(A) An EAEDC
applicant or client is responsible for establishing that he or she is disabled.
The Department shall help the applicant or client in obtaining the necessary
information and may require the applicant or client to attend an exam required
by the agency or organization under contract/agreement with the Department to
provide disability evaluation services.
(1)
The applicant or client must provide the Department:
(a) clinical and/or laboratory findings
establishing that he or she has an impairment or combination of impairments
that substantially reduces or eliminates his or her ability to support himself
or herself; and
(b) information
regarding the various vocational factors as specified in
106 CMR
703.193(C): Physical
Impairment and, if applicable,
106 CMR
703.193(D): Mental
Impairment.
(2)
If an applicant or client, without good cause, does not appear for a scheduled
medical examination, fails to provide required medical releases, or otherwise
fails to cooperate in the disability determination process, the Department or
the agency or organization under contract/agreement with the Department to
provide disability evaluation services, when required, shall make a
determination of disability based on information received from the applicant or
client and other available sources. Religious or personal reasons opposing
medical examinations or tests do not constitute good cause.
(B) The Department and, if applicable, its
agents, shall take reasonable steps to help applicants and client in obtaining
the information necessary to make a disability determination.
(1) The worker and/or an agent of the
Department is responsible for:
(a) referring
an applicant or client to a competent medical authority as defined in
106 CMR
701.600: Definition of Terms
if the applicant or client does not have a competent medical authority and, if
requested, scheduling an appointment with the competent medical authority;
and
(b) assisting the applicant or
client in completing the Disability Supplement when, such help is requested for
by the applicant or client.
(2) If the clinical and/or vocational
information submitted by the applicant or client is incomplete or ambiguous so
that a disability determination cannot be made, the agency or organization
under contract/agreement with the Department to provide disability evaluation
services is responsible for:
(a) gathering
the information needed to make a disability determination by contacting any
competent medical authority, physician, psychologist, or nurse practitioner
and/or hospital identified by the applicant or client, to obtain information on
any impairment that may potentially affect the applicant's or client's ability
to work provided such impairments have been identified by the applicant or
client, a competent medical authority or is otherwise evident in the record.
The competent medical authority who completed the medical
report shall be contacted for additional information and/or clarification
and/or, if appropriate, further tests, prior to contacting any other competent
medical authority; and
(b)
arranging for a competent medical authority to examine the applicant or client
to obtain additional information or tests, as necessary, to clarify the
incomplete or ambiguous clinical and/or vocational information that has been
submitted to the Department by and/or obtained by the agency or organization
under contract/agreement with the Department to provide disability evaluation
services from a competent medical authority.
