Expected to Work/Barriers to Full Employment Policy & Procedures

Published Date: February 23, 2018
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03 Client Categories/Types

Barriers to Full Employment (BFE)

Client Sub-Type 43 Severe Handicap

Characteristics

Client Sub-type 43 Severe Handicap is applied to an individual who meets the criteria for severe handicap as defined in the Assured Income for the Severely Handicapped (AISH) Act.

Under the AISH Act, “Severe Handicap” is an impairment of mental and/or physical functioning, that in a Director’s opinion:
  • After considering any relevant medical or psychological reports, causes substantial limitation in the person’s ability to earn a livelihood; and
  • Is likely to continue to affect that person permanently because no remedial therapy is available that would materially improve the person’s ability to earn a livelihood.

Income Support (IS) workers have discretion to assign an individual, who meets IS financial eligibility criteria, to Sub-type 43 in the following circumstances:

  • The client is approved for Canada Pension Plan-Disability (CPP-D) benefits; or
  • The client is designated AISH eligible by an AISH worker/Adjudicator; and it is determined (through consultation between AISH and IS staff) that the IS program is better able to meet the household’s financial needs; or
  • The client provides medical substantiation of an impairment that is consistent with the AISH definition of severe handicap.

Client is Eligible for Canada Pension Plan-Disability Benefits

Clients receiving CPP-D benefits demonstrate, through the CPP-D approval process, that they meet AISH medical criteria and may be assigned to Sub-type 43.

Client is Eligible for AISH Program Benefits

AISH workers/Adjudicators have sole authority to designate an individual AISH eligible. When an IS client is approved for AISH benefits, consultation occurs between AISH and IS staff to determine which program best meets the household’s financial need.  If it is mutually agreed upon that the AISH program best meets the household’s financial needs, the client file is transferred to AISH. If it is determined that the household’s needs are best met through the IS program, the individual is assigned to Client Sub-type 43. Consultation between AISH and IS staff should reoccur if there are significant changes in clients’ circumstances and/or amendments to program policy.

Note
For clients with an outstanding debt, workers must calculate the benefit level without considering the debt recovery rate prior to determining which program better meets the financial needs of the household.

Client’s Medical Substantiation is Consistent with AISH Medical Criteria

IS workers may assign a client to Sub-type 43 if convinced that medical documentation provided by the person’s physician meets AISH medical criteria and constitutes reasonable evidence of a severe and permanent handicap. These guidelines also apply to IS clients who are in process of applying for AISH or awaiting an eligibility decision from an AISH Administrator.

Clients assigned to Sub-type 43 Severe Handicap by an IS Worker, who have NOT been deemed AISH eligible, MUST be assigned AISH medical code 606060 Income Support with Severe Handicap.

Note
Clients assigned to Sub-type 43 Severe Handicap by an IS worker are NOT considered to be AISH eligible. Each client is required to complete the AISH application process and can only be designated AISH eligible by an AISH worker or Administrator.

Substantiation

  • EMP 0207 Medical Information form,  or
  • Note/report from a physician or nurse practitioner, or 
  • (DS2444) AISH Application Part B Medical Report, or
  • Eligibility for CPP-D Benefits, and 
  • A completed Employability Assessment in Mobius within a reasonable period of being assigned to Client Sub-type 43.

If uncertain whether a client’s medical documentation substantiates an impairment that is consistent with AISH medical criteria, the IS worker is advised to:

  • Consult with an AISH worker or Adjudicator; and/or
  • Solicit additional medical information and consult with the physician or nurse practitioner who completed the client’s medical report or EMP 0207 Medical Information form.

Clients in Sub-type 43, who are employed or attending part-time training, are NOT automatically re-categorized to BFE Client Sub-type(s) 44, 45 or 46, as they will no longer be eligible to receive the $175 monthly Handicap Benefit.

