Situations Not Requiring a Separate Disability Determination Services (DDS) Decision

Situations Not Requiring a Separate Disability Determination Services (DDS) Decision A. In the following situations a separate blindness/disability determination for Medicaid is not needed. The applicant/beneficiary is considered to be blind/disabled: 1. Applicant receives Title II Disability. The applicant receives benefits on an ongoing basis based on the applicant’s own disability, and the disability onset date is verified to include all months to be covered by the Medicaid application, i.e., the month of application and any retroactive months. Receipt of Title II disability must be re-verified at each redetermination. 2. Disability Decision Overturned by Administrative Law Judge (ALJ) Order. An ALJ reverses a disability denial and establishes disability with a disability onset date that covers all months of the Medicaid application. If the Medicaid applicant is otherwise eligible, eligibility can be established as of the date of the onset of disability as established by the ALJ order, but no earlier than: a) The Medicaid application date, or b) Three months before the Medicaid application date if retroactive benefits are an issue. 3. Deceased Applicants. A verified death date establishes disability if a disability, due to any illness or accident that resulted in death, existed in all months for which Medicaid eligibility was requested. 4. Disabled Adult Children. Disability has been established by the Social Security Administration for an applicant who is over eighteen (18), entitled to Medicare and receiving Title II benefits as a child (C1-C9 beneficiary). The disability onset date must be determined.