1. Expanding Foundations: Non-MAGI
Disability
Expanding Foundations: Non-MAGI

2. Disability Objectives:
Goal: To gain further understanding of Disability, and the associated business processes to meet this requirement
Objectives:
After this module, participants will be able to:
Perform data entry on the Disability Determination screen in CBMS
Identify when the disability requirement is met, and when the disability app is necessary
Gather, complete and submit a disability application
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3. Disability Definition
Resulting in multiple ‘markedly’ or at least one ‘severely’ limited functional domain
Resulting in an Inability to perform substantial gainful activity
Lasting 12 months or more,
Medically Determinable Impairment,
Adults
Children
*****Note: This is supplemental and non-required information only, Disability Determinations are not made by the eligibility worker*****
Medically Determinable impairment
Must be ‘more than not severe’ (cause limitations)
‘Medically determinable’ as in meeting a diagnostic criteria
12 months or more
Can be expected to last 12 months or more
Resulting in death or expected to result in death negates the 12 months requirement
Resulting in an Inability to perform substantial gainful activity
Assessed based on actual limitations
Looks at all jobs in the country
Age and work history are increasingly considered from age 50 to 64
Resulting in multiple ‘markedly’ or at least one ‘severely’ limited functional domain
On a scale of: not, mildly, moderately, markedly, severely (limited)
Limitations compared to average child of the same age
6 broad domains used by SSA to describe childhood functioning
(1) Acquiring and using information,
(2) Attending and completing tasks,
(3) Interacting and relating with others,
(4) Moving about and manipulating objects,
(5) Caring for yourself, and
(6) Health and physical well-being

4. Disability Criteria Age 65+ SSA Determination
State Contractor Determination
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5. Disability Determination Process
Check for age then SSA disability determination:
State Verification and Exchange System (SVES) for SSDI
State Data Exchange (SDX) for SSI
Award letter from SSA verifying SSI, SSDI or future diary date

6. Title XVI
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7. Title II
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8. Disability Determination Process
If there is no disability determination from SSA:
State Disability Contractor
Complete Disability application and Medical Release Form
08/18/2014 Dated medical release form
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9. Disability Application

10. Comments Page Page 19 Required:
App date, program, Your contact information
Helpful but not required:
Your observations related to the conditions claimed in the application. (If you had contact with them)
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11. Release Form
Signature needed

12. ARG Contact Information
Mailing Address:
Arbor E&T, Action Review Group
P.O. Box 340
Olyphant, PA 18447
Application Status (pending, new or in appeal):
address:
Phone number: (877)
Fax number: (877)
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13. Auto-Mail
CBMS will mail the app for you!
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14. Determination Notice
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15. Full vs. Limited Disability
Disability Criteria
Full vs. Limited Disability
Full Disability
(All Programs)
Meets the SSA disability criteria
All
waivers
Limited Disability
(WAwD)
Meets the SSA disability criteria without consideration of substantial gainful activity
WAwD clients:
CMHS and EBD waivers only
Full disability is for LTC
Limited is for WawD
**WawD is eligible for EBD and CMHS waivers only
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16. Data Entry Info
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17. Disability Data Entry
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18. Medical Conditions Screen
Required info only to open tabs
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19. Disability Determination Screen
EBD: Retro date
Onset date: Retro date for ARG, Onset date for SSA.
Status date: Date status was last changed
Result date: Date the last decision on disability was made.
Diary Date: Date case will be re-reviewed for ongoing disability.
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20. Data Entry Practice
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21. Disability Wrap-up Re-visit Objectives: Can you?
Perform data entry on the Disability Determination screen in CBMS
Identify when the disability requirement is met, and when the disability app is necessary
Gather, complete and submit a disability application
Goal: To gain further understanding of Disability, and the associated business processes to meet this requirement
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