Clients in Sub-type 43 who maintain full-time employment, over a twelve month period, at minimum wage rates (or higher) should be referred to a Career Employment Consultant (CEC) for a review of their Employability Assessment.  Individuals NOT designated as AISH eligible, may be reassigned to a client sub-type that more accurately represents their current circumstances. If the client is AISH eligible, the CEC is advised to consult with an AISH worker.

Guidelines for Issuing (DS2444) AISH Application Part B Medical Report to IS Clients

If more comprehensive medical information is required to determine whether a client should be assigned to Sub-type 43, an IS worker may issue the (DS2444) AISH Application Part B Medical Report to the client for physician’s completion.

Prior to issuing the (DS2444) AISH Application Part B Medical Report, IS workers MUST examine all available medical documentation. If sufficient medical evidence exists, it may be unnecessary to request additional information.

Providing the (DS2444) AISH Application Part B Medical Report may be appropriate in situations where: 

  • The IS worker, after completing an employability assessment and reviewing available medical documentation, is confident that the client meets AISH medical criteria, but requires additional medical substantiation to support this decision; or
  • There is insufficient detail on a client’s completed medical note/report or EMP 0207 Medical Information form and the IS worker cannot with reasonable certainty, determine the severity of the medical condition and its impact on the client’s ability to earn a livelihood; or
  • The client’s file contains several short-term medical notes and/or EMP 0207 Medical Information forms which cumulatively deem the client unemployable, due to medical issues, for a period of 18 months or longer.

When issuing an (DS2444) AISH Application Part B Medical Report, IS workers MUST advise clients that personal medical information provided by their physician via the completed the (DS2444) AISH Application Part B Medical Report will be used by the Government of Alberta in the administration of the AISH program and other government benefits programs. This medical report may be shared with: 

  • AISH and IS program staff;
  • The AISH Appeal Panel in any appeal regarding the applicant's medical eligibility;
  • The Canada Pension Plan Disability  program to help determine the applicant’s medical eligibility for that program; and
  • A medical consultant or psychological consultant on contract with Alberta Community and Social Services.
Note
Section 40 (1) (l) of the
FOIP Act
gives the authority to share information for the purpose of determining or verifying an individual's suitability or eligibility for a program or benefit.

The IS program will pay costs associated with completing the (DS2444) AISH Application Part B Medical Report in accordance with established fee agreements.

Process for Transferring AISH Files to the Income Support Program 

AISH eligible clients whose financial needs are best met by receiving IS benefits, are to have their file transferred to the IS Program and are to be assigned to Client Sub-type 43 Severe Handicap. When transferring an AISH client file to the IS program, AISH staff:

  1. Ensures that AISH payments owing to the client are issued and that outstanding overpayments are processed;
  2. Informs IS staff that the file is set for transfer and initiates electronic file transfer; and
  3. Forwards copies of AISH approval documents AISH Eligibility Decision & (DS2444) AISH Application Part B Medical Report, etc. to the IS program.
Note
The remainder of the AISH client’s file is retained by the AISH office.  Normal disposition for closed files applies. Files to be reviewed for possible action are listed on the SCCP2230-4 File Disposition Report. Detailed instruction on
File Transfers  may be referenced under the Administrative Procedures section.

Process for Transferring Income Support Files to the AISH Program

Income Support recipients who are assessed as AISH eligible and whose financial needs are best met by receiving AISH benefits, are to have their file transferred to the AISH Program.  When transferring an IS client file to the AISH program, IS staff:

  1. Ensures that IS payments owing to the client are issued and that outstanding overpayments are processed;
  2. Informs AISH staff that the file is set for transfer and initiates electronic file transfer; and
  3. Returns original AISH eligibility documents AISH Eligibility Decision & (DS2444) AISH Application Part B Medical Report, etc. contained in the client’s IS file to the AISH Program.

    Note
    The remainder of the IS client’s paper file is retained by the IS office.  Normal disposition for closed files applies. Files to be reviewed for possible action are listed on the SCCP2230-4 File Disposition Report. Detailed instruction on
    File Transfers 
    may be referenced under the Administrative Procedures section.