DDSD - EW Procedures

Sending the DDSD Packet

Each District Office SSPM must ensure that all DDSD packets are reviewed by the designated District Office Liaison before they are mailed to DDSD. When the Liaison or DDSD rejects a referral due to incomplete or missing information, the EW must ensure that the packet is corrected and resubmitted within a reasonable time period (ten days).

Important: Rejected DDSD packets are monitored by the State. The county is subject to corrective action measures if the number of rejected packets is excessive.

Note: Once the completed referral packet is sent to DDSD, EW should add the case flag type of "Medi-Cal - DDSD Pending" for tracking purposes.

DDSD Address / Phone

DDSD packets must be sent at least once weekly to:

Los Angeles State Programs Branch

DDSD-LA State Programs

P.O. Box 992

El Segundo, CA 90245-0992

DDSD Master Files: (310) 615 - 2800

General Fax: (855) 837 - 3238

Fax number to request a copy of the MC 221R after diligent search:
(855) 837 - 3236

Fax numbers for Presumptive Disability (PD) requests:

General Requests: (310) 615 - 2713

Urgent Requests: (855) 837 - 3239

Delayed DDSD Referrals

Due to the Radcliffe v. Coye, et al lawsuit, a “90-Day Status Letter” (MC 179) must be sent when a disability decision will not be reached within 90 days. For new applicants, the 90 days begin from the date of application. For continuing recipients, the 90 days begin on the date that the client informs the EW that he/she is disabled.

Important: When completing the MC 221, remember that the “Date Applied” refers to the date the individual applied as a disabled person.

Procedure

In order to comply with this requirement:

DDSD must send a 90-day status letter to the client when the case is in their possession and a disability decision will not be reached within 90 days.
The EW must send an MC 179 when the DDSD packet has not been submitted to DDSD by the 80th day. (It may be sent prior to the 80th day if the EW knows the packet will not be forwarded to DDSD by the 80th day.)
- Note the reason for the delay on the letter.
  - The cause of the delay is not limited to EW caused errors or oversight. It can be that the client delayed in completing the forms, failed to provide necessary information, or even that the client was unable to provide information earlier due to his/her medical condition.
- Attach a copy of the MC 179 to the DDSD referral and note that it has been sent on the MC 221 in the County Worker Comments section.
- If the letter is missing, DDSD will send a letter to the EW requesting that it be sent. The EW must then send the MC 179 to the client and forward a copy to DDSD.

Packets Rejected by DDSD

DDSD returns the entire referral with a cover letter “Notice of Returned Disability Packet”, informing the EW of the error(s) that prevented DDSD from processing the packet. The EW must contact the client in order to make the necessary correction(s). Do NOT mail the DDSD packet and cover letter directly to the client for correction.

DDSD is not to receive direct inquiries from the client.
Returning the entire packet to the client could result in a loss of documents and/or unnecessary delays.

If the disability packet needs to be resubmitted, the EW must ensure that all corrective actions have been taken and a copy of the DDSD cover letter “Notice of Returned Disability Packet” is included with the packet. Document the date that the packet is resubmitted to DDSD on the case copy of the MC 221 and enter a case narrative on the Journal page.. Resubmit through the designated EW Supervisor.

DDSD Actions When Referral is Received

Upon receipt of an application or reevaluation request, DDSD will try to make a determination from available medical evidence.

DDSD will schedule and pay for a consultative examination, if necessary.

DDSD will contact a source nearest to the applicant's residence for the appointment.
DDSD will notify the client of the appointment.

DDSD informs the EW of the disability evaluation results with a “DDSD Disability Determination - Response to MC 221” letter. A determination is to be sent from DDSD to the EW within 90 days (unless client has a pending application for SSI/RSDI).

DDSD may grant Presumptive Disability if available evidence shows a likelihood that disability will be established once complete evidence is obtained and a formal determination is done. These instructions will come from DDSD through the Medi-Cal Program Coordinator.

Reporting Changes to DDSD

In order to prevent delays in the disability determination, EWs must inform DDSD when:

An applicant withdraws his/her request for Medi-Cal (DDSD will not render a disability decision).
Medi-Cal is denied or discontinued on the basis of non-medical information (i.e., excess property).
The applicant moves to another county.
An applicant changes his/her name, address, phone number, or message number.
The applicant wishes to cancel an “Authorization for Release of Information” (MC 220).
The applicant dies, subsequent to the DDSD referral. (Send a copy of the death certificate.)
The applicant wishes to submit additional medical evidence.
The applicant's social security number has changed. (DDSD files their records according to the SSN.)
Other pertinent information which may be of importance to DDSD.

EWs may report new information or changes to DDSD by calling Master Files to identify the assigned analyst and phoning the analyst directly; or, by sending an MC 222 LA.

CalSAWS automatically generates a MC 222 LA when one or more of the following changes are entered into the system and the case is in pending DDSD status. The EW must review the Documents subsystem to decide whether the MC 222 is appropriate for mailing to DDSD. If not, the MC 222 LA must be deleted from the print queue.

Change of address
Change of telephone number
Change of social security number
Case closed
Client deceased
Change of county worker
Change of language/Interpreter

For all other changes or additional information that must be reported to DDSD, the EW must manually request the MC 222 LA from the Client Correspondence subsystem or DEBS Forms Library.

Note: Do not use the County Worker Comments section of the MC 221 to report changes or to update information, as DDSD may reject it as an incomplete packet.