Disabled Adult Child (DAC)

Disabled Adult children (DAC) are potentially eligible for zero SOC MC if their SSI/SSP was denied or discontinued due to an increase in their RSDI. Craig v Bontá EWs at the Medi-Cal Benefits Assistance (MBA) office receive a monthly referral listing of DAC individuals from Social Security. There is no need for EWs to send DAC cases to MBA.

Note: For cases with DAC and non-DAC household members, the assigned EW will exclude the DAC individual and approve/deny the rest of the household members as usual. The DAC individual will be set up on their own case when they show up on the monthly listing as mentioned above.

DAC Screening Test

To be Pickle eligible, a DAC must meet all of the following criteria:

  • Be at least 18 years old,
  • Have previously received SSI/SSP on the basis of blindness or a disability which began before reaching 22 years old, and
  • Currently be receiving RSDI benefits based on blindness or disability, and
  • Have been discontinued from SSI/SSP as a result of becoming entitled on or after July 1, 1987 to RSDI child's benefits (paid on the basis of a disability which began before 22 years old) or because of an increase in those child disability benefits.

    • Note: Individuals who are discontinued from SSI/SSP due to admission to a LTC facility are not eligible under these DAC provision. A regular MC determination is required in these cases. DACs are listed in the monthly Craig v Bontá Exception Eligibles Report, reviewed by MBA.

If the initial screening test is passed, determine Pickle eligibility as described below.

The amount of RSDI benefits to be budgeted must never be greater than the amount that the person was receiving at the time his/her SSI/SSP was discontinued.

Note: For anyone discontinued after January 1987, the Disregard Computation is not necessary since the actual RSDI amount at the time of the SSI/SSP discontinuance should be the current amount received. If the person was discontinued prior to January 1987, a disregard computation is needed.

Budgeting

A Pickle Screening (SCD 1363) is not required for DACs.

When determining a Pickle financial eligibility computation for DACs, CalWIN will:

  • Disregard the entire RSDI amount received as child’s benefits.
  • Disregard any subsequent cost-of-living increases
  • Include all income from any other sources

Note: In most cases, none of the DAC’s current RSDI benefits will be budgeted. This is a special limited category of Pickle MC.

Aid Codes

Individuals who are found eligible under these provisions are identified as follows:

  • Blind- Aid Code 6A
  • Disabled - Aid Code 6C

Related Topics

Pickle Amendment - Lynch v. Rank

Pickle Eligible Child