Aid Rules Updated for Disabled

Section 1. Section 131 of the social services law is amended by adding a new subdivision 21 to read as follows:

21. In addition to any requirements in section three hundred thirtytwo-b of this article, if at any time a local social services district has reason to believe that an applicant for or recipient of public assistance has a disability, which may be evidenced by the fact that an individual has failed to successfully complete the process required to receive or continue to receive public assistance, such local social services district shall offer reasonable accommodations to assist the individual in successfully completing such processes. For the purposes of this subdivision, "disability" shall have the same meaning as set forth in subdivision five of section three hundred thirty of this article.

§ 2. Subdivision 5 of section 330 of the social services law is renumbered subdivision 9 and four new subdivisions 5, 6, 7, and 8 are added to read as follows:

5. "Disability" shall mean a physical or mental impairment that substantially limits one or more major life activities of an individual.

6. "Physical or mental impairment" shall include but not be limited to any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more body systems, such as neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, immune, circulatory, hemic, lymphatic, skin and endocrine, as well as

EXPLANATION--Matter in italics (underscored) is new; matter in brackets

[ ] is old law to be omitted.

LBD01041-01-9

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any mental or psychological disorder, such as intellectual disability, organic brain syndrome, emotional or mental illness, and specific learning disabilities.

7. "Major life activity" shall include but not be limited to caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, sitting, reaching, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, interacting with others, working, as well as the operation of major bodily functions, including functions of the immune system, special sense organs and skin, normal cell growth, digestive, genitourinary, bowel, bladder, neurological, brain, respiratory, circulatory, cardiovascular, endocrine, hemic, lymphatic, musculoskeletal, and reproductive functions.

8. "Executive function" shall mean a set of mental skills and processes utilized in an individual's daily activities, including but not limited to, impulse control, working memory and mental flexibility.

§ 3. Section 332-b of the social services law, as added by section 148 of part B of chapter 436 of the laws of 1997, paragraph (b) of subdivision 2 as amended by chapter 214 of the laws of 1998 and subdivision 4-a as added by section 1 of part Y of chapter 54 of the laws of 2016, is amended to read as follows:

§ 332-b. Disability program. 1. (a) Upon application and recertification for public assistance benefits, or whenever a district has reason to believe that a [physical or mental impairment] disability may prevent the individual from successfully completing any process required in to receive or continue to receive public assistance or fully engaging in work activities, the social services district shall inquire whether the individual has any [medical condition] disability which would limit the individual's ability to successfully complete any process required to receive or continue to receive public assistance or participate in work activities pursuant to this title.

(b) An individual who is eligible to receive comprehensive health services through a special needs plan defined in paragraph (m) or (n) of subdivision one of section three hundred sixty-four-j of this [chapter] article, regardless of whether such a plan is operating in the individual's social services district of residence, shall be considered disabled and unable to engage in work activities or shall be considered work-limited.

(c) A local social services district that utilizes a screening or any other form of assessment to determine whether or not an individual has a disability shall not condition the eligibility of benefits on the willingness or failure of an individual to complete such screening or assessment. Any screening or assessment offered in a local social services district shall be completed solely at the option of the applicant for or recipient of benefits and such applicant or recipient shall not be denied, sanctioned, or terminated from benefits on the ground that he or she declined to complete such assessment or screening or declined or failed to participate in or obtain a professional evaluation.

2. (a) [Under the circumstances set forth in subdivision one of this section] If an applicant for or recipient of public assistance has selfidentified as having a disability, written notice shall be provided to the individual of the opportunity to provide, within [ten] fifteen calendar days, any relevant medical documentation, including but not limited to drug prescriptions and reports of the individual's treating health care practitioner, if any; such documentation must contain a

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specific diagnosis as evidenced by medically appropriate tests or evaluations and must particularize any work related limitations as a result of any such diagnosis.

