Med 9 form 2026

The document is the MED-9 form used by the Colorado Department of Human Services to assess medical eligibility for the Aid to the Needy Disabled (AND) program. It outlines the process for determining if an individual is totally and permanently disabled or has a substantial impairment that affects their ability to work. Medical personnel must complete specific sections detailing the individual's disabilities, medical history, and functional capacity. The form also includes sections for county representatives to evaluate and score the applicant's residual functional capacity.

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Click ‘Get Form’ to open the med 9 form in the editor.
Begin with Section 1, where you will enter your name, address, and contact information. Ensure all details are accurate for effective communication.
In Section 2, medical personnel must complete the red section. They should indicate the client's date of birth and social security number, followed by selecting the qualifying disability from the provided options.
Proceed to Section 3, where applicants need to fill in their highest grade completed, age, job training type, and provide an explanation of their disability.
Complete Section 4 by having a county representative assess and document any limitations related to employment capabilities using the Residual Functional Capacity Scoring Matrix.
Finally, ensure that all sections are signed and dated appropriately before submitting the form for processing.

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