Common use of Disability Determination Process and Tools Clause in Contracts

Disability Determination Process and Tools. ‌ The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If an individual is claiming a medical limitation or stating that they are unable to work at all, they are given an agency medical form to be filled out by their physician. The individual is not engaged in any work activities until employability status can be determined and the individual is notified of the agency's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician, Industrial Medical Associates, (IMA) may be requested in order to help determine employability status. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: If an individual is claiming a medical limitation or stating that they are unable to work at all, they are given an agency medical form to be filled out by their physician. The individual is not engaged in any work activities until employability status can be determined and the individual is notified of the agency's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician (IMA) may be requested in order to help determine employability status. When all the information is reviewed and a determination is made, the client is sent a 4005/4005a to inform him/her of the agency's decision on his/her employment status.

Disability Determination Process and Tools. ‌ The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If Clients are referred to an individual is claiming independent medical evaluator for a medical limitation evaluation and the employability status is determined by a Nassau County Staff. Temporary Assistance applicants and recipients, who demonstrate/claim to be exempt from or stating that limited in the scope to employment requirements because of disability, are referred to an indepent medical evaluation and status is determined by medical staff. The client is advised they can provide documentation from their own medical provider within 4 business days following the IMA examination. The results of the medical evaluation are unable forwarded to the DSS Medical Director who makes the final employability determination. Applicants and Recipients who are demonstrate/claim disability, but are deemed non-exempt, or work at alllimited by the Medical Director, they are given an agency medical form a Notification of Disability Review Findings and the Right to Contest at the eligibility review. Individuals, who are found to be filled out exempt by our Medical Director, are referred to the Disabled Client Assistance Program (DCAP) for screening after the eligibility review. Temporary Assistance applicants and recipients, who demonstrate/claim to be exempt or work limited because of the need for substance abuse rehabilitation, are referred for employability determinations to the Nassau County Department of Drug and Alcohol Addiction. Alcohol and Substance Abuse Counselors (CASAC’s) employed by the Nassau County Department of Drug and Alcohol Addiction advise the Department of the employability assessments for this applicant population. Individuals who are temporarily determined to be exempt are given follow-up dates by our Medical Director for the resubmission of medical evidence. Clients determined to be nonexempt at the follow-up determination are sent a Notification of Disability Review Findings and the Right to Contest apprising them of the determination and their physicianright to a Fair Hearing to contest the determination. Failure to submit follow-up medical evidence of work exempt status will result in a case closing. Work limitations are written on the Work Experience Program (WEP) referral forms and are provided to the WEP site supervisors. DSS Employment Unit staff also calls site supervisors before assigning work limited clients to WEP sites to insure that the sites can utilize work limited WEP participants. Follow-up calls are routinely made by DSS Employment Unit staff members to WEP site supervisors to confirm client’s initial compliance with assignments. WEP site supervisors know that DSS staff is available to discuss issues that arise related to a WEP participant’s performance. The individual WEP participant is not engaged in any work activities until employability status also informed that he or she can be determined and the individual is notified of the agency's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral discuss difficulties that arise with regard to the agency's contracted physician, Industrial Medical Associates, (IMA) may be requested in order to help determine employability statusWEP placement with the appropriate Employment Unit worker. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: If an individual is claiming Temporary Assistance applicants, who demonstrate/claim to be exempt from or limited in the scope of employment requirements because of disability, are sent to the medical practitioner at IMA for a medical limitation examination to determine employability. Applicants who claimed disability, but are deemed non-exempt, or stating that they are unable to work at alllimited by the Medical Director, they are given an agency a Notification of Disability Review Findings and the Right to Contest at the eligibility review. Applicants, who are found to be exempt may be referred to the Disabled Client Assistance Program (DCAP) for screening after the eligibility review if appropriate. TA recipients who demonstrate/claim to be exempt from or limited in the scope of employment requirements because of disability, are issued a medical form 279 which is to be filled out completed by their physicianown doctor. The individual form is not engaged in any work activities until employability status can be determined and returned to the individual is notified of the agency's determination. When DCAP unit where the agency doctor or medical is received by director reviews it and makes an employability determination based on what the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician (IMA) may be requested in order to help determine employability status. When all the information is reviewed and a determination is made, the client is sent a 4005/4005a to inform him/her of the agency's decision on his/her employment statusclient’s doctor wrote.

