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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 102 – Non-Financial Requirements Page |92 Effective Month: September 2018 102.09.03 EXCEPTIONS TO OBTAINING DDS DISABILITY APPROVALS There may be instances when DDS has already determined disability using SSI criteria for the same period of time to be covered by a Medicaid application. If so, a separate Medicaid determination is not needed. However, if the disability onset date, as established by SSA, does not include all months of requested Medicaid eligibility for a Medicaid-only application or a SSI retroactive application, a separate DDS decision is required. Situations Which Do Not Require a Separate Disability Determination In the following situations a separate blindness/disability determination for Medicaid is not needed. The Specialist can consider the applicant/beneficiary to be blind/disabled and complete the eligibility determination process when one of these exceptions applies: • Applicant Receives Title II Disability – The Medicaid applicant receives Title II disability benefits on an ongoing basis based on his own disability and the disability onset date is verified to include all months to be covered by the Medicaid application, i.e., the month of application and any retroactive months. Receipt of Title II disability must be re-verified at each redetermination. • Disability Decision Overturned by Administrative Law Judge (ALJ) Order - An Administrative Law Judge (ALJ) reverses a disability denial and establishes disability with a disability onset date which covers all months of the Medicaid application. If the Medicaid applicant is otherwise eligible, eligibility can be established as of the date of the onset of disability as established by the ALJ order, but no earlier than: o The Medicaid application date; or o Three months before the Medicaid application date if retroactive benefits are an issue. Example: An ALJ order reversed a disability decision and established disability effective February 2008. The application for Medicaid is filed on July 2, 2008. If the Medicaid applicant met all other requirements and requested retroactive benefits, eligibility could be established effective April 1, 2008.