509 Disability

Policy

Disability is a condition of eligibility for three Medical Assistance (MA) categories.

SSI-MAO

Disability is one of three conditions (aged, blind, or disabled) that allow a person to qualify for SSI-MAO.  To meet the disability condition, a person must be:

·         Determined disabled under the rules for the Supplemental Security Income (SSI-Cash) program, or

·         Diagnosed with a serious mental illness (SMI) by the Arizona Department of Health Services (ADHS).

ALTCS and ALTCS-FTW

A person must be medically in need of long-term care services as determined by the Pre-Admission Screening (PAS).

Freedom To Work

The customer must be determined to have a disability by the Disability Determination Services Administration (DDSA) to qualify for Freedom To Work under the Basic Coverage Group (MA402).

A person must be determined to have a severe impairment by the Disability Determination Services Administration (DDSA) to qualify for Freedom To Work under the Medically Improved Coverage Group (MA402).

Definitions

Proof

For ALTCS or FTW-ALTCS:

A Pre-Admission Screening (PAS) decision showing that the customer has been determined to be medically in need of long-term care.

For SSI-MAO:

Records from SSA showing the person is receiving Social Security Disability payments, or has been determined to have a disability.

An SMI Determination Summary Report or SMI Eligibility Outcome form that includes a  SMI determination of functional inability to live in an independent setting or risk of serious harm to self or others.

For FTW:

Records from SSA showing the person is receiving Social Security Disability payments, or has been determined to have a disability.

Records from DDSA showing the person has been determined to have a Severe Impairment.

Legal Authority