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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 September 2010 Subchapter Subject Page ending with Page M0310 GENERAL RULES & PROCEDURES M0310.112 22

b. Severe Impairment?

Does the individual have a severe impairment, as defined by SSA, that meets the durational requirement (i.e. has lasted or is expected to last for a continuous period of not less than 12 months, or which is expected to result in death)? If no, the person is not disabled. If yes, DDS will proceed to the next step. c. Impairment Equals Severity Requirements?

Does the individual have an impairment that meets or equals the severity requirements of a medical condition contained in the Social Security Listing of Impairments? If yes, a finding of disability is made. If no, DDS will proceed to the next step. d. Prevents Performing Past Relevant Work? Does the individual have an impairment that prevents him from performing past relevant work? If the individual can perform past relevant work, the person will be found not disabled. If the individual cannot perform past relevant work, DDS will proceed to the next step. e. Prevents Performing Any Work?

Does the individual have an impairment that prevents him from performing any substantial gainful employment? If the individual cannot perform any work, the person will be found disabled. If the person has the capacity to adjust to other types of work, the person will be found not disabled. Age, education, training and skills acquired in past work are considered in making this determination. 4. Other Benefits Related to Disability a. Benefits Administered by the SSA The SSA uses the SSA disability definition in the determination of eligibility for SDDI and SSI benefits. b. Benefits Administered by the Railroad Retirement Board (RRB) The RRB makes disability determinations for railroad employees who have applied for the Railroad Retirement (RR) disability benefits. A determination of “total” disability means the individual is disabled for all regular work. “Occupational” disability means the individual is disabled for regular railroad occupation, but is not “totally” disabled. Individuals who receive a “total” disability determination are disabled using the SSA criteria. B. Policy The following individuals meet the definition of being disabled for the purposes of meeting a Medicaid covered group and are not to be referred to DDS: