Contents

10.1 Functional Disability
10.2 Details on the FDI Page
10.3 Additional Duration Questions on FDI
10.4 Specific Diagnoses

The Functional Disability Indicator contains "disability logic" to indicate that an applicant appears to meet functional criteria for Social Security Administration (SSA) disability. The disability logic considers current screen items (e.g., age, ADLs, IADLs, HRS, etc.,) plus additional items added to the "FDI Page" of the CLTS FS.

The Functional Disability Indicator is only in testing. Every completed FDI screen will be compared to Social Security disability determinations made by Wisconsin's Disability Determination Bureau (DDB). DDB is a state agency contracted to determine SSA disability following SSA's process. The SSA process requires DDB to mail requests for documentation to the applicant's physicians, hospitals, therapists, and other health care providers; and parents, teachers and school staff, etc. DDB staff read through all the documentation and apply SSA criteria in a 5-step sequential process to allow or deny SSA disability.

The FDI tests whether Wisconsin's functional screen method could yield the same decisions more quickly. First, it should be noted that the FDI can only indicate possible disability allowances (i.e., approvals). The FDI cannot indicate denials, because the functional screen lacks all the medical test results that might justify an allowance. Initial testing shows that FDI results for children do match disability allowances by Wisconsin's Disability Determination Bureau.

If the FDI proves to be accurate and reliable, some county and state processes may be revised to help families sooner. But the final SSA disability determination must still come from the Disability Determinations Bureau.

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10.2 Details on the FDI Page

Content of the Functional Disability Indicator Page

The FDI page adds additional items not found elsewhere on the CLTS Functional Screen. Examples of Functional Screen items not repeated on FDI page that do count toward functional disability include: Terminal condition, TPN, Cancer Stage IV, Recurrent Cancer.

Parental Report Only or Allowable Documentation

These boxes apply to information on the FDI with the exception of Diagnoses. Diagnoses on the FDI are checked as per Instructions in Section 3.6.

• Allowable documentation - Check this box if at least one of the items checked on the FDI page is obtained from:
  • Health care records.
  • School records only if diagnoses are documented as having been made by qualified diagnostician as per Instructions in Section 3.6.
    
    
• Parental report - Check this box if:
  • Parents testify as per instructions in Section 3.6.
  • Screeners' observations are confirmed by parental report. No matter how obvious something is (e.g., tube feeding, TPN, Down Syndrome, or amputated limb) screeners are required to verify it with the parent. This reduces screener subjectivity and puts responsibility for claims upon the parent.
    
    
• Check both boxes if information is based on a mix of parental report and allowable documentation.

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10.3 Additional Duration Questions on FDI

The FDI page will ask the screener to indicate duration for certain items checked elsewhere in the CLTS FS. For example: Ventilator from the Health-Related Services page. SSA varies in its duration requirements depending on the skilled nursing care need. Some conditions ask the screener to check if the condition "has already lasted 6 months" and "is expected to last for at least 6 months from now." A few ask only the total duration, adding past and future:

Total duration of 12 months or more - Consider continuous months.

Check this box if:

• Condition has been true for past 3 months and is expected to last at least 9 more months.
• Condition has been true for past 10 months and is expected to last at least 3 more months.
• Child has used wheelchair for past year, except for a few weeks following surgery last winter.

Do not check this box if:

• Child used wheelchair for 7 months 3 years ago, and 3 months 2 years ago, and will need wheelchair again for next 3 months.
• Condition began 6 months ago and will be completely corrected next month.

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10.4 Specific Diagnoses

Check diagnoses only in accord with instructions Section 3.6.

Down Syndrome

In most cases the diagnosis will be Down Syndrome (Trisomy 21). Some children with Mosaic Down Syndrome do not have the usual cognitive and physical traits of typical Down Syndrome so is excluded here. In children with Mosaic Down Syndrome, some of their cells have Trisomy 21 and some cells do not.

Malignant tumor except brain or thyroid diagnosed within past 2 years

This item is redundant with other cancer items on the FS, such as Cancer Stage IV, Recurrent Cancer, and terminal condition. A malignant tumor is cancer.

Do not check this box if:

• Malignant tumor (not brain or thyroid) diagnosed more than 2 years ago.
• Malignant tumor of brain or thyroid.

Other catastrophic congenital abnormality:

Check this box if:

• Life-threatening deformities of brain, heart, or lungs.
• Condition is terminal without surgical correction

Do not check this box if:

• Non-life-threatening congenital conditions such as cleft palette, quadriplegia.
• Conditions that can be medically managed.

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