes as much of the information as possible. o None of the spaces are left blank. If the information is not known, "unknown" is entered in the indicated space. ➢ Private Hospitals, Out-of-State Facilities The procedures are as follows: • The Worker contacts BMS to determine if the facility is certified. • If so, a DFA-RT-9 is prepared.

loading…

Page 1174

Official source

West Virginia Income Maintenance Manual Chapter 13

West Virginia Income Maintenance Manual Page 21 Chapter 13 Determining Disability, Incapacity, and Blindness

If the client was in a West Virginia mental hospital, the Worker sends a memorandum to the Human Services Mental Health Coordinator in the county in which the hospital is located. ➢ Veterans Affairs (VA) Hospitals and Clinics If the client has been in a VA hospital and/or is currently receiving, or has recently received, medical services from a VA clinic, the Worker sends the request for a copy of medical reports to the appropriate facility. The letter is addressed as follows: • For VA hospitals and outpatient clinics located in a VA hospital, write to Chief, Medical Information Services. • For VA clinics located outside of a VA hospital, write to Chief, Medical Administration Services. ➢ Private Hospitals, In-State and Border Facilities Form DFA-RT-9 is used to request reports from private hospitals. Special instructions for completion of the forms are as follows: • The county office determines person to whom the form is addressed. • There are spaces on the form to enter the applicant's hospital ID number, the dates the applicant was in the hospital, and the name of his physician. Entries are made as follows: o If the applicant cannot provide all the required information, the Worker completes as much of the information as possible. o None of the spaces are left blank. If the information is not known, "unknown" is entered in the indicated space. ➢ Private Hospitals, Out-of-State Facilities The procedures are as follows: • The Worker contacts BMS to determine if the facility is certified. • If so, a DFA-RT-9 is prepared.