Virginia local departments of social services issue this evaluation when a TANF applicant or recipient reports a disability that has to be verified. The treating or examining provider documents the disability, and the worker uses the returned form to record a reduced ability to work, which can exempt the person from TANF work participation. When the form is needed and never comes back, the TANF application is denied.
The applicant's treating or examining medical provider completes the medical section on the disability and signs it. The eligibility worker generates the form for the case, and the applicant brings it to the provider and returns it.
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Medical Evaluation
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There is no public blank to download. The local department of social services generates the DSS-822 for a specific TANF case in its eligibility system and sends it to the applicant with a DSS-810 checklist. The applicant brings that copy to the treating or examining provider, who completes the medical section and signs it before it goes back to the local agency.
When the medical evaluation is needed to establish eligibility and the applicant does not return it, the local department denies the TANF application for failure to provide verifications. The notice of action includes a comment that the Medical Evaluation form was not provided, so an incomplete or missing provider section can block the application.
The worker enters the provider's verification on the case's disability details and records a reduced ability to work. TANF can then be approved with the work participation status set to exempt because of a temporary medical condition or disability, instead of requiring the applicant to take part in work program activities.