Obtaining Medical Verification

• Inform the client that they must be seen by a doctor and the doctor must complete the medical verification form (SCD 1400) as proof of their unemployability.

  • Note: if the individual is NOT receiving Medi-Cal, add the Medi-Cal program to the case and process the Medi-Cal application.

• Generate the "General Assistance Program Request for Medical Information" (SCD 1400)
• Review "Consent to Release Social Services Records to SSI Advocacy Program Approved Attorneys" (SCD 1400 Attachment) with the client and ensures a copy is sent to Imaging.
• If the client already has a doctor/primary care physician, skip to Step 4.
• If the client does not have a doctor/primary care physician, continue to Step 2.

For clients without a doctor/primary care physician:

• Explain that a Health Alliance Clinician can help them find a doctor and in some cases can complete a temporary SCD 1400 until they are able to see the doctor.
• Ask the client if they would like to be referred to a Health Alliance Clinician.

If the client does not accept the Health Alliance referral, remind them that they are responsible for finding their own doctor and getting the SCD 1400 completed. Skip to Step 4.

If the client accepts a Health Alliance referral, the EW:

• Accesses the calendar "Health Alliance WPC Appointment at GA", from One Drive.
• Schedules the appointment in an available slot.
• Confirms the client's telephone number.
• Informs the client of the time of the appointment and to expect a call from the clinician within a period of 30 minutes before and after the appointment time.
• Sends the referral through the DEBS Referral App with the following information: client's confirmed phone number, client's email address (if applicable), appointment date and time, clinician's name (from the One Drive calendar), EW extension number, and any other relevant information the clinician may need to know.
• Ensures that the required forms are signed by the client and shared with the Clinicians (see below).

Process for paper applications or clients with no email access: 

• Scans all signed required forms to PDF (HHS #585.12 - Attachments A and B, SCD 103, SCD 1400).
• Attaches the PDF documents to the email generated by the DEBS Referral App (must be emailed to HealthAllianceGA@hhs.sccgov.org with subject line containing client's last name, first name, and date/time of appointment).

Process for BenefitsCal applications or clients with email access:

• Notifies the client that an electronic version of the forms SCD 1400 and SCD 103 will be sent to by email to be signed via DocuSign.
• Sends the SCD 1400 and SCD 103 through DocuSign with the signing order as follows: the client, the EW, the clinician who the appointment was scheduled with (cindy.la@hhs.sccgov.org or nga.nguyen2@hhs.sccgov.org)

  • Note: The SCD 1400 template already has the correct signing order in DocuSign and must not be modified.

• Updates client's employability status to unemployable in CalSAWS and enters the maximum 60-day due date.
• Continuing EW: If the SCD 1400/medical verification is not received by the 60th day, GA must be discontinued (use NOA GA 043)
• If the SCD 1400/medical verification is returned and shows the client is unemployable, update the end date/due date in CalSAWS to match the date indicated on the completed SCD 1400.

  • Note: If the SCD 1400 indicates the client's disability will last 12 months or longer, send the client the SCD 169 to take to Social Security and explain that they must apply for any Disability and/or Social Security Benefits they may be eligible for. Also send a referral to SSI Advocacy (see "Referrals to SSI Advocacy"). Ensure the SSP 14 has been signed and imaged.

• If the SCD 1400 indicates the client is employable, update the status in CalSAWS and schedule the client for a VS orientation. Refer to CB 23-63.