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If the blind person refuses the recommended treatment without good cause, the worker is to report this fact and the reason(s) for his refusal to the MRT. The decision to discontinue MA due to the refusal of recommended treatment will be made by the MRT. This determination cannot be made by the eligibility worker.

2412.25.00 DEFINITION OF DISABILITY (MED 1) To qualify as Disabled under MA D, MADW, or MA R, an individual must be determined disabled according to SSI criteria.61

Disability for adults is defined as the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death, or which as lasted or can be expected to last for a continuous period of not less than twelve (12) months.62

If the individual is a child under the age of 18, the individual will be disabled if the child has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve (12) months. No child who engages in substantial gainful activity may be considered disabled.63 If MRT determines a person to be disabled and a later determination is made by SSA that agrees with the MRT decision, there is no change regarding the determination of disability for that individual.

If MRT determines a person to be disabled and the SSA later determines the person is not disabled, then the SSA determination supersedes the MRT approval, and the MA D will be reviewed for possible termination of MED 1 benefits. If a SSA denial is received, and the denial is not appealed within 65 days (see IHCPPM 2412.50.00), then the MED 1 category should be closed, and the Medicaid hierarchy will be explored (see IHCPPM 2412.50.00). An individual can qualify for the basic category of MEDWorks, MADW, if that person meets the above disability definition except for the fact that he is working. The above definition also applies to MA R. A recipient of MEDWorks in the basic category, MADW, who becomes ineligible in that category due to medical improvement, can qualify in the medically improved category of M.E.D. Works, MADI, if the medical condition has not been resolved, or the person is not completely recovered.64