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MRT Referrals & PA-601T. MRT Referral Guidelines. The caseworker/case manger should determine that a family would be eligible under all other technical and financial eligibility factors before referring to MRT for a determination.

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MRT Referral Guidelines

The caseworker/case manger should determine that a family would be eligible under all other technical and financial eligibility factors before referring to MRT for a determination.

Allow the individual 10 days to return the information to determine technical and financial eligibility.

If the individual returns the information and would be technically and financially eligible, we can send the referral to MRT.


MRT Helpful Tips

The following are some helpful tips in completing a Medical Review Team referral. Following these guidelines could substantially reduce the time it takes to get a determination from MRT.

  • Annotate the Status on the PA-601T
  • MRT codes KWP Good Cause and Incapacity Deprivation differently in their computer system. The rationales are worded differently, and criteria for making the decision are looked at differently.
  • Under the “Status” section, there are boxes to advise the MRT of the reason for the current referral. Check the correct box to ensure a quick return.

Release of Patient Records

  • Complete MRT-15 correctly, in its entirety
  • Make sure the patient signs the MRT-15 where it says “patient signature”. Sources do not accept a spouse’s signature in place of the patient’s.
  • We need original signatures on each MRT-15. Do not make copies!
  • Each form must be signed and dated by a witness. The Family Support worker can witness the client’s signature. Incomplete or incorrect MRT-15’s will be returned by MRT and could cause a delay.
  • Be sure to include one MRT-15 for each medical source listed on the PA-601T, and at least three extra for the file.

PA-601T Completion

  • Complete the PA-601T in its entirety, do not skip any items
  • Frequently, the date of birth, county name and number, town, zip code, and/or phone number is omitted.
  • Be sure to include the case type (C, E, L or M) with case number. MRT has to stop and call the field worker for this information. When they have to call several different counties per day, it can be very time-consuming.
  • To ensure the form is legible, it is to be completed electronically.

What’s Up With Doc?

  • MRT is not always familiar with names of doctors, clinics, addresses, and hospitals in all counties of the state. For this reason, it is vital to include the doctor’s first AND last name. Also, make every attempt to spell it correctly.
  • Include the complete address and phone number. MRT uses a computer program to request medical records, and must input the name of the doctor/clinic/hospital and the town where their office is located. If any of this information is incorrect, the computer cannot find that source.
  • If the doctor is in a clinic or group, we also need the name of the group/clinic.

Dates of Treatment

  • Include Dates for All Sources
  • They only request medical information that is relevant to making a medical decision. If the last visit to a doctor or hospital was over one year ago, it is generally irrelevant, and they do not request that record.
  • If they are working on a case that is a re-determination, they will only request records from sources seen since the last decision.
  • If the client cannot remember specific dates, try to pin him/her down to a specific time period such as: last month, within the last 6 months, not in the last year, etc. This will be more help than “don’t know” or blank.


  • MRT, Hearing Officer, or appeal Board may state that an individual is incapacitated for a limited time. A re-determination of incapacity must be completed when the limited time is coming to an end.
  • Complete a new PA-601T every time a case is submitted to MRT.
  • Interview the client and list only medical sources seen since the last PA-601T was completed.
  • Send old medical records and a copy of the last MRT decision (PA-6) along with the new PA-601T.
  • Complete new MRT-15s for all current doctors listed.
  • MS 2393 outlines procedures for re-determinations.

Special Exams

MS 2389 outlines the procedures to be used if MRT schedules a special examination.

This may be needed if the individual has no previous medical records.