SSI Facilitation – Participation in the SSI Process and Medical Treatment

Revised on: August 6, 2024

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. For Interim Assistance Reimbursement (IAR) policy information, see SSA Interim Assistance Reimbursement Authorization.
  2. ABD recipients who are not U.S. 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.
  3. If ABD is closed for not participating in the SSI application process, we consider ABD eligibility once the client takes necessary steps (within their power) to participate.
  4. ABD recipients must follow through with the SSI application process which may include spending down or selling resources unless they have good cause. Refer to Over SSA Resources: ABD Eligibility procedure for steps to take.

Examples:

ABD recipient has $20,000 in retirement account. This account does not count towards resource limit for cash assistance. We receive verification that the SSI application is denied due to excess resources because SSA counts the retirement account. Retirement does not meet the definition of federal aid assistance. We determine the client has good cause because pursuing early retirement would result in a significant penalty in their retirement benefit amount. ABD eligibility should continue.

ABD recipient owns property in another country. They are unable to travel there and sell the property and there isn’t anyone in-country who can sell the property and send them the funds. For ABD this is considered an unavailable resource. The SSI application is denied due to excess resources because SSA counts the property. Because the client has done everything in their power to meet the SSI requirements, they qualify for good cause and remain active on ABD cash.

ABD recipient has $10,000 in a checking account. The SSI application is denied due to excess resources. However, the client is still financially eligible for ABD because the resource limit is $12,000. The client will need to discuss with SSA their options and notify CSD of the outcome. The facilitator will need to determine if they have good cause. 
  1. SSI Facilitators assist with the SSI application process. See the CSD Procedures Handbook: SSI Facilitation- Good Cause Process.
  2. ABD recipients must participate in medical treatment for their disabling condition(s) unless they have good cause not to do so. Good cause reasons include the following:
    1. The treatment provider has identified a risk that the treatment may cause further limitations or loss of function, and the client is not willing to take the risk.
    2. Treatment is not available without an out-of-pocket cost to the client,
    3. The client’s fear of the treatment may interfere with the treatment or reduce its benefits.
    4. The client practices an organized religion that prohibits the treatment.
    5. The client has been diagnosed with a terminal illness and does not wish to accept treatment.
    6. The client’s disability is permanent and there is no available treatment to improve the condition.
  3. Disability Specialists verify medical treatment participation for ABD recipients every six months and provide ongoing support to the client to help them participate as needed. See CSD Procedures Handbook: ABD Medical Treatment for Disabling Conditions.
    1. Treatment verification can include but is not be limited to:
      1. Self-attestation 
      2. Appointment letter. 
      3. ABD medical treatment participation letter (DSHS 14-478) completed/signed by provider. 
      4. Digital verification of the appointment. 
      5. Contact from the provider.
      6. Collateral statement provided by client from anyone that can verify client’s upcoming/completed appointment. 
Note: After a case has been closed for failing to provide good cause, verification must be obtained. Self-attestation cannot be accepted.  See  WAC 388-449-0200.

 

 

Related Procedures (Staff Only)