The Level of Care Evaluation Unit (LOCEU) is housed with the Oklahoma Health Care Authority. The LOCEU makes decisions regarding categorical relationship to disability using the same definition as used by the Social Security Administration. A decision of categorical relationship by the LOCEU is required when SSA makes a disability decision effective after medical services were received or if SSA will not make a disability decision.
A referral can be sent to the LOCEU if:
- an individual has been denied by Social Security for a reason other than failure to meet the disability definition;
- For short term programs (SSP, QMBP, SLMB, QI-1), Social Security must make a decision before a request can be made to LOCEU. If SDX shows “H80”, a decision cannot be requested from LOCEU, except pending cases with Nursing Care or Advantage.
- an individual has been determined disabled by Social Security Administration, but the approval date is effective after medical services were provided.
Remember, if the client is applying for Nursing Care or ADvantage Waiver services, a referral can be sent to LOCEU if there is a pending application with Social Security (H80).
When completing a referral to LOCEU, the AFS worker will send a completed Medical Social Summary, form 08MA022E (ABCDM-80-D), and include pertinent medical information substantiating or explaining the individual’s physical and mental condition. The medical information might include physical exam results, psychiatric, lab, and x-ray reports, hospital admission and discharge summaries, and/or doctors’ notes. Medical information must be current (less than 90 days old).
Send the completed referral and all supporting documentation to LOCEU at OHCA. (NOT DHS State office)
- Can be sent by email to LOCEU@okhca.org
Refer to the LOCEU Flowchart “Process for Getting a Disability Decision from LOCEU”
The MDL and MDI screens in IMS should show receipt of the information within a week of submission. When additional information is needed or a decision has been made it will appear on the MDL and MDI screens. These IMS screens must be checked by the AFS worker at least once per week because notification will be sent no other way.
Depending on the results you received from LOCEU determines whether you certify your application and for what period of time. Otherwise it is certified as you would if you had a SSA/SSI decision.
DO NOT send a referral to LOCEU if:
- the Social Security Administration has determined that the individual is not disabled;
- the individual has not applied with the Social Security Administration;
- the request is to relate the individual for receipt of Personal Care
If the referral has been made, and there is nothing displaying on the MDI screen within 10 days, contact OHCA LOCEU at LOCEU@okhca.org.
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