Page 24

Chapter: 1450 Technical Requirements Program: CIC 21 1. the nonlegal father is not living in the home with the mother and child or pregnant woman; or 2. the mother or legal father lives apart from the child. 1450.0721.02 Verification - Other Continued Absences (CIC) Information must be obtained from the primary information person concerning the circumstances of the continued absences. 1450.0722 Incapacity (CIC) Exists when both parents live together:

1. and one or both parents are determined to be physically or mentally incapacitated. 2. although one parent is absent due to an incapacitating condition. 1450.0722.01 Definition of Incapacity (CIC) Incapacity exists when the parent has a physical or mental illness, impairment, or defect supported by medical evidence and expected to last longer than 30 days. The incapacity must be severe enough to substantially reduce or entirely eliminate the individual’s ability to support or care for the child.

A parent who has an incapacitating condition must either be:

1. unable to work; 2. unable to engage on a full-time basis in his usual occupation including caring for his children or any comparable alternate occupation available in the community; 3. able to engage full-time in an occupation, but accepts substantially reduced wages due to the debilitating nature or effects of the condition, (consideration must be given to the limited employment opportunities available to handicapped individuals); or 4. handicapped or disabled his entire life. 1450.0722.02 Verification of Incapacity (CIC) Incapacity is established by one of the following:

1. the receipt of Social Security (RSDI) or SSI benefits on the basis of disability or blindness; 2. a medical statement from a licensed physician that an incapacity or disability exists; 3. receipt of Workers’ Compensation, Vocational Rehabilitation, Veteran Disability or other public assistance benefit when eligibility is conditional upon a determination of incapacity or disability; 4. pending SSI or SSDI application supported by a medical diagnosis of disability; 5. clinic records; or 6. hospital records (medical or psychiatric).

The Department will review the incapacity if the parent’s condition is expected to improve sufficiently or the parent will resume functioning at a usual level of competency. The review must be scheduled for the month the change is expected to occur. 1450.0722.03 Gathering Incapacity Information Applications (CIC) Since incapacity is not a factor in determining family Medicaid eligibility, applicants will not be pended for incapacity verification. Applicants will only be pended for disability information when necessary to establish SSI-Related Medicaid eligibility. 1450.0722.04 Gather Incapacity Information Ongoing (CIC)