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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Medicaid: Forms An Analyst May Ask You To Complete (Supplemental Questionnaires)

Other Forms Used By Analysts To Determine If You Are Disabled For Medicaid Purposes

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Other forms that may bge used in the process that you are not expected to complete:

Physician Statement: In addition to obtaining your medical records, the state will sometimes send a questionnaire to one or more of your doctors to complete. The forms include questions about restrictions in your ability to perform work-related tasks, social functioning, and activities in daily living (transportation, household chores, personal hygiene) -- all information that you have provided yourself. (So be sure to tell your doctor about these affects on your daily living, and to note them in your medical record.)

To learn more about how to maximize your time with your doctor, see: How To Work Most Effectively With Your Doctor.

Daily Activities Questionnaire, Third Party. This questionnaire may be sent to friends or relatives you listed who have information about the effect of your health on your daily activities. It asks for third party observation of your condition and the impairments it causes.

If Medicaid does contact any of the people you suggested about your daily activities, consider getting similar statements from other people as well to bolster your case. It may be very helpful to include former co-workers, especially a supervisor who noticed your declining job performance.

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