Michigan's Disability Determination Service (DDS) needs to know not only a client's psychiatric diagnosis but what they can still do. The DHS-49-E, Mental Residual Functional Capacity Assessment, answers that question. A psychiatrist or fully licensed psychologist completes it alongside the DHS-49-D exam report for State Disability Assistance, Family Independence Program or Medicaid disability decisions.
A psychiatrist or fully licensed psychologist completes the whole assessment. The client completes the DHS-49-F questionnaire and signs the DHS-1555 release separately.
Download the current version from the source each time; forms change without notice.
Mental Residual Functional Capacity Assessment
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When a client's disability claim involves a mental health condition, including after a prior denial when the client reports a new or worsening condition. Michigan's administrative manual tells staff to request a DHS-49 for physical conditions and the DHS-49-D and DHS-49-E for mental health conditions.
A psychiatrist or a fully licensed psychologist. Michigan requires medical evidence of disability to be based on the findings of an M.D., D.O. or fully licensed psychologist, and evidence from a physician assistant must be co-signed by an M.D. or D.O.