Disability Determination - Review of Disability

Created on: 
Oct 21 2014

WAC 388-449-0150 When does my eligibility for the Aged, Blind, or Disabled (ABD) cash benefits end?

Review and Termination of ABD Cash

  1. The Disability Specialist must review current medical evidence and determine whether the individual meets the ABD disability criteria detailed in WAC 388-449-0001 (3) at least every 24 months.
  2. The Disability Specialist must initiate the disability review far enough in advance to request and consider available medical evidence from the individual's treating medical providers and request clarification and/or additional medical records when necessary to determine ongoing ABD eligibility.
  3. If the individual meets Equal Access (EA) criteria, the Disability Specialist must follow all requirements of the EA plan when reviewing disability.
  4. The Disability Specialist may initiate an early Disability Review at any time, if the Department receives information indicating that the individual is no longer likely to meet SSI disability criteria.
  5. Eligibility for ABD cash ends when a final disability determination is made by SSA or when the individual no longer meets the ABD disability criteria detailed in WAC 388-449-0001 (3).
  6. A final SSA disability determination includes an SSI or SSDI denial at the SSA Post-Appeal stage or an unfavorable determination at the initial, reconsideration, or hearing state for which the individual fails to file a timely appeal.
  7. When SSI or SSDI is denied for any reason, the SSI Facilitator reviews the case record and SSI notice to determine if the individual continues to meet ABD financial criteria detailed in WAC 388-400-0060 and the ABD disability criteria outlined in WAC 388-449-0001 (3).
    1. If it appears the individual no longer meets ABD financial criteria, the SSI Facilitator notifies the Financial Service Specialist that a review of eligibility is needed.
    2. If it appears the individual no longer meets ABD disability criteria, the SSI Facilitator notifies the Disability Specialist that an early Disability Review is needed.
NOTE: An ABD Disability Review is not required for recipients age 65 or older.
NOTE: Screen for EA and implement any necessary accommodations when an individual frequently fails to follow through and/or expresses difficulty understanding program requirements.