DDSD Decisions

When a disability determination is made, DDSD notifies the EW of its decision with an SP2 DDSD 221R or SP4 DDSD 221R. The EW must take certain actions. The required actions are determined by the disability determination made by DDSD. Refer to the sections below to determine the correct action.

DDSD decision letters are numbered and they are returned to the EW with a copy of the MC 221:

DDSD Letter  Decision
SP2 DDSD 221R
  • Is Disabled, Is Blind, or Continues to be Disabled;
  • Is Not Disabled, Is Not Blind, or Ceases to be Disabled (No Rational attached);
  • No Determination.
SP4 DDSD 221R/Rationale
  • Is Not Disable, Is Not Blind, or Ceases to be Disabled (Rational attached).
DEP SP1 
  • Notice of Returned Disability Packet (Packet returned to EW with reasons).

Is Disabled   

When “Is disabled”, “Is blind” or “Continues to be Disabled” of the SP2 DDSD 221R is checked, this indicates that, based on the DDSD medical/vocational evaluation, the applicant is disabled under MN criteria. The onset date provided will take into consideration any request for up to three months retroactive coverage prior to the date of application. The EW must:

  1. Approve the application as eligible or reclassify the client as disabled MN, effective with the disability onset date or application date, as appropriate.
  2. Record the reexam date in CalSAWS if the DDSD decision includes a reexamination date. When sending a reexamination packet include:
    1. The old (prior) MC 221, “Disability Determination and Transmittal”, and
    2. The new MC 221, and
    3. The appropriate number of new MC 220s, “Authorization for Release of Information”, and
    4. A new MC 223/223C

Note: The recipient is still considered to be disabled until DDSD notifies the EW otherwise. If the recipient fails, without good cause, to cooperate in completing the necessary reexamination DDSD forms, he/she must be discontinued.

Is Not Disabled

When “Is not disabled”, “Is not blind”, or “Ceases to be Disabled” of the SP2 DDSD 221R or SP4 DDSD 221R is checked, it indicates that based on the DDSD medical/vocational evaluation, the applicant does not meet MN disability criteria. The EW must:

  1. Determine eligibility under any other program prior to discontinuance/denial.
  2. Deny/discontinue the applicant when disability is the only basis of eligibility.

No Determination

“No Determination” or “Z Basis Codes” on the SP2 DDSD 221R means that DDSD is unable to make a determination. This usually means that DDSD does not have sufficient information and the client has failed to contact or cooperate with DDSD as requested. Thus, DDSD needs further help from the EW in order to obtain the information required to make the disability determination.

Below are examples of why disability cannot be established:

  • Applicant failed to respond to phone calls and letters;
  • Applicant failed to attend requested consultative examination;
  • Applicant requested to discontinue the evaluation process;
  • Applicant was discontinued from SSA disability for non-disability reasons, however the SSA reexam date is past due;
  • Applicant if working and possibly earning in excess of the SGA amount, form MC 272 is needed, etc.

Do not deny the DDSD applicant for lack of disability when the DDSD letter states “No Determination”. If the client failed to cooperate with DDSD, attempt to obtain the requested information and a good cause determination must be made (determine if the applicant had good cause for not cooperating with DDSD). If additional information is needed from the EW (such as a missing form), follow instructions on the DDSD letter immediately and resubmit packet without delay.

When the DDSD letter states “No Determination”, the EW must:

  1. Provide the new address, if known, or other needed information to DDSD and resubmit the packet.
  2. Attempt two separate contacts, if information is not known, to obtain client’s cooperation and/or the needed information, and resubmit the packet to DDSD.
  3. Determine good cause if the reason for a “no determination” was failure to cooperate. Good cause may consist of, but is not limited to:
    1. EW failure to provide the appropriate forms to the client.
    2. EW failure to inform the client that failure to cooperate with DDSD will result in denial/discontinuance.
    3. The applicant moved and did not receive the request for information.
    4. The applicant was unable to get the information to DDSD in the time allowed because of physical/mental illness or incapacity
    5. Level of literacy or social/language barriers preclude the client from comprehending the instructions.
    6. The client did not have adequate transportation to reach a required destination.
  4. After determining whether there is good cause:
    1. If it is less than 30 days since DDSD returned the packet, and the client has good cause, and no new medical conditions or treatment services are claimed:
      1. Complete a new MC 221 carefully documenting that good cause was found, and
      2. Check “Resubmitted Packet” in Item 8, “Type of Referral”, and
      3. Resubmit limited packet along with the new MC 221 to DDSD. Refer to Limited Packet.
    2. If it is MORE than 30 days since DDSD returned the packet, and the client has good cause:
      1. Complete a new MC 221 indicate that good cause was found, and
      2. Check “Resubmitted Packet” in Item 8, “Type of Referral”, and
      3. Resubmit a full packet containing the new MC 221 to DDSD. Refer to Full Packet.
    3. If the client claims new medical conditions, and/or new or additional medical sources or information, and the client has good cause:
      1. Complete new MC 221 and MC 223/223C, and
      2. Have client complete additional MC 220s as necessary, and
      3. Resubmit a full packet containing the new MC 221, MC 223/223C, and MC 220s to DDSD.
        1. Refer to Full Packet.
    4. If good cause does not exist:
      1. Deny application or discontinue client for failure to cooperate or loss of contact if no other linkage exists. 

“No Determination” (Noncooperation by Doctor)

When an evaluation cannot be completed because the doctor does not cooperate in producing records:

  • DDSD will return the packet to the EW indicating that the doctor did not cooperate.
  • The EW must deny the pending DDSD MC case.
  • The EW must instruct the applicant to file an appeal, clearly declaring the reason for the appeal when filing.

Related Topics

MAGI MC and DDSD

Determining SGA

DDSD Decision Chart