DHS-8462-ENG 5-24 (1.1.0)

State Medical Review Team (SMRT) Document Portal

This portal can be used to submit documents to State Medical Review Team (SMRT).

Do not use the portal to submit documents to a county or tribal agency. View Agency Addresses (DHS-5207) to find the correct contact information.

How do I submit documents?

Partners and providers must select the appropriate option in order to submit documents correctly.

State Medical Review Team (SMRT)
- Who should use this option? Doctors, hospitals, schools, counties, navigators, tribes, and other partners and providers who need to submit SMRT documents.
- What should they submit? Disability documents needed for SMRT determination.

Use this portal to submit documents to Minnesota Department of Human Services (DHS) for SMRT disability determinations.

SMRT forms
- SMRT forms may include the SMRT Adult and Child Disability Worksheets (DHS-6125), (DHS-6125B) and (DHS-6126), (DHS-6126B), SMRT Authorization to Release Protected Health Information (DHS-6124), SMRT Education and Work History (DHS-3883), General Consent/Authorization for Release of Information (DHS- 3549), and Work Activity Questionnaire.
Medical documentation
- Medical documentation may include any medical or mental health information.
School documentation
- School documentation may include team assessments, individualized education plans, 504 service plans, or any other information from a school.
Legal authority documentation
- Legal authority documentation may include legal guardianship order or medical power of attorney.

Contact SMRT at 651-431-2493 or 800-235-7396, Monday through Friday from 9:00 AM - 3:00 PM.

Enter the person's legal name as it appears on their case.

FIRST NAME

MIDDLE INITIAL OR NAME

LAST NAME

DATE OF BIRTH (MM/DD/YYYY)

Do you have the PMI or SMRT case number

Yes – I have a SMRT Case Number

Yes – I have a PMI Number

SMRT CASE NUMBER

PMI NUMBER

Documents must be in PDF or TIF format.
File sizes are limited to either one large file at a maximum of 500mb OR multiple files with a maximum of 50mb each.

Do you want to attach one large file or multiple smaller files?

One file

Multiple files

You may attach a large file up to 500mb.

You may attach up to 10 files that are no larger than 50mb each.

CONTACT PERSON'S NAME

ORGANIZATION

DIRECT PHONE NUMBER

PHONE NUMBER EXTENSION

EMAIL ADDRESS