(b) If, [prior to submitting his or her medical documentation, the individual is referred to a health care practitioner certified by the office of disability determinations of the office of temporary and disability assistance or, if applicable, to the contracted agency or institution by or with which such health care practitioner is employed or affiliated for an examination pursuant to subdivision four of this section, such individual shall make best efforts to bring such documentation to the examination, and in no case shall provide such records to the examining health care practitioner certified by the office of disability determinations or, if applicable, to the contracted agency or institution by or with which such health care practitioner is employed or affiliated later than four business days after such examination; provided that the individual may demonstrate good cause as defined in regulations, for failure to provide such records within the specific time periods] at the time such written notice is provided, the individual does not have any relevant medical documentation described in paragraph (a) of this subdivision, the individual shall be referred to an independent health care practitioner or to a health care practitioner certified by the Office of Disability Determinations of the Department of Social Services for an examination as described in subdivision three of this section.

[3.] (c) The district [may in its sole discretion] shall accept such medical documentation as described in paragraph (a) of this subdivision, that contains a specific diagnosis as evidenced by medically appropriate tests or evaluations as sufficient evidence that the individual cannot fully engage in work activities and in such case shall modify work assignments consistent with the findings in such medical documents.

3. The health care practitioner who performs the professional evaluation as described in paragraph (d) of this subdivision shall:

(a) review and consider all records or information provided by the individual or any records or information that are pertinent to the claimed medical condition previously on file with the health care practitioner if such health care practitioner is the individual's primary treating physician;

(b) make a specific diagnosis as to whether the individual has a disabling condition as evidenced by medically appropriate tests or evaluations;

(c) based on the health care practitioner's specific diagnosis, determine whether the individual is:

(i) disabled and unable to engage in work activities pursuant to this title indefinitely or for a stated period of time, in which case the applicant or recipient shall be exempt in accordance with paragraph (a) of subdivision one of section three hundred thirty-two of this title;

(ii) disabled but able to engage in work limited activities with stated limitations pursuant to this title indefinitely or for a stated period of time;

(iii) disabled but able to fully engage in work activities pursuant to this title without limitations either indefinitely or for a stated period of time; or

(iv) not disabled;

(d) render to the individual and the local social services district within ten days of the individual's appointment:

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(i) their determination based on medically appropriate tests or evaluations;

(ii) whether such individual has a disability;

(iii) the severity of the disability, if one exists;

(iv) the functional limitations resulting from that disability, if any;

(v) what accommodations, if any, are appropriate and necessary; and

(e) in the event that the health care practitioner identifies a condition, other than the alleged condition, that may interfere with the individual's ability to successfully navigate the application process or fully engage in work activities, the practitioner shall report such condition to the individual and the district as well; and

(f) if, during the professional evaluation it is determined that an individual has a disability, the district shall be required to offer reasonable accommodations not only in the context of a recipient's required work activity, but also with regards to any other process required in connection with receiving public assistance.

4. [In instances where the district determines either that the documentation is insufficient to support an exemption from or limitation on work activities or that further medical evaluation is appropriate, the individual shall be referred to a health care practitioner certified by the Office of Disability Determinations of the Department of Social Services for an examination of such individual's medical condition.

The health care practitioner who performs the examination of the individual shall:

(a) review and consider all records or information provided by the individual or his or her treating health care practitioner that are pertinent to the claimed medical condition;

(b) make a specific diagnosis as evidenced by medically appropriate tests or evaluations in determination of the individual's claimed condition;

(c) render to the individual and the social services district, an opinion, particularizing the presence or absence of the alleged condition; and

(d) In the event that he or she identifies a condition, other than the alleged condition, that may interfere with the individual's ability to fully engage in work activities, the practitioner shall report such condition; and

(e) determine whether the individual is:

(i) disabled and unable to engage in work activities pursuant to this title for a stated period of time, in which case the applicant shall be exempt in accordance with paragraph (a) of subdivision one of section three hundred thirty-two of this title;

(ii) for a stated period of time, not disabled, but work limited, and able to engage in work activities pursuant to this title, with stated limitations, or

(iii) neither disabled nor work limited.

4-a.] If the practitioner to whom the individual is referred pursuant to [subdivision four or] paragraph (b) of subdivision two of this section issues an opinion that differs from the applicant's treating health care practitioner, the practitioner shall provide a written determination that specifies why the practitioner disagrees with the applicant's treating health care practitioner's disability determination and present evidence that supports the opinion.

5. When an applicant or recipient has requested or a social services official has directed a determination pursuant to this section, no

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assignment to work activities may be made until completion of such determination, unless the applicant or recipient agrees to a limited work assignment not inconsistent with the medical condition alleged by such person.