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RSDI and Disability
The receipt of Social Security RSDI disability payments establishes disability status for MC. All reexaminations required to determine a continued disabled status are requested by Social Security. The Social Security decision on disability status is binding. Medi-Cal eligibility must be continued as long as Social Security benefits based on the client's disability are being paid and the individual is otherwise eligible.
Verification Requirement
Intake
RSDI disability status and reexamination date must be verified at each application.
The EW must use the IEVS report to gather necessary information. If additional information or clarification is needed, the EW must send and SCD 169 to Social Security requesting, in the “Other Information Requested” or “Comments” area, the:
- Disability onset date (establishing the beginning date of disability linkage), and
- Medical reexamination date (enter in CalSAWS when reexam date becomes available).
Redetermination
Receipt of a Social Security RSDI disability payment(s) must be verified at each annual MC redetermination. The disability onset date and/or medical reexamination date must be verified with Social Security if the dates are unknown. An IEVS report or an SCD 169 or any other verification from Social Security can be used.
Follow-Up
As long as the client continues to receive RSDI benefits, no follow-up on the reexam date is required. SSA's determination is binding until SSA revises its decision. If RSDI benefits are stopped, a DDSD packet must be initiated to determine if the client is still disabled.
Related Topics
Reexaminations on Appealed DDSD Denials