Current through Register Vol. 48, No. 38, September 20, 2024
a) To be eligible
for assistance as a disabled person, an individual must be determined disabled
as currently defined by the Social Security Administration. (See 20 CFR 416,
Subpart I, April 1, 1984.)
b) If an
individual is receiving Supplemental Security Income (SSI) or primary Social
Security (OASDI) benefits, the Department shall accept the Social Security
Administration's (SSA) determination of disability. The Department will make
the determination of disability when the client has been denied SSI on the
basis of too much income. The Department uses the same criteria for disability
as is used under SSI. (See 20 CFR 416, Subpart I, April 1, 1984.)
c) Determination Process
1) If an individual receiving assistance is
determined currently "not disabled" by SSA under the SSI or primary OASDI
programs, the Department shall accept SSA's determination of disability and
cancel the case, no matter which agency made the original determination of
eligibility.
2) If the individual
appeals the SSA determination of disability to SSA, and continues to receive
SSI and/or OASDI, assistance shall be continued or reinstated through the level
of a determination by an Administrative Law Judge (ALJ) subject to the time
limits of subsection (c)(3) of this Section.
3) If the client notifies the Department of
his appeal to SSA within 10 days after the date of the Department notice,
assistance will be continued with no break. If the client notifies the
Department of his appeal to SSA within 11 through 65 days after the date of the
Department notice, assistance will be reinstated back to the original date of
cancellation. If the client notifies the Department of his appeal to SSA more
than 65 days after the date of the Department notice, assistance will be
provided prospectively only, unless the client actually appealed to SSA within
65 days from the date of the Department notice, in which case assistance will
be reinstated back to the original date of cancellation.
4) If an Administrative Law Judge finds the
individual "not disabled", the Department shall accept that finding as final.
The individual shall not have the right to appeal the determination of
disability to the Department at any time during this process.
d) Redetermination of disability
is a condition of continuing eligibility for individuals who are not applying
for or receiving SSI or OASDI benefits.
