CAU determines if a client is disabled by using SSA guidelines and criteria. A P3 TA client must provide medical information from their source of medical care. If a client states they are unable to obtain medical information without payment, the Department will make payment for the medical information. A client who fails to provide medical information, or who fails to cooperate with the Department's efforts to obtain medical information, is ineligible for P3 TA.
If, upon receipt of the medical information, CAU requests further information that cannot be provided without payment, the Department will make payment necessary to secure the additional information.
A person who:
- was denied SSI due to a finding of "not disabled" within the 12 months before the month of the TA application, and
- does not have an appeal pending at the reconsideration or ALJ level, and
- is unable to appeal the SSI denial because the period for filing the appeal has lapsed,
will not be found disabled by CAU unless:
- there is a substantial change in the person's medical condition, or
- there is a change in other factors such as length of time since working or reaching age 50, 55, or 60, or
- there is new medical evidence not previously available.
If CAU finds the person not disabled, but eligible or probably eligible for GA-TA based on regularly taking prescribed medication, see PM 03-18-03.