DDSD Status Reports

DDSD produces two separate quarterly case status reports:

“PENDING MEDI-CAL DISABILITY CASES” — shows all the cases that are still pending with DDSD, and
“CLOSED MEDI-CAL DISABILITY CASES” — shows all the cases that DDSD has closed during the quarter.

Important: This list is NOT a substitute for the DDSD determination letter. If DDSD has closed a case and the EW has not received the decision, a duplicate must be requested by contacting DDSD.

Cases may appear on the report(s) more than once. For example, a case with the Basis Code “Z55” means that the DDSD referral was received and rejected back to the EW due to an error in the DDSD packet. When the case is subsequently corrected and re-referred, the name will appear on the pending list. Once DDSD has made a decision, the name will again appear on the list of closed cases with a different basis code.

The lists contain the following information:

Pending List

Applicant's Last Name
Applicant's First Name
SSN (This is how DDSD files their cases.)
LVL - Indicates the Type of Referral (Initial, Reevaluation, Reexamination, etc.)
Birth Date
Applied Date (the date of application entered by the EW on the MC 221)
Receipt Date (The date case was received by DDSD.)
CWD (Our county number, 43.)
Code (Used by DDSD only, local CWD office number.)
Branch (Indicates the DDSD office processing the disability determination.)
DEA Last Name (Last name of the DDSD analyst assigned to the case.)

Closed List

Applicant's Last Name
Applicant's First Name
SSN (This is how DDSD files their cases.)
LVL - Indicates the Type of Referral (Initial, Reevaluation, Reexamination, etc.)
Birth Date
Applied Date (the date of application entered by the EW on the MC 221)
Receipt Date (The date case was received by DDSD.)
DEC. (Decision Code: A = Allowed, D = Denied, N = No Determination.)
BASIS CODE (Reason case was closed.
Closure Date (The date DDSD closed their case.)
CWD (Our county number, 43.)
Code (Used by DDSD only, local CWD office number.)
Branch (Indicates the DDSD office processing the disability determination.)
DEA Last Name (Last name of the DDSD analyst assigned to the case.)

Basis Codes

The following is a list of DDSD decision Basis Codes.

Note: If Basis Code is not listed below, contact the MC Program Coordinator.

Allowance Basis Codes (Disability Approved)

A55	Reexamination Case Review - Continuance of Disability
A61	Impairment meets level of severity in Listing of Impairments
A62	Impairment(s) equals level of severity in Listing of Impairments
A63	Medical/vocational considerations result in favorable decisions
A64	Medical/vocational considerations - arduous unskilled work
A65	Disabled child claim - medically equals severity of Listing
A66	Disabled child claim - functionally equals severity of Listing
A98	Hearing Reversal Decisions
A99	Adoption of federal (SSA) allowance/continuance decision
B61	Allowance for statutory blindness

Denial Basis Codes (Disability Denied)

N30/N41*	Impairment not severe
N31/N42*	Capacity for SGA — any past relevant work
N32/N43*	Capacity for SGA — other than past relevant work
N34/N45*	Impairments prevent SGA for less than 12 months
N35/N46*	Impairments prevent SGA at time of adjudication/not expected to prevent SGA for a period of 12 months
N36	Claimant refuses to seek treatment at a county facility
N39	Drug/Alcohol Addiction Material to Decision
N41	Evaluation for blindness only - statutory blindness criteria not met
N43/N51*	Disabled child claim-impairment severe, but does not meet or medically/ functionally equal
N44	Child claim-impairment not severe. With/without visual impairment alleged
N55	Reexamination case review - Cessation of disability
N57	250% WDP Denial - based on evidence in file, the applicant does not meet the Social Security Administration’s definition of disability
Z53	Adoption of federal (SSA) denial/cessation decision
Z59	Adoption of federal (SSA) denial/cessation decision where DA&A was material to the decision

*Indicates visual impairment alleged.

No Determination Basis Codes

“Z” codes indicate that a disability determination has not been made. Generally, EW action is required. After taking appropriate action, the EW must resend the DDSD packet to DDSD. A 90-Day Status Letter (MC 179) must be sent to the client (except for Z53 and Z59 cases), if it is now the 80th day, or it is evident that DDSD will not be able to make a decision by the 90th day. If an MC 179 is sent to the client, include a copy in the DDSD packet.

“Z” Codes

Z55	Case returned to county for packet deficiency
Z56	No determination closures (includes withdrawal and failure issues)
Z70	Duplicate cases - prior case in same DDSD office
Z71	Duplicate cases - prior case in other DDSD office

22.22.2 Monitoring Requirements

DDSD status reports are received quarterly from DDSD. One copy for each District Office is distributed by the MC Program Coordinator to the DDSD Liaison.

Follow-up Action - EW Supervisors and EWs

EW Supervisors and EWs are to use the listings to ensure that:

DDSD has received the referral,
Rejected packets (Code Z55 cases) are corrected and returned to DDSD,
DDSD cases pending 90 or more days are checked to see if DDSD has made a decision, and
To request a duplicate DDSD decision if none was received.

22.22.3 DDSD Decision Needed

If a duplicate DDSD decision is needed, EW must send the request to the MC Program Coordinator with client’s name, SSN, DOB and the date of application. The Coordinator will forward the request to DDSD.

Important: Duplicate DDSD decisions should be requested as soon as possible after DDSD has closed the case. The original case documents are only kept at the DDSD office for a few months, after which they are sent to state archives.