What happens when someone on ODSP gets a medical review date

This is a translation of “What happens when someone on ODSP gets a medical reveiw date” published in June 2017, produced in English by CLEO (Community Legal Education Ontario). Japanese Social Services is wholly responsible for the accuracy of this translation, produced with permission of CLEO.

What happens when someone on ODSP gets a medical review date

This month’s On the Radar talks about the process that the Ontario Disability Support Program (ODSP) uses when they do a medical review.

There’s more detailed information on the Steps to Justice website.

 

Who gets a medical review date

To qualify for income support from ODSP, a person usually has to prove that they’re a person with a disability.

When the Disability Adjudication Unit or the Social Benefits Tribunal decides that someone is a person with a disability, they may set a medical review date.

They do this if they think that the person’s health might improve.

 

Medical Review Package

The Disability Adjudication Unit handles medical reviews. When they’re ready to do someone’s medical review, they send them a Medical Review Package. The package has instructions and forms that have to be filled out and sent back within 90 days.

 

Completing Medical Form Part A

Medical Form Part A is already partly filled out when the person gets the Medical Review Package. It has information about the person’s medical conditions from the last time they had to show ODSP that they qualified for income support as a person with a disability.

One of the following “approved health professionals” must complete the Medical Form Part A:

  • a family doctor or a specialist
  • a psychologist or a psychological associate
  • an optometrist
  • a nurse practitioner

And for someone to keep getting income support as a person with a disability, they must send in a completed Medical Form Part A.

 

Completing Medical Form Part B

There’s no need to send in Medical Form Part Bunless the person has a new medical condition that’s not listed in Part A.

Even if they do have a new condition, they don’thave to complete Medical Form Part B if the health professional who completes Medical Form Part A says:

  • the physical or mental health problems listed in Part A have not gotten significantly better, and
  • the medical conditions listed in Part A are likely to stay the same or get worse.

But there are times when it can be helpful to have a health professional complete Medical Form Part B, even if it’s not necessary.

Medical Form Part B has 2 sections:

  • Health Status Report
  • Activities of Daily Living Index

Health Status Report

This must be filled out by an approved health professional.

In the Health Status Report, the health professional lists any medical conditions the person has that are not listed in Medical Form Part A.

The health professional must say whether a medical condition is likely to:

  • improve
  • stay the same
  • get worse

Or, they can say that they don’t know.

And they must give other information about the medical condition, for example, how it affects the person.

Activities of Daily Living Index

There’s a longer list of approved health professionals who can complete this form.

In the Activities of Daily Living Index, a health professional describes how much a person’s health problems limit their ability to:

  • work
  • look after themselves
  • take part in activities at home and in the community

The Activities of Daily Living Index does not have to be filled out by the same health professional who fills out the Health Status Report.

 

Completing other forms in the Medical Review Package

The 2 other forms in the Medical Review Package are:

  • Consent to the Release of Medical Information
  • Self Report

They don’t have to be completed by a health professional.

 

Sending in the Medical Review Package

The completed forms must be sent to the Disability Adjudication Unit within 90 days.

But a person can contact the Disability Adjudication Unit if they need more time. For example, they might not find a health professional to complete the forms in time.

 

Getting a decision

The Disability Adjudication Unit looks at the completed Medical Review Package and decides if the person still meets the ODSP definition of a person with a disability.

If they say that someone is no longer a “person with a disability”, ODSP pays income support for 3 more months and then cuts it off.

 

Getting legal help

If a person’s income support is cut off, they may be able to appeal the decision.

For help appealing the decision, they can contact their local community legal clinic.

 

This email alert gives general legal information. It is not a substitute for getting legal advice about a particular situation.

Original Source: http://mailchi.mp/cleo/revised-version-on-the-radar-what-happens-when-someone-on-odsp-gets-a-medical-review-date

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