Disability Determination Process and Tools. ‌ The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If an individual is claiming a District utilizes County Nurse Practitioner to assist with medical limitation reviews. An applicant or stating that they are recipient who claims to be unable to work at all, they are given or who has limitations regarding employment or participation in work-related activities will be issued an agency medical form LDSS- 4526 to be filled out completed by their physicianall his/her treating health care provider(s) and to be returned to the agency within 10 days. Upon receipt of the completed medical report(s), the agency will determine the applicant/recipient's ability to work and any limitations he/she might have with respect to employment or participation in work-related activities. The individual LDSS staff may decide if the recipient's medical documentation is not engaged in any work activities until employability status can be determined sufficient to make a decision. The worker will send either an LDSS-4005 or a DSS-4005(a) to the client notifying him/her of the disability determination and the individual is notified right to request a fair hearing. The LDSS staff may refer individuals either who claim to have a physical or mental impairment or who it suspects of having a physical or mental impairment to IMA for a determination of the agencyindividual's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician, Industrial Medical Associates, (IMA) may be requested in order to help determine employability statuscondition. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: If an individual is claiming a District utilizes County Nurse Practitioner to assist with medical limitation or stating that they are unable to work at all, they are given an agency medical form to be filled out by their physicianreviews. The individual is not engaged in TA/Employment Supervisor and/or staff designated by the TA intake TA/Employment Directors can review all available medical documentation and make the determination of status. Phone calls will be made by the worker who requested the medical report to any work activities until employability status can be determined and the individual is notified of the agency's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral treating physicians to the agency's contracted physician (IMA) request any additional documentation that may be requested in order required. The LDSS staff may refer individuals either who claim to help determine employability status. When all the information is reviewed and have a physical or mental impairment or who it suspects of having a physical or mental impairment to IMA for a determination is made, the client is sent a 4005/4005a to inform him/her of the agencyindividual's decision on his/her employment statusmedical condition. Refer to nurse practitioner for questions to assist with determination.

Disability Determination Process and Tools. ‌ The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If an individual at application or recertification, or during the assessment process, a client is claiming identified as having a physical or mental impairment which would limit his or her ability to participate in work activities the client will be verbally advised and for the TANF population referred to Industrial Medicine Associates (IMA) for a medical limitation or stating that they are unable to work at all, they are given an agency medical form to be filled out by their physician. The individual is not engaged in any work activities until employability status can be determined evaluation and the individual is notified informed to bring any medical documentation to the IMA exam, or within 4 days following the date of the agency's determinationexam, for IMA to consider. When Both the agency SN and NTA SNAP population, are given the medical examination form (DSS 4526) to have their medical practitioner complete and return within ten days, along with the DSS2642 which officially affords them ten days. In the case where a Safety Net client presents a completed medical(DSS4526), the district will review it and make a determination based on information contained in that medical. Upon receipt of a fully completed medical or an IMA evaluation, the client is received by provided a LDSS4005 or 4005(a), via mail or in person, to notify him or her of the agency, it is reviewed by disability determination and the right to request a TA Examiner and a Senior Examinerfair hearing. If the agency medical is not clear about the limitation(s)a SNAP recipient fails to supply documentation of a claimed exemption, a referral he/she will be determined to the agency's contracted physician, Industrial Medical Associates, (IMA) may be requested in order to help determine employability statusnon-exempt from SNAP work requirements. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: If an individual is claiming a medical limitation or stating that they are unable to work at all, they are given an agency medical form to be filled out by their physician. The individual In cases where IMA is not engaged in any work activities until employability status can be determined utilized, Employment workers review and the individual is notified of the agency's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician (IMA) may be requested in order to help determine employability status. When all the information is reviewed and Upon receipt of a determination is madefully completed medical , the client is sent provided a 4005/4005a LDSS4005 or 4005(a), via mail or in person, to inform him/notify him or her of the agency's decision on his/her employment statusdisability determination and the right to request a fair hearing. Each time a determination or re-determination is made of an exempt or non-exempt status the appropriate LDSS-4005 or LDSS 4005(a) notice is sent to the individual.

