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N.J.A.C. 10:71-3.12 This file includes all Regulations adopted and published through the New Jersey Register, Vol. 57 No. 12, June 16, 2025 NJ - New Jersey Administrative Code > TITLE 10. HUMAN SERVICES > CHAPTER 71. MEDICAID ONLY > SUBCHAPTER 3. ELIGIBILITY FACTORS § 10:71-3.12 Disability; definitions (a) An individual is disabled for purposes of this part if he/she is unable to engage in any substantial gainful activity by reason of a medically determinable physical or mental impairment 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 12 months (or, in the case of a child under the age of 18, if he/she suffers from any medically determinable physical or mental impairment of comparable severity). (b) A physical or mental impairment is an impairment which results from anatomical, physiological or psychological abnormalities which are demonstrable by medically acceptable clinic and laboratory diagnostic techniques. Statements of the applicant including his/her own description of his/her impairment (symptoms) are, alone, insufficient to establish the presence of a physical or mental impairment. (c) An individual is "blind" for purposes of this part if he/she has central visual acuity of 20/200 or less in the better eye with the use of a correcting lens. An eye which is accompanied by limitation in the field of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees shall be considered as having central visual acuity of 20/200 or less. (d) The presence of a condition diagnosed as addiction to alcohol or drugs will not itself be the basis for a finding that the individual is or is not under a disability. Annotations Notes Chapter Notes Case Notes As evidenced by his RSDI status, a recipient was Medicaid eligible from January through August 31, 2014 due to his disability under N.J.A.C. 10:71-3.12, and he was noticed to that effect. His Medicaid was valid and continued until August 31, 2014, and there was no authority for the Bergen County Board of Social Services to recoup Medicaid benefits for that period. J.C. v. Bergen Cnty. Bd. of Social Serv., OAL DKT. NO. HMA 09134-14, 2014 N.J. AGEN LEXIS 520, Initial Decision (August 28, 2014). Severe physical impairment constitutes disability for New Jersey Care eligibility. D.K. v. Division of Medical Assistance and Health Services and Ocean County Board of Social Services, 97 N.J.A.R.2d (DMA) 25. Insufficient finding of disability defeats Medicaid benefits application for blindness. BP. v. Division of Medical Assistance and Health Services and Middlesex County Board of Social Services, 97 N.J.A.R.2d (DMA) 1.