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TRICARE Policy Manual 6010.60-M, April 1, 2015
Medicine
Chapter 7
Section 3.6
Specific Learning Disorders
Issue Date:  December 5, 1984
Authority:  32 CFR 199.4(c)(3)(ix)
Revision:  C-1, March 10, 2017
1.0  DESCRIPTION
Specific Learning Disorders are diagnosed when the individual’s achievement on individually administered, standardized tests in reading, mathematics, or written expression is substantially below that expected for age, schooling and level of intelligence. The learning problems significantly interfere with academic achievement or activities of daily living that require reading, mathematical, or writing skills. The learning disorders recognized by the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) are: Specific Learning Disorder, with impairment in reading; Specific Learning Disorder, with impairment in written expression; and Specific Learning Disorder, with impairment in mathematics. A condition is not considered a specific learning disorder if it is a result of or is associated with such conditions as mental retardation, infantile autism or pervasive developmental disorder, visual or hearing impairments, acquired aphasia (normal language followed by onset of language disorder often associated with head trauma, seizures, or Electroencephalogram (EEG) abnormalities) or dysarthria (abnormal articulation due to disorders of the oral speech mechanisms or documented neurological abnormalities).
2.0  POLICY
2.1  Diagnostic, evaluation, and treatment services and supplies, including special education services, provided in conjunction with a learning disorder may not be cost-shared.
2.2  Learning disorders, individually and collectively, are not qualifying conditions for eligibility under the Extended Care Health Option (ECHO). (See Chapter 9, Sections 2.1 to 2.4).
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