Disability Determination Process and Tools. ‌ The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If an - A physical examination is required prior to any JOBTRAK assignment. Physicals are conducted by the Xxxxx Memorial Walk-In Clinic unless the client chooses to go to their primary care provider. - Any individual is who claims to have a limitation or disability must provide the agency with the name(s) of his or her medical provider(s) and sign a release of information. - A participant claiming a medical limitation or stating disability may be required by ACDSS to make an appointment with his/her health care provider(s) to obtain current information about the person's health. It is the client's responsibility to provide documentation of this to the agency. -If it is determined by the health care provider that they are unable the individual has no limitations, or can work with limitations, the individual will be assigned to work at all, they are given an agency medical form to be filled out by their physician. The individual is not engaged in any appropriate work activities until employability status can be regardless of whether the individual has applied for SSI - If it is determined and by the health care provider that the individual is notified unable to work, the district may refer the individual to a health care provider for a second opinion, and/or may require that the individual apply for SSI. - Each time that a determination or redetermination is made of an exempt or non-exempt status the agencyappropriate LDSS-4005 or LDSS-4005(a) notice is sent to the individual - If there are no work activities that can safely accommodate the individual's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s)limitations and/or plan of treatment, a referral to the agency's contracted physician, Industrial Medical Associates, (IMA) person with medical limitations may be requested in order offered the option of proposing a community service plan as his/her work activity. However, if the individual is unable to help determine employability statusarrange for community service, no negative action will be taken. - An individual with documentation of permanent and/or total disability will be referred to AIM and Legal Services, to pursue SSI. Such an individual will also be provided information regarding ACCES-VR services and the ADA, and will be encouraged to seek assistance for becoming self-supporting. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: If an individual is claiming a A member of the DSS Employment Unit reviews the medical limitation or stating that they are unable to work at all, they are given an agency medical form to be filled out by their physician. The individual is not engaged in any work activities until documentation for employability status can be determined and then will track the individual is notified of the agency's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician (IMA) may be requested in order to help determine employability status. When all the information is reviewed and a determination is made, the client is sent a 4005/4005a to inform him/her of the agency's decision on his/her employment status.request new documentation as needed

