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pdfDisability Case Selection
May 13, 2009
1
Select Case Level
May 13, 2009
2
Confirm Case Creation
May 13, 2009
3
Form Selection
May 13, 2009
4
About You, Part 1 of 2
June 24, 2009
5
About You, Part 2 of 2
Other Names = Yes, but no other names entered
May 13, 2009
6
Other Names Used
May 13, 2009
7
About You, Part 2 of 2
Other Names = Yes, with another name entered
May 13, 2009
8
Contacts, Part 1 of 3
May 13, 2009
9
Contacts, Part 2 of 3
Person Completing Report = Claimant
May 13, 2009
10
Contacts, Part 3 of 3
Person Completing Report = Someone Else
May 13, 2009
11
Medical Conditions
Medical Conditions Propagated from mainframe, no new conditions entered
June 8, 2009
12
Medical Conditions
Medical Conditions Propagated from mainframe, plus one new condition entered
June 8, 2009
13
Work and Onset
Are you currently working? = Not Yet Answered
May 13, 2009
14
Work and Onset
Claimant never worked
May 13, 2009
15
Work and Onset, Part 1 of 2
Claimant stopped working because of condition(s), did not make changes in work activity before stopping work
May 13, 2009
16
Work and Onset, Part 2 of 2
Claimant stopped working because of condition(s), did make changes in work activity before stopping work
May 13, 2009
17
Work and Onset, Part 1 of 2
Claimant stopped working because of other reasons, did make changes in work activity before stopping work
May 13, 2009
18
Work and Onset, Part 2 of 2
Claimant stopped working because of other reasons, did make changes in work activity before stopping work
May 13, 2009
19
Work and Onset
Claimant is currently working, condition has caused changes in work activity
May 13, 2009
20
Work and Onset
Claimant is currently working, condition has not caused changes in work activity
May 13, 2009
21
Job History
Initial View
June 1, 2009
22
Job History
No Jobs
June 1, 2009
23
Job History
One Job
June 1, 2009
24
Job History
Two to Five Jobs
June 1, 2009
25
Job History
Six or More Jobs
June 1, 2009
26
Job Information
Claimant had more than one job in last 15 years before becoming unable to work
June 1, 2009
27
Job History
User has entered five jobs
May 13, 2009
28
Add Job, Part 1 of 4
Claimant had only one job in last 15 years before becoming unable to work
June 1, 2009
29
Add Job, Part 2 of 4
Claimant had only one job in last 15 years before becoming unable to work
June 1, 2009
30
Add Job, Part 3 of 4
Claimant had only one job in last 15 years before becoming unable to work
June 1, 2009
31
Add Job, Part 4 of 4
Claimant had only one job in last 15 years before becoming unable to work
June 1, 2009
32
Job History
User has entered one job
June 1, 2009
33
Medical Sources
Initial view
May 13, 2009
34
Medical Sources
User has indicated claimant has medical sources, but has not entered any
May 13, 2009
35
Doctor/Therapist Information, Part 1 of 2
May 13, 2009
36
Doctor/Therapist Information, Part 2 of 2
May 13, 2009
37
Medical Sources
User has indicated claimant has medical sources and entered a doctor
May 13, 2009
38
Hospital/Clinic Information, Part 1 of 3
May 13, 2009
39
Hospital/Clinic Information, Part 2 of 3
May 13, 2009
40
Hospital/Clinic Information, Part 3 of 3
May 13, 2009
41
Tests Summary
May 13, 2009
42
Test Information
No body part involved
May 13, 2009
43
Test Information
Body part involved
May 13, 2009
44
Physical and Mental Condition Information – Plan A
Claimant adds physical or mental condition while adding test
May 13, 2009
45
Physical and Mental Condition Information – Plan B
Claimant adds physical or mental condition while adding test
May 13, 2009
46
Medicines Summary
May 13, 2009
47
Medicine Information
May 13, 2009
48
Other Medical Information
Initial View
May 13, 2009
49
Other Medical Information
User has indicated claimant has other medical source, but has not entered any
May 13, 2009
50
Other Medical Information
May 13, 2009
51
Other Medical Information
User has entered an other medical source
May 13, 2009
52
Education and Training
Initial View
May 13, 2009
53
Education and Training, Part 1 of 2
User has indicated claimant received special education and job training/vocational school, but has not entered any
May 13, 2009
54
Education and Training, Part 2 of 2
User has indicated claimant received special education and job training/vocational school, but has not entered any
May 13, 2009
55
Special Education Information
Initial View
May 13, 2009
56
Special Education Information
User has entered a school
May 13, 2009
57
Remarks
May 13, 2009
58
| File Type | application/pdf |
| File Title | Slide 1 |
| Author | 414761 |
| File Modified | 2009-07-29 |
| File Created | 2009-07-29 |