2662 Related to Disability, Including Blindness

To receive Medicaid coverage based on disability, the individual must be determined blind or disabled in accordance with Social Security Administration (SSA) disability standards for any month in which eligibility is determined. To receive MediKan coverage, the individual must meet the MediKan definition of disability.

SSA Definition of Disability (Medicaid) - The inability to do any substantial gainful activity due to a medically determinable physical or mental impairment that is expected to last for a continuous period of at least 12 months or result in death.

SSA Definition of Blindness (Medicaid) - Central visual acuity of 20/200 or less in the better eye with the use of a correcting lens, which has lasted (or is expected to last) for a continuous period of at least 12 months or result in death.

MediKan Definition of Disability - A severe impairment that significantly limits the individual’s physical or mental ability to perform basic work activities and is expected to last at least 12 months or result in death. Basic work activities include but are not limited to: Physical functions such as walking, standing, sitting, lifting, pushing, pulling, and carrying; Capacities for seeing, hearing, and speaking; Understanding, carrying out, and remembering simple instructions; Use of judgement; Responding appropriately to supervision, coworkers, and usual work situations; Dealing with changes in a routine work setting.

The presence of a severe impairment alone does not preclude the individual from performing past relevant work or adjusting to other work.

The Social Security Administration determines disability or blindness as part of the eligibility determination for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Individuals receiving either Social Security Disability benefits or SSI based on disability are considered to have met the disability standard.

Verification of an SSA disability determination is required. Verification may be obtained through electronic data sources or SSA-issued documentation. Receipt of Social Security benefits alone does not automatically indicate the individual meets disability criteria, as some SSA benefits are not based on a disability determination (e.g., early retirement or survivor's benefits). Contact with the local SSA office may be needed to determine whether a disability decision has been made.