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Documents
Here you will find a resource
of Documents you may need to apply for benefits.
Note: All documents listed are in PDF format
unless otherwise specified. To view a PDF file, you need Adobe Acrobat Reader.
If you do not have Adobe Acrobat Reader, you
may download it here:
www.adobe.com
Pooled Trust Documents
AGED Disbursement Request Form PDF
AGED Welcome Package PDF
Master Trust - Amended 09.07 PDF
Joinder Agreement - Amended 09.07 PDF
Asset Fee Agreement PDF
Trust Required Documentation PDF
Other Pooled Trust Documents
Non-Profit
Participation Agreement
Department of Health & Human Services Memo to States 06.05.1996 PDF
Attorney & Guardian
Documents
Professional Guardian & Attorney Requirements for Payment Disbursement 09.2007
PDF
DCF, SSI, Medicaid
Guidelines
DCF Federal Trust Guidelines PDF
DCF State Trust Guidelines A-22 PDF
Medicaid Payback Guidelines 11.2005 PDF
SSI Related Program Limits 04.2007 PDF
Disability Determination for SSI Medicaid PDF
DCF Forms
Authorization & Waiver of Confidentiality 06.2007 PDF
List of Required Documents for DCF Appointment 05.2006 PDF
DCF Florida Pooled Trust Review Form A-22-6 PDF
DCF Pooled Trust for the Disabled Form PDF
DCF Scanning & Shredding Procedure 06.2007 PDF
Disability Determination Driver 07.2005 PDF
Disability Determination & Transmittal Form 07.2005 PDF
DCF Individual Designation of Representative Form PDF
DCF Fair Hearing Request Form 06.2007 PDF
DCF Modernization: Where to Complain Form 06.2007 PDF
DCF ICP Supplemt to Application Packet PDF
DCF Presumptive Disability Checklist PDF
DCF Authorization to Release Medical Information PDF
DCF Request for Assistance Form PDF
Department of Elder Affairs Forms Order Form 05.2006 PDF
Managed Integrated Care Fact Sheet 06.2007 PDF
Social Security / Disability
Documents
Social Security Disability Procedure & Requirements 06.2006 PDF
Social Security Issue Paper #3 01.21.2005: Additional Help to Those Who Need it
Most: Those With High Drug Costs & Those With Low Incomes PDF
Social Security - 5 Steps of Disability 12.2005 PDF
Social Security - Disability Over Age 72 PDF
Disability Determination for SSI Medicaid PDF
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