Disability Determination Process and Tools. ‌ The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If an individual declares a disability or work limitation, the individual is claiming given a medical limitation or stating that Medical Examination for Employability Assessment, Disability Screening and Alcoholism/Drug Addiction Determination form to bring to their practitioner to complete. The individual is required to return the completed form within 10 days. If the individual states they are unable to work at allor have a work limitation due to men tal health issues and attend Oswego County Behavioral Health Services (OHBS), the individual signs the releases of information (ROIs) and the ROIs and form are sent to OHBS on behalf of the individual, with a request that the practitioner complete and return the form within 10 days. If OHBS does not return the completed form, the individual is then given a Medical Examination for Employability Assessment, Disability Screening and Alcoholism/Drug Addiction Determination form to bring to the practioner to complete. OCDSS may allow a written statement from the practitioner if the statement contains the necessary elements to determine disability. If an individual states they are given an unable to obtain medical documentation and requests assistance, OCDSS will assist the individual with obtaining the documentation. OCDSS staff, which can include Employment Specialist, Temporary Assistance Staff and Supervisory Staff are responsible to review medical documentation, monitor the recommended treatment pl an, determine the employment status, and review progress no fewer than three months and no greater than twelve months, unless otherwise indicated on the completed Medical Examination for Employability Assessment, Disability Screening and Alcoholism/Drug Addiction Determination form. A recipient claiming a medical exemption is required to provide a medical update within 10 days, by submitting a completed medical form. If the form is not received in the agency medical within that timeframe, a reminder notice is sent to the recipient indicating the form has not been received and is required to be filled out by their physiciansubmitted within 10 days. OCDSS reserves the right to contract with an independent medical exam provider to conduct physical, mental and IQ evaluations. In addition, should an individual be referred to an independent medical exam, Oswego County may use this information, along with any other documentation to determine the status of an individual's disability and potential to be restored to self -sufficiency. The mandated Alcohol and Substance Abuse Screening is completed on-site, by contracted Office of Alcohol and Substance Abuse Services (OASAS) licensed providers in the county. Individuals determined from the screening to need further drug/alcohol assessment a re referred for an initial assessment, completed on-site by an OASAS provider. If further evaluation and/or treatment is recommended following the initial assessment, an off-site appointment is scheduled with an OASAS provider. If the individual is not engaged in any work activities until employability status can be determined recommended for Drug and Alcohol treatment by the OASAS provider, the individual is notified in writing of employability and the agency's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral requirement to the agency's contracted physician, Industrial Medical Associates, (IMA) may be requested in order to help determine employability statuscomply with any treatment recommendations. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: If an OCDSS reviews information obtained from the participant, participant's medical providers, drug and alcohol providers, independent medical evaluations, and any other information deemed pertinent by OCDSS to determine the status of the individual's disability as well as the individual's potential to be restored to self-sufficiency. Local district staff use this information to determine if the individual is claiming a medical limitation exempt, nonexempt, or stating that they are unable to work at all, they are given an agency medical form to be filled out by their physicianlimited. The individual is not engaged notified in any work activities until employability status can be determined and the individual is notified writing of the agencydistrict's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician (IMA) may be requested in order to help determine employability status. When all the information is reviewed and a disability determination is made, the client is sent a 4005/4005a to inform him/her of the agency's decision on his/her employment statusvia forms LDSS-4005/4005a.

Disability Determination Process and Tools. ‌ The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If The LDSS has contracted with St. Mary's Hospital for physical, mental health and drug/alcohol evaluations. CLients are generally referred to the contracted provider for an individual is claiming evaluation when they do not already have a medical limitation or stating that they are unable to work at all, they are given an agency medical form to be filled out by their physiciantreating practitioner. The individual is not engaged in any work activities until employability status can be determined and LDSS also accepts medical documentation from the individual is notified of the agencyclient's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician, Industrial Medical Associates, (IMA) may be requested in order to help determine employability statuspractioner. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: If an individual is claiming Generally, TA staff, namely the Intake Worker, makes the initial employability determinatin during the application process as to whether the client will pursue a medical limitation or stating is employable, The Intake worker will make the appropriate referrals at that they are unable to work at all, they are given an agency medical form to be filled out by their physiciantime. The individual Employment worker determines subsequent employability changes once the case is not engaged in any work activities until employability status can be determined opened. They collect all of the medical documentation received on the client and review it to determine whether the individual is notified exempt, non- exempt, or work limited based on this evidence and in accordance with NYCRR guidelines. Once the determination is made the Employment worker will notify the individual of the agency's determination. When determination in writing with the agency medical is received by the agencyLDSS-4005 and 4005a, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(sNotification of Temporary Assistance Work Requirements Determination (Exempt/Non-Exempt), a referral to the agency's contracted physician (IMA) may be requested in order to help determine employability status. When all the information is reviewed and a determination is made, the client is sent a 4005/4005a to inform him/her of the agency's decision on his/her employment status.

