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1140 Chapter 7:Worker guides • Section 7: OSIPM worker guides (07/2026) Note: The individual must be receiving Title II Social Security Benefits (SSB). Receiving railroad retirement benefits (RRB) is not countable as DAC income—it must be SSB. To calculate DAC income, the amount of the individual’s countable SSB income is determined as follows: • For an individual who loses SSI as a result of receiving an initial award of Title II DAC benefits, the original Title II DAC benefit amount, including any subsequent COLAs, that creates ineligibility for SSI is excluded.
For example, John received a monthly SSI payment of $686.78 while a parent was working. When John’s father retired, a Title II DAC benefit payment of $900 began. The following month, the $900 DAC payment being received made John ineligible for SSI. When John applies for Medicaid, the entire initial DAC payment of $900 will be disregarded when his Medicaid eligibility is determined and any subsequent COLAs that created ineligibility for SSI. • For an individual who received both SSI and Title II DAC benefits and who lost SSI as a result of receiving an increase in Title II DAC benefits, the disregard is determined as follows:
For individuals who received a non-COLA-related increase to Title II Disabled Adult Child benefits that created ineligibility for SSI, the amount of the increase, and any subsequent COLAs, is excluded and the amount received prior to the increase is used as the countable income amount. » For example, Judy is an SSI recipient. While a parent worked, Judy received a monthly SSI payment of $686.78. When Judy’s father retired and began receiving social security retirement, Judy began receiving a Title II DAC benefit payment of $500 a month. While the SSI payment decreased, the initial DAC payment did not cause Judy to lose SSI eligibility. When Judy’s father died, a DAC payment began of $750 a month. The increased amount put Judy over the SSI income limit, and SSI payments ended. Judy applies for Medicaid. ODHS|OHA must disregard the secondary increase of $250 ($750 - $500 = $250) because it was that increase that caused Judy to lose SSI eligibility. ODHS|OHA would count only $500.00 of Judy’s DAC payment (and any other countable income) to determine Medicaid eligibility.
For an individual who lost SSI due to an annual Title II COLA, all COLAs received since the last month that the individual was eligible for and received both Title II DAC and SSI benefits are excluded. » For example, Billy received SSI and DAC benefits concurrently and then lost SSI eligibility. ODHS|OHA would disregard any a COLA received for any DAC payments received since the last month that Billy was eligible for and received DAC and SSI benefit concurrently. Pickle Amendment eligible individuals The Pickle Amendment was initiated by Representative J. J. Pickle who introduced Public Law 94-566 to Congress to deal with the situation where an individual receiving SSI has a minimal increase in income that results in the unintended consequence of losing their SSI and Medicaid eligibility. Therefore, this Public Law became known as the Pickle Amendment. Congress provided for the Pickle exception because they realized that an individual who was formerly eligible for SSI could not obtain or afford medical coverage just because of a small increase in income. In order for an individual to meet the Pickle Amendment requirements for OSIPM, all of the following must be met: • The individual must currently be receiving Title II Social Security Benefits (SSB for the aged, survivors or