425-3 PROCEDURES FOR INITIAL BLINDNESS

425-3 PROCEDURES FOR INITIAL BLINDNESS OR DISABILITY DECISIONS

425-3 A. BLIND OR DISABLED APPLICANTS WHO HAVE BEEN FOUND ELIGIBLE FOR SSA , AND DO NOT APPEAR ELIGIBLE FOR SSI

SSA disability requirements are the same as the disability requirements for the SSI and APA programs. Persons who have been determined eligible to receive SSA disability benefits also meet the blind or disabled criteria for APA . SSA usually requires a five-month waiting period from the date that they determine the disability began before they begin to pay disability benefits. Persons who are eligible for SSA disability include individuals who are serving their five-month waiting period. Persons who are eligible for SSA disability who do not appear income eligible for SSI are not required to apply for SSI .

The case worker must verify that eligibility for SSA disability exists. APA benefits are then authorized if the individual meets all other factors of eligibility for the APA program.

425-3 B. BLIND OR DISABLED APPLICANTS WHO APPEAR ELIGIBLE FOR SSI

Individuals in this category include persons who appear eligible for SSI benefits as well as persons who may be eligible for both SSA Disability benefits and for SSI benefits.

Applicants in this category are not eligible for APA or Medicaid benefits while awaiting an SSI eligibility decision, but may be eligible for Interim Assistance. To receive Interim Assistance benefits, these applicants must meet the eligibility requirements described in manual section 426-2 .

425-3 C. BLIND OR DISABLED APPLICANTS WHO DO NOT APPEAR ELIGIBLE FOR SSI AND HAVE NOT BEEN DETERMINED ELIGIBLE FOR SSA DISABILITY

Applicants in this category include persons who do not appear eligible for SSI and who have applied for and are waiting for an SSA disability determination. It also includes individuals who do not appear eligible for SSI and have previously been determined ineligible for SSA disability for a reason other than lack of blindness or disability.

These applicants are not eligible for Interim Assistance because they are not financially eligible for SSI . (See section 426-2B .) They must meet all APA eligibility requirements except for a finding of blindness or disability, and for Medicaid they must meet all other factors of eligibility, see ADLTC MS 530 . The blindness or disability is determined by the DDS . The APA /Medicaid application must be pended for a DDS determination.

As a condition of eligibility, each applicant in this category must provide all of the following completed forms:

APA 4 , "Disability and Vocational Report" and

MED 2 , "Medical Release of Information".

Once the applicant provides the required forms, follow the procedures listed below:

Document the receipt of the APA 4 and MED 2 in the case file and complete the agency portion of the APA 4 .

Immediately mail all forms, along with a completed form GEN 141 , Referral for Disability Determination, and any other related medical/social/work history materials, to:

Disability Determination Services

Attn: DPA Adjudicator

619 East Ship Creek, Suite 305

Anchorage, AK 99501

The district office will maintain a log of all disability determination requests it sends to the DDS .

The DDS , under an agreement with the Division of Public Assistance, will issue a decision: blind/disabled, not blind/disabled, or failed to cooperate.

The DDS will send its decision back to the district office. The district office will log the DDS decision and forward it to the case worker.

The case worker will promptly:

Approve the application and authorize full APA and Medicaid benefits if the DDS has decided the individual is blind or disabled, and the individual meets all other eligibility factors of the APA and Medicaid program. To determine the benefit start dates for APA and Medicaid, refer to manual section 410-7 ; or

Deny the application if the DDS has decided the individual is not blind or disabled; or

Deny the application if the individual has failed to cooperate with the DDS in the process of determining blindness or disability; or

Deny the application if the individual is not eligible for APA for any other reason.