461-125-0830 Effective 01/01/16
Medical Documentation; Disability and Other Determinations
- Medical documentation must be written and must contain all the following:
- A diagnosis in medical terminology, including an explanation of whether the impairment limits the individual's ability to perform normal functions and, if so, how.
- A prognosis, including an expected recovery time frame.
- Clinical findings from physical examination, psychiatric evaluation, X-rays, or a laboratory procedure, including specific data supporting diagnosis of a condition that causes disability, either on a medical or psychiatric basis.
- Except as provided otherwise in section (3) of this rule:
- To determine eligibility, the Department will accept evaluations from the following medical sources: medical evaluations only from licensed physicians, including psychiatrists, osteopaths, and ophthalmologists; mental evaluations only from psychiatrists and licensed or certified psychologists; and measurement of visual acuity and visual fields only from ophthalmologists and licensed optometrists.
- The Department will accept supplemental medical and vocational information to augment evaluations from acceptable medical sources, from a licensed social worker, licensed physical or occupational therapist, or licensed nurse practitioner.
- Except for eligibility determinations in the OSIP, OSIPM, QMB, and SFPSS programs, the Department will also accept medical evaluations from licensed nurse practitioners and physician assistants; and mental evaluations from psychiatric mental health nurse practitioners.
- The client must provide or cooperate in obtaining sufficient medical documentation for the Department to determine eligibility.
Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.404, 411.710, 412.006, 412.009, 412.014, 412.049
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.404, 411.710, 412.006, 412.009, 412.014, 412.049