Disability Determination Process and Tools. ‌ The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If The TA/Employment Unit is assisted by the BILT team which employs staff who assist applicants and recipients in the process of applying for disability benefits. This process is initiated once a medical statement indicating a long-term disability has been received from one or more of the above entities and the District agrees with the medical statement. Referral to IMA for an independent evaluation will be made when an individual is claiming a medical limitation or stating indicates that they are unable to work at all, they are given an agency medical form to be filled out by do not agree with their physician. The individual is not engaged in any work activities until employability status can be determined and the individual is notified of ’s evaluation; the agency's determination’s determination and/or when no other medical provider is available to do an evaluation. When Upon receipt of medical verification, the agency applicant/recipient will be referred to the Disability Advocate in the BILT Unit if the medical is received by review indicates, in the agency’s judgment, it that an application for SSI is reviewed by appropriate for the applicant/recipient. Form LDSS-4005 or LDSS form 4005(a) will be sent to all applicant/recipients anytime there is a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician, Industrial Medical Associates, (IMA) may be requested change in order to help determine their employability statuscode. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: If an individual As noted above, the Employment Unit is claiming a medical limitation or stating that they are unable to work at all, they are given an agency medical form to be filled out assisted by their physician. The individual is not engaged in any work activities until employability status can be determined and the individual is notified members of the agency's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral BILT Team to the agency's contracted physician (IMA) may be requested assist in order to help determine determining employability status. When all Meetings are scheduled between the information units for case review as needed. A course of action which best suits the individual’s needs is reviewed and a determination is made, the client is sent a 4005/4005a to inform him/her of the agency's decision on his/her employment statusthen determined.

Disability Determination Process and Tools. ‌ The district’s process for determining an individual’s disabilities and/or work limitations is in accordance with 18 NYCRR 385.2(d). Check all that apply, and describe the process: District participates in the OTDA managed contract for independent medical evaluations. District contracts directly with a physician to provide independent medical evaluations. District accepts physician’s statement provided by participant. District accepts physician’s statement provided by participant but refers for an independent evaluation when deemed necessary. Other process (please describe): If an individual is claiming a District utilizes County Nurse Practitioner to assist with medical limitation reviews. An applicant or stating that they are recipient who claims to be unable to work at all, they are given or who has limitations regarding employment or participation in work-related activities will be issued an agency medical form LDSS- 4526 to be filled out completed by their physicianall his/her treating health care provider(s) and to be returned to the agency within 10 days. Upon receipt of the completed medical report(s), the agency will determine the applicant/recipient's ability to work and any limitations he/she might have with respect to employment or participation in work-related activities. The individual LDSS staff may decide if the recipient's medical documentation is not engaged in any work activities until employability status can be determined sufficient to make a decision. The worker will send either an LDSS-4005 or a DSS-4005(a) to the client notifying him/her of the disability determination and the individual is notified right to request a fair hearing. The LDSS staff may refer individuals either who claim to have a physical or mental impairment or who it suspects of having a physical or mental impairment to IMA for a determination of the agencyindividual's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral to the agency's contracted physician, Industrial Medical Associates, (IMA) may be requested in order to help determine employability statuscondition. The local process for reviewing the medical documentation to determine if the individual is exempt, nonexempt, or work limited is as follows: District directs the contracted physician or individual’s physician to determine status. District review team reviews and determines status (described below). Specialized disability/medical staff or unit reviews and determines status (described below) Other: If an individual is claiming a District utilizes County Nurse Practitioner to assist with medical limitation or stating that they are unable to work at all, they are given an agency medical form to be filled out by their physicianreviews. The individual is not engaged in TA/Employment Supervisor and/or staff designated by the TA intake TA/Employment Directors can review all available medical documentation and make the determination of status. Phone calls will be made by the worker who requested the medical report to any work activities until employability status can be determined and the individual is notified of the agency's determination. When the agency medical is received by the agency, it is reviewed by a TA Examiner and a Senior Examiner. If the agency medical is not clear about the limitation(s), a referral treating physicians to the agency's contracted physician (IMA) request any additional documentation that may be requested in order required. The LDSS staff may refer individuals either who claim to help determine employability status. When all the information is reviewed and have a physical or mental impairment or who it suspects of having a physical or mental impairment to IMA for a determination is made, the client is sent a 4005/4005a to inform him/her of the agencyindividual's decision on his/her employment statusmedical condition. Refer to nurse practitioner for questions to assist with determination.