IM-25 03/14/97 CLARIFICATION OF IM-10 DATED JANUARY 30, 1997: TERMINATION OF SOCIAL SECURITY (SS) AND SUPPLEMENTAL SECURITY INCOME (SSI) PAYMENTS WHERE DRUG ADDICTION AND/OR ALCOHOLISM (DA&A) IS THE CONTRIBUTING FACTOR FOR DISABILITY
| SUBJECT: |
| CLARIFICATION OF IM-10 DATED JANUARY 30, 1997: TERMINATION OF SOCIAL SECURITY (SS) AND SUPPLEMENTAL SECURITY INCOME (SSI) PAYMENTS WHERE DRUG ADDICTION AND/OR ALCOHOLISM (DA&A) IS THE CONTRIBUTING FACTOR FOR DISABILITY |
| DISCUSSION: |
| Memo IM-10
dated January 30, 1997 stated that if an individual terminated from SSI
or SSDI due to the new DA&A requirements is not eligible for TANF,
staff must immediately take action to close the Medicaid case by sending
an IM-80. If an individual requested a hearing after receiving the
adverse action notice, staff were to request medical information and submit
it to MRT for a disability determination. This procedure is INCORRECT.
Memo IM-10 correctly states that these individuals are not eligible for Medicaid unless they are re-determined disabled by MRT or are eligible another type of assistance (TOA) that is not based on disability. HOWEVER, PRIOR to any action being taken to close the case the recipient must be given the opportunity to have a disability determination made by MRT. When notice is received that SSI/SSDI benefits have terminated for a person receiving Medicaid based on disability, medical information should immediately be requested for submission to MRT. This procedure is stated in Chapter XI, Section XIV, page 3. It applies to persons whose SSI/SSDI benefits are terminated due to the DA&A requirements, the same as recipients terminated for any other reason. If MRT determines that an individual is not disabled, eligibility for another TOA should be explored prior to closing the case. If any case has been closed based on the instructions in IM-10 without doing a new disability determination, the case should immediately be cancel closed and medical information requested. If a hearing has been requested on adverse action notices sent based on IM-10, the hearings unit will contact the county office to determine if a new disability determination was completed. If a new disability determination was not completed a hearing decision will be issued reversing the action to close the case and instructing the county to do a new determination. For your information, many of these persons losing eligibility for SSI/SSDI have not had medical redeterminations done by SSA. However, the information in SDX/BENDEX does not distinguish among these persons. |
| NECESSARY ACTION: |
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