NY Soc Serv L § 332-B (2021)
2021 New York Laws SOS - Social Services Article 5 - Assistance and Care Title 9-B - Public Assistance Employment Programs 332-B - Disability Program.

§   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 may prevent the individual from  fully  engaging  in  work  activities,  the  social services  district  shall inquire whether the individual has any medical condition which would limit the individual's ability to  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, 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.   2.  (a)  Under  the circumstances set forth in subdivision one of this section, notice shall be provided to the individual of  the  opportunity to   provide,   within   ten   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 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.   3.  The  district may in its sole discretion accept such documentation 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.   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 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.   6.  When  an  applicant  or  recipient  receives  notification  of the examining medical professional's disability  determination,  he  or  she shall  also  be  notified  of his or her right to request a fair hearing within ten days of such notice. If such applicant timely requests a fair hearing, no assignment to work activities pursuant to this title may  be made  pending  such  hearing  and  determination unless the applicant or recipient agrees to a limited work assignment not inconsistent with  the medical  condition  alleged by such person. Provided, however, that if a social services district has reason to believe that  such  recipient  or applicant  does  not actually suffer from a work limiting condition, the district shall  provide  the  applicant  or  recipient  with  notice  of potential  sanctions  pursuant  to  subdivision  three  of section three hundred forty-two of this title, and provided  further  that  recipients will  be  subject  to sanctions pursuant to subdivision three of section three hundred forty-two of this title if the district determines,  based on  clear  medical evidence, that there is no basis for the individual's claim that he or she is unable to fully engage in work  activities,  and that  the  individual  intentionally  misrepresented  his or her medical condition.   7. Any applicant or recipient determined to be work  limited  pursuant to  this  section  may be assigned to work activities only in accordance with the limitations and protections  set  forth  in  paragraph  (e)  of subdivision five of section three hundred thirty-five-b of this title.