Division of Family and Economic Security, Bureau of Working Families

Wisconsin Works (W-2) Manual

5.7.1 Sharing Information with SSA

The Mental Health Report (126) and the Medical Examination & Capacity form (2012) may be used as a communication tool between SSASSASocial Security Administration and the W-2W-2Wisconsin Works agency on SSISSISupplemental Security Income or SSDISSDISocial Security Disability Insurance applications.

The forms can be shared with SSA at any point in the application or appeal process as long as the FEPFEPFinancial and Employment Planner obtains a written release of information from the participant.

The participant can complete a release of information through either:

  1. A form from the W-2 agency; or
  2. Handwritten note that grants permission for the FEP to contact SSA.

A release of information:

Gives the FEP permission to obtain information from SSA.

Does not give the FEP authority to automatically get appointment letters or decision notices regarding a W-2 participant’s case.

If information contained on either the Mental Health Report (126) or the Medical Examination & Capacity (2012) forms conflicts with SSA’s decision, the FEP may need to follow up with both SSA and the provider to obtain the correct information. Conflicting decisions can be detrimental to participants if, for example, they are completely restricted from activity by the provider and deemed able to work by the SSA.

For more information on assisting a participant with the SSI application process, see 9.5.1.