Florida's Temporary Cash Assistance work requirements can be excused for a caregiver who must stay home to care for a disabled household member. This one-page DCF form documents that need. The caregiver describes the care arrangement in Part A, and a physician certifies in Part B that the person is temporarily or permanently disabled to the extent personal care is required, with dates.
A physician completes Part B, the Physician's Statement, with the primary diagnosis as an ICD-10-CM code, the dates the need for care began and may end, and their state license number. The caregiver completes Part A.
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Statement of the Need for Care
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That the named person, whose primary diagnosis is given as an ICD-10-CM code, is temporarily or permanently disabled to the extent that personal care is required. The physician adds when the need for care began and how long it may last, their license details, signature and contact information.
Part B asks for the approximate date the need for care began and the date it may last through, alongside the certification that the person is temporarily or permanently disabled to the extent personal care is required. The signed form then goes back to the DCF eligibility specialist named at the bottom of the page.