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(MRG) UPDATED: JUNE 2010 29 CATEGORICAL FACTORS SSI-RELATED DISABILITY Policy: Persons under the age of 65, who are certified disabled by either the Social Security Administration (SSA), the State Medicaid Disability Review Team, or local Medicaid Disability Review Team are eligible to receive Medicaid providing they meet all the financial and other eligibility requirements. Disability is defined as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than twelve (12) months. A child may be determined disabled if s/he has a medically determinable physical or mental impairment that results in marked and severe functional limitations that have lasted or are expected to last for at least 12 months or result in death. The standards used to determine disability for Medicaid A/Rs are the same as those used by SSA to determine eligibility based on a disability for SSI or Retirement, Survivors’ Disability Insurance (RSDI) (See Medicaid Disability Manual). However, for the Medicaid Buy-In program for Working People with Disabilities (MBI-WPD) (See CATEGORICAL FACTORS MEDICAID BUY-IN PROGRAM FOR WORKING PEOPLE WITH DISABILITIES) the first step of the sequential evaluation, known as the SGA test (See CATEGORICAL FACTORS SUBSTANTIAL GAINFUL ACTIVITY), is eliminated. All disability determinations for MBI-WPD are performed by the State Disability Review Team. References: SSL Sect. 366 366-ee Dept. Reg. 360-2.4(a)(2) 360-3.3(b)(2) 360-5 Medicaid Disability Manual ADMs 10 OHIP/ADM-4 10 OHIP/ADM-2 10 OHIP/ADM-01 04 OMM/ADM-5