*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***

Chapter 12 - Certification of Disability

Effective:  June 1, 2015

12.10 - State Medical Review Team (SMRT) Disability Determinations

Archived:  June 1, 2016 (Previous Versions)

State Medical Review Team (SMRT) Disability Determinations

The State Medical Review Team (SMRT) is a unit at DHS that determines disability in consultation with medical professionals appointed by the commissioner. A primary function of SMRT is determining disability for people who are applying for (or appealing the denial of) Social Security Administration (SSA) disability benefits or Railroad Retirement Board (RRB) disability benefits. Contact SMRT staff at dhs.smrt@smrt.mn.us or 651-431-2493 or 800-235-7396.

Referral Process.

Expedited Case Criteria

Submitting the Referral.

Response from SMRT.

Related Topics.

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Referral Process

Complete a State Medical Review Team Referral for Disability Determination (DHS-6123) for each referral to SMRT.

Expedited Case Criteria

SMRT expedites the disability determination process in three situations which are considered severe. Write "EXPEDITE CASE" on the referral form (DHS-6123) so SMRT sees it immediately when an expedited determination is needed.

Expedited referrals are accepted in the following circumstances:

l  Compassionate Allowance Listing (CAL)

Social Security has identified specific conditions that are so severe SMRT can approve with minimal verification. An impairment summary and verification requirements for each condition is located under the Section Number link on the CAL list.

l  Awaiting Discharge from a Facility

Notify SMRT if a client is in a facility awaiting discharge. SMRT verifies that the client is likely to meet disability criteria and can be discharged immediately if MA is approved and there is a place willing to accept the client upon discharge.

l  Faced with a Potentially Life-Threatening Situation

Notify SMRT if a client does not have access to treatment or medication that could lead to a life-threatening situation. SMRT verifies that the client is likely to meet disability criteria, has a condition requiring treatment or medication and could be in a life-threatening situation without treatment or medication.

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Submitting the Referral

There are two options for submitting SMRT referrals:

l  Fax the referral to 651-431-7461 or 800-311-3137.

l  Send the referral via secure SIR email to dhs.smrtcases@state.mn.us in one file in portrait orientation.

Response from SMRT

SMRT enters a MAXIS case note when they determine that additional evidence or an exam is needed. The case note includes details of what is needed or the scheduled date of an exam. Check the status of a SMRT referral in MAXIS prior to contacting SMRT.

Once the review is complete, SMRT faxes the decision to the county, indicating approval or denial.

Related Topics

For more information, see:

TEFRA Referrals to SMRT.

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