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State Hearing Decision - Hearing Decisions and Administrative ...

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EXHIBITS<br />

STATE HEARING DECISION CONTINUATION<br />

Appendix<br />

DDA:<br />

1. Referral to DDA<br />

2. Social Summary Report<br />

3. Mental Functional Capacity Assessment<br />

4. Objective Medical Documentation (3 pages)<br />

5. Five Step Sequential Evaluation Process<br />

Appellant:<br />

A. Prescription Medication List<br />

B. <strong>State</strong> <strong>Hearing</strong> Request<br />

Page 8 of 8

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