TX HHS Form 2423. Request for Medical Evidence

The TX HHS Form 2423, Request for Medical Evidence, helps facilitate the disability determination process for individuals seeking services from Texas Health and Human Services (HHS). This form is typically used in situations where an applicant requires a disability determination as part of their eligibility assessment for available services.

To expedite the disability determination process, HHS requests that applicants provide medical evidence, specifically the most recent 12 months of signed medical records from their treating physician. These records should detail the diagnosis and any impact the condition(s) have on the applicant's activities of daily living. This information will be collected during an initial face-to-face contact.

If you have questions regarding this requirement, please contact your case manager at the telephone number listed above. It is essential to provide accurate and complete medical evidence to ensure a timely and effective disability determination. Key points to keep in mind:

• The form is used for applicants requiring a disability determination as part of their eligibility assessment.
• Medical evidence includes the most recent 12 months of signed medical records from the treating physician.
• The information will be collected during an initial face-to-face contact.