2023 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.