Vermont's Economic Services Division (ESD) uses Form 210A to get a medical provider's report on a participant's ability to take part in training and employment activities. In programs such as Reach Up and 3SquaresVT, that report supports decisions to defer a participant from work requirements or to modify them. The finished report goes back to ESD, where the case manager uses it in the participant's plan.
The participant's medical provider completes and signs the report on the participant's ability to take part in training and employment activities.
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Training and Employment Medical Reports
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The participant's medical provider completes and signs the report. It describes how the participant's health affects their ability to take part in training and employment activities, which ESD uses when deciding whether work requirements in programs such as Reach Up should be deferred or modified.
Vermont's Economic Services Division accepts documents through its online Document Uploader, which works from a phone, tablet or computer, as well as by mail and at district offices. The report should reach ESD promptly, since the case manager relies on it to set the participant's work or training requirements.
DCF posts Form 210A as a PDF on the Economic Services Division's applicant forms page, in the supplemental forms list. The same page lists Form 210PO, Exemption Personal Obstacle or Barrier, and links to the Document Uploader and to district office contacts.