Incapacity Deprivation

 There MUST be 2 parents of a common child in the home  One of the parents (or both) allege that there is a condition of mind or body, which makes the parent physically or mentally unable to provide the necessities of life for his/her child. In Order to Use Incapacity Deprivation (Code 30 on KAMES):

 If one of the parents of a common child is alleging incapacity, DO NOT complete an Unemployed Parent case on this family.  A determination of “Not Incapacitated” must be received before we can start looking at a UP case. Incapacity or Unemployment?

 Have lasted, or be expected to last, at least 30 days  Be present at the time of application  Be such that it eliminates or substantially reduces the parent’s ability to provide support and care for the otherwise eligible child. The Incapacity Condition Must:

 Homemaking and child care functions  Consideration of the parent’s age, education, training and work experience. The “Ability to Support and Care” Includes:

In some instances, a case worker or case manager can do a “field determination”, verifying the incapacity of the parent. If an individual does not meet field determination criteria, then a referral must be sent to the Medical Review Team (MRT). A caseworker/case manager can never say that an individual is NOT incapacitated. Leave that to the experts at MRT! Incapacity Field Determinations

 SSI benefits are received.  SSI was received within the past 12 months, but was discontinued due to income or resources, and NOT an improvement in their condition.  Individual is age 65 or over.  Individual has a “K” adult medical case.  Individual has a “M” adult medical case. Field Determination Reasons

 RSDI, Black Lung, or Railroad Retirement based on disability is received.  “Notice of Favorable Decision” has been received from the SSA office, Bureau of Hearings and Appeals.  Incapacity has been determined by MRT, hearing officer, Appeal Board, or Circuit Court with the decision stating no re- determination needed and there is no visible improvement in the condition. More Field Determinations

 Individual is hospitalized, or in an alcohol or substance abuse facility, on the date of processing the application, and a statement from the doctor indicates the period of incapacity has or will exceed 30 days.  Receipt of 100% VA benefits.  An individual is on approved sick leave from a job, and the employer is holding the job for their return. More Field Determinations

 An individual had surgery, which requires a period of time for recovery, as specified by a doctor’s statement. A field determination can be made for up to six weeks.  An individual had an illness or injury, which requires a period of time for recovery, as specified by a doctor’s statement. More Field Determinations

 A woman is deemed to be in a high-risk pregnancy condition. This is verified by a doctor’s statement, and lasts through the pregnancy and the 6-week postpartum period. We do not expect that you memorize this list! These reasons are listed in Vol. III, MS 2381 More Field Determinations

 Use form PAFS-5.1 to refer individuals to the local Social Security Office, to apply for SSI/RSDI benefits, if they appear to have a disabling health condition.  Do not delay processing the KTAP application, if the individual has applied for SSI/RSDI, and a determination is pending.  An individual has the right to apply for KTAP or MA benefits even if they are denied or discontinued by SSI/RSDI. If Disability Benefits Are Not Received: