Sanctions-SSI Applications

Purpose: 

Social workers are agents of change who empower our clients to improve their own lives.

WAC 388-449-0200 - Am I eligible for cash assistance for Aged, Blind, or Disabled (ABD) while waiting for Supplemental Security Income (SSI)?

Clarifying Information

  1.  Compliance with DSHS and SSA is a condition of eligibility for ABD cash.
  2. Individuals who the Department has established don’t meet the definition of “qualified alien” for SSI eligibility aren’t required to pursue SSI. For example: PRUCOLs and people terminated from SSI due to the seven year rule aren’t qualified aliens.
  3. PROCOLs may have enough work quarters to qualify for SSDI and must pursue SSDI.
  4. Non-Citizens must cooperate with the SSI/SSDI application process until it is established by SSA that they don’t meet the requirements for either program.
  5. When cash assistance has been terminated because the person failed to comply with pursuing disability benefits even if they claim good cause, only authorize further ABD cash assistance after the person verifies they have taken action to comply.

Medical Treatment

  1.  ABD cash clients must cooperate with SSA requirements. To be eligible for SSI, individuals must provide documentation that their impairments are disabling despite appropriate medical treatment.
  2.  Clients must follow through with recommended treatment for all potential disabling condition.   The only good cause reasons for failing to cooperate with recommended medical and mental health treatment are:
    1. The client provides proof that their treating provider has discussed a treatment risk and the person is pursuing a less dangerous treatment option.
    2. The client provides proof there is a direct out of pocket medical cost for the recommended treatment. Transportation or other incidental costs don’t meet the good cause requirement for failing to cooperate with treatment.

Worker Responsibilities

If a person fails to apply for SSI, or follow through with any SSA requirement:

  1. Send form 14-509  Good Cause letter to schedule an appointment with a SSIF.
  2. If the person had good cause for failing to comply with the SSI application process, explain the requirement and coordinate with DDDS or SSA to help the person fulfill the requirement.
  3. If the person failed to file an SSI application, reconsideration, or hearing request, complete the application or request for appeal at the good cause appointment regardless of whether good cause is established.
  4. Use the 14-118 to notify financial services to terminate ABD cash benefits until the person has signed the IARA, filed the SSI application, completed the consultative examination, or any other SSA requirement regardless of whether good cause is established. 
  5. If the person complies with signing the IARA or the SSA application process requirement before ABD benefits have terminated, use the 14-118 to notify financial services to reinstate ABD benefits because the person has complied.

Search IESA Clarification Database