DDSD Referral Required

A DDSD referral is appropriate when the client alleges disability and meets any of the following conditions:

Condition	Description
No Prior SSA Evaluation	Client’s disability has never been evaluated by Social Security.
SSA Application Status is Unknown or Pending	Client’s application for SSA RSDI or SSI/SSP is unknown and attempts to verify the status have not been successful.
SSA Application Denied Due to Excess Income/Resources	Client’s application for SSI/SSP is denied due to excess income/property and client meets property requirements for MC.
SSA Approved Claim	SSA has approved the client’s disability claim and the client is requesting retroactive MC coverage prior to SSA’s disability onset date.
SSA Denied Claim	SSA denied disability claim: Within or over 12 months ago and client alleges a new condition not previously considered by SSA, and has not reapplied with SSA. Over 12 months ago and the same condition has worsened, and has not reapplied with SSA.
SSA Discontinued Claim	SSA discontinued SSI/SSP benefits for reasons other than disability and client still has the same medical condition which was the basis for the prior SSI approval. A limited packet is sent to find out the reexam date.
SSA Refuses to Reopen Claim	SSA, at its discretion, refuses to accept a reopening request.
Railroad Retirement Board (RRB) Disability	RRB determined Occupational Disability only.
Good Cause	Client was denied MC benefits for failure to cooperate with DDSD and good cause is established.

When previously stated methods of disability verification are not available, a referral to DDSD must be made on any applicant or recipient who is potentially disabled.

DDSD Referral Required

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