Section VI. PROGRAM FOR PERSONS WITH DISABILITIES
1-16. GENERAL
The Program for Persons with Disabilities is a program of financial assistance for
military personnel on ACTIVE DUTY. It is for the benefit of spouses or children who are
moderately or severely mentally retarded or who have a serious physical disability and
are in need of specialized institutional care, training, or rehabilitation. Benefits cover
required services only when the services are not available from public institutions or
agencies.
1-17. ELIGIBILITY
a. Criteria. Those eligible for the Program for Persons with Disabilities include
family members, spouses, and/or children of members of a uniformed service who are
serving on ACTIVE DUTY (or ACTIVE DUTY for training) pursuant to a call or order that
does not specify a period of 30 days or less, or family members of such personnel who
died while entitled to hostile fire pay. No other TRICARE beneficiaries are eligible for
this program.
b. General Requirements. The Program for Persons with Disabilities was
established to provide financial assistance when an ACTIVE DUTY member's disabled
family members have, by virtue of residency laws, been excluded from appropriate
publicly-operated programs or institutions for the disabled. There is, then, a require-
ment that all local resources be considered and those determined to be adequate used
before an application for coverage by TRICARE can be made. To be considered for
benefits, there must be a medical determination that the applicant is moderately or
severely retarded or has a serious physical disability. Eligibility for benefits is based on
the:
(1) Duration of Disability. If the condition is expected to result in death; or
has lasted (or with reasonable certainty is expected to last) for a minimum of twelve
months; and
(2) Extent of Disability. If the disability is so severe that it precludes the
handicapped individual from substantially engaging in basic productive activities of daily
living expected of unimpaired persons of the same age group.
c. Management Plan. Services and supplies provided the individual under this
program must be appropriate to the individual's disability. To the maximum extent
possible, they should benefit the individual through the treatment of the disabling
condition or through enhancing his ability to cope with or overcome his disability. The
primary goal of the Program for Persons with Disabilities is to help the individual to
achieve as nearly a normal life style as possible. When feasible, the individual is
maintained in his home or returned to his home, public school, and community
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