38. Are you subject to the time limit and work rules while DTA evaluates your disability claim?

You will be considered disabled and eligible for an exemption while DTA and the Disability Evaluation Service evaluate your first claim for a disability exemption. 106 C.M.R. § 703.190(F); Appendix E (DTA Online Guide) DTA Transitions, July 2015, p. 4.

If your claim is denied, you will be considered non-exempt as of the month you claimed disability. Months when your claim of disability was pending will count towards your 24-month time limit.

If your claim is denied, you can apply for a disability exemption later. The second time you will not be considered disabled until a decision is made on your claim, unless you are applying for the exemption in a new five year eligibility period. 106 C.M.R. § 703.190(F),(G); DTA Transitions, Mar. 2002, p. 7. See Question 34 for more information on when the five-year period begins and ends.

Even if you do not qualify for a disability exemption while your new claim is evaluated (because you were already denied the exemption during your current five-year eligibility period), you may have “good cause” because of physical or mental health reasons for not meeting work activity, Pathways to Work, or time limit extension requirements. 106 C.M.R. § 701.380(B)(7), (8). To show you have good cause, you must

• make a new disability exemption request, and
• have a doctor or psychologist fill out a “Good Cause Medical Statement” form for you. Ask your DTA worker for this form. See DTA Field Operations Memo 2002-13 (May 22, 2002); Appendix E (DTA Online Guide)

If you do not have a doctor who is familiar with your condition, DTA should grant you “good cause” if you give DTA a letter from a social worker or someone who knows you explaining that because of your disabilities you need more time to get a doctor to complete the “Good Cause Medical Statement.” This is called “disability accommodation.” See Questions 24, 25, 26

Advocacy Reminders

• DTA counts months during which you have “good cause” towards your 24 months of time-limited benefits. If you are later approved for an exemption for those months, be sure DTA has taken those months off your time clock.
• Not renewing a disability exemption when it expires does not count as a denial. If you request a disability exemption later, you have the right to be considered exempt while your request is being reviewed. You do not have to submit a Good Cause Medical Statement. See Appendix E (DTA Online Guide)