425-4 REVIEW OF BLINDNESS OR DISABILITY DECISIONS

425-4 REVIEW OF BLINDNESS OR DISABILITY DECISIONS

425-4 A. SSA AND SSI DETERMINATIONS

The Social Security Administration periodically reviews blindness or disability decisions that allow the payment of SSA disability or SSI benefits. Review of SSA or SSI blindness or disability decisions is not necessary for APA purposes. If DPA receives information indicating that SSA or SSI disability payments have been terminated because Social Security has found that blindness or disability no longer exists, APA benefits shall be terminated.

425-4 B. DDS DETERMINATIONS

State-only decisions are subject to periodic review by the state. The DDS is the agency responsible for conducting these blindness and disability reviews. The frequency of state-only blindness or disability reviews is set by the DDS .

The DDS does not retain any of the material that they used to initially determine an individual's blindness or disability. Instead, they send the material to the DPA District Office that serves the individual. The District Office must keep all such material with the individual's case file and resubmit it along with newly completed APA 4 and MED 2 forms to the DDS at the time of the individual's periodic review. Because of this, any material that the DDS sends to the DPA District Office must never be archived. The DDS must be informed in the transmittal document that these materials are being submitted for a continuing disability review, since the DDS uses different criteria for disability review determinations than for initial disability determinations.

425-4 C. CHANGE IN SSA OR SSI STATUS

An APA recipient may sometimes become ineligible for Social Security Disability or SSI benefits. If an APA recipient is no longer eligible for SSI or SSA disability for a reason other than a finding that blindness or disability no longer exists, continued eligibility for APA may exist. If the individual is otherwise eligible, the case worker must continue APA benefits and refer the client's case to the DDS for a new blindness or disability decision. This is necessary because SSA will no longer review the individual's disability determination, and there will be no eligibility for SSI or SSA disability to form a basis for APA disability.

SSI recipients who become ineligible for an SSI payment because of excess income are put into SSI nonpay status. Do not confuse nonpay status with the actual closure of an individual's SSI case. It is not necessary to refer these individuals to the DDS unless the individual's SSI claim is actually closed.