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1137 Chapter 7:Worker guides • Section 7: OSIPM worker guides (07/2026) OSIPM worker guides Introduction While the chapters within the Oregon Programs Eligibility Notebook are intended to cover all areas of eligibility, there may be miscellaneous pieces of information that do not fit into a single topic or that supplement other topics. The OSIPM worker guides are available as a tool to accompany the rest of Oregon Administrative Rule and the Oregon Programs Eligibility Notebook for these areas. This Section of OPEN is a work in progress and may not include all OSIPM worker guides. If you cannot find what you need here, please check APD Staff Tools. Other resources Non-MAGI Tasks: Contains information on many Non-MAGI tasks and task types for Eligibility Workers, including Benefit Decrease Review, PMDDT Referral Response, SELG Updates, LTC Hardship Approval, etc. Verifying assumed and protected eligibility This worker guide is intended to help workers determine if an individual has assumed eligibility under 1619(b) or protected eligibility under the Pickle Amendment, as a Disabled Adult Child (DAC), or as a widow or widower. 1619(b) status This is an assumed eligible category. Section 1619(b) of the 1987 SSA legislation provides for continued Medicaid eligibility for individuals whose incomes are too high to qualify for an SSI cash payment, but are not high enough to offset the loss of Medicaid or publicly funded attendant care. Individuals will be assumed eligible under 1619(b) Medicaid status if the sole cause for SSI payment cessation is increased earnings over the break-even point. SSA determines 1619(b) status. In order to qualify for 1619(b) an individual must meet all of the following: • Must have been eligible for an SSI cash payment for at least one month • Must still be disabled • Must still meet all other eligibility rules, including resources • Must need Medicaid in order to work • Must have gross earned income that is insufficient to replace SSI, Medicaid and any publicly funded attendant care SSA will ask the individual if they need Medicaid in order to maintain their employment. It is important that they answer yes to that question. If they do not, they will not be determined eligible for 1619(b). An individual who is determined to be 1619(b) eligible is assumed to meet the financial and citizen/non-citizen requirements for Medicaid. This means that the individual will receive OSIPM for as long as they are 1619(b) eligible and meet all the non-financial requirements. Resources do not have to be considered. They still must meet residency and pursuit of health care coverage (except Medicare) and cash medical support requirements. Verify at initial application and at each redetermination that the individual is still 1619(b) eligible. Individuals may lose 1619(b) by earning too much or they may go back on SSI or SSDI. If they lose 1619(b)