Page 506

506 (07/2026) Chapter 2:Eligibility • Section 9: Employed Persons with Disabilities (EPD) determination will need to be conducted by the Presumptive Medicaid Disability Determination Team (PMDDT). PMDDT does not look at the current employment as part of the individual’s Past Relevant Work. PMDDT looks at Substantial Gainful Activity (SGA) differently than the SSA. They do not consider a working individual to be earning above SGA unless their adjusted earned income is in excess of the EPD Adjusted Earned Income Standard, which is 250% of the Federal Poverty Level. If an ongoing EPD participant was determined to have a disability by SSA and lost their SSDI eligibility due to their own income, the SSA determination remains effective for one year from the date that the individual loses eligibility for SSDI. This automatic extension of disability applies only to individuals who are eligible for and receiving EPD at the time they lost SSDI due to earnings. Note: Basis of need may NOT be determined at the local office level or by a Community Developmental Disability Program (CDDP). Pursuit of assets As of June 3, 2025, individuals are not required apply for other benefits to pursue assets, including SSA income or unemployment compensation. Individuals are still required to cooperate with the following: • Personal Injury Liens • Medical Assignment • Child and Cash Medical Support Employment Employment means an ongoing work activity for which the individual provides ODHS|OHA with one of the following: • Tax payment verification under the Federal Insurance Contribution Act (FICA); • Tax payment verification under the Self-Employment Contribution Act (SECA); or • Clear and convincing evidence of self-employment. This can include a business plan, profit and loss statement, or other documents that verify an individual is engaged in a self-employment enterprise. There are number of different types of self-employment enterprises an EPD participant could become involved in. In some cases, an enterprise might not produce significant earned income immediately. In those cases, other types of verification of self-employment, as mentioned above, would need to be gathered from the individual or from third parties knowledgeable about the individual’s situation. Self-employment requirements in the EPD program are more stringent than those for other programs. For more information on self-employment, see Treatment of specific assets. The definition of “employment” does not include bartering or trading. Also, individuals who work for organizations that are not required to pay FICA under federal tax laws are considered to meet the definition of employment even if the employer does not file FICA. Self-employed individuals often file or pay SECA payments. These payments are often made on a quarterly basis. However, individuals are not required to do so to meet the definition of employed for EPD purposes.