Page 15

MS 2000 [3]

A. SSI or presumptive SSI under Title XVI of the Social Security Act or disability/blindness payments under Titles I, II, X, XIV, or XVI of the Social Security Act. A description of these titles is as follows:

1. Title I - Old-Age and Medical Assistance for the Aged;

2. Title II - Federal Old-Age, Survivors and Disability Insurance Benefits;

3. Title X - Aid to the Blind;

4. Title XIV - Aid to the Permanently and Totally Disabled;

5. Title XVI - Aid to the Aged, Blind or Disabled or for such Aid and Medical Assistance for the Aged;

B. State Supplementation;

C. Disability retirement benefits from a Federal, State, or local governmental agency because of a disability considered permanent under Section 221(i) of the Social Security Act. This includes Federal Employees Compensation Act (FECA) payments that an individual elects to receive in place of Civil Service Retirement (CSR) benefits. This does not include FECA payments received pending a determination of eligibility for Civil Service disability;

D. Annuity payments under:

1. Section 2(a)(1)(iv) of the Railroad Retirement Act of 1974 and is determined to qualify for Medicare by the Railroad Retirement Board; or

2. Section 2(a)(i)(v) of the Railroad Retirement Act of 1974 and is disabled based upon the criteria used under Title XVI of the Social Security Act;

E. A veteran with a service-connected or nonservice-connected disability rated by the Veterans Administration (VA) or paid as total (100%) by the VA under Title 38 of the United States Code;

F. A veteran considered by the VA to require regular aid and attendance or to be permanently housebound under Title 38 of the United States Code;

G. A surviving spouse of a veteran considered by the VA to be in need of regular aid and attendance or permanently housebound, or a surviving child of a veteran and considered by the VA to be permanently incapable of self-support under Title 38; or

H. A surviving spouse or child of a veteran considered by the VA to be entitled to compensation for a service-connected death or pension benefits for a nonservice-connected death under Title 38, who has a disability considered permanent under Section 221(i) of the Social Security Act. Disabilities considered permanent under the Social Security Act include: 1. Permanent loss of use of both hands, both feet, or one hand and one foot; 2. Amputation of the leg at the hip;