VIA Metropolitan Transit in San Antonio uses this four-page application to issue a Reduced Fare card to riders with a diagnosed disability who do not already qualify through Medicare, age or a VA rating. The medical section on page 4 applies the Federal Transit Administration's two criteria: a disability, and inability to use public transportation as effectively as someone without one.
The applicant completes pages 1 to 3, including nine questions on how the disability affects bus travel. A medical professional certified to treat the specific disability completes the medical section: ICD-10 codes, ten yes-or-no bus tasks, comments, signature and medical license number.
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Reduced Fare Application (VIA Metropolitan Transit) - Medical Section
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Ten tasks the applicant can or cannot do as effectively as someone without a disability: reading and comprehending, recognizing places, walking various distances, making decisions, waiting half an hour standing, boarding vehicles with ramps, counting money, riding buses standing, stepping down up to 15 inches, and communicating.
The form instructs the medical professional not to proceed if any part of the medical section was completed before they received it. Every item must be answered, using NA when not applicable or UNK when unknown, and all disabilities that affect use of public transportation should be listed.
A medical professional certified to treat the applicant's specific disability. VIA directs applicants with physical disabilities to their family doctor or treating specialist, and those with psychiatric or psychological disabilities to a psychiatrist, psychologist or licensed counselor. The signer gives title, facility and medical license number.