425-4        REVIEW OF BLINDNESS OR DISABILITY DECISIONS

425-4 A.   SSA AND SSI Supplemental Security Income DETERMINATIONS

The Social Security Administration periodically reviews blindness or disability decisions that allow the payment of SSA disability or SSI Supplemental Security Income benefits.  Review of SSA or SSI Supplemental Security Income blindness or disability decisions is not necessary for APA purposes.  If DPA receives information indicating that SSA or SSI Supplemental Security Income disability payments have been terminated because Social Security has found that blindness or disability no longer exists, APA benefits shall be terminated.

425-4 B.   DDS Disability Determination Service DETERMINATIONS

State-only decisions are subject to periodic review by the state.  The DDS Disability Determination Service is the agency responsible for conducting these blindness and disability reviews.  The frequency of state-only blindness or disability reviews is set by the DDS Disability Determination Service.

The DDS does not retain any of the material that they used to initially determine an individual's blindness or disability.  Instead, they send the material to the DPA District Office that serves the individual.  The District Office must keep all such material with the individual's case file and resubmit it along with newly completed APA #4 and Med #2 forms to the DDS at the time of the individual's periodic review.  Because of this, any material that the DDS sends to the DPA District Office must never be archived.  The DDS must be informed in the transmittal document that these materials are being submitted for a continuing disability review, since the DDS uses different criteria for disability review determinations than for initial disability determinations.

425-4 C.   CHANGE IN SSA OR SSI Supplemental Security Income STATUS

An APA recipient may sometimes become ineligible for Social Security Disability or SSI Supplemental Security Income benefits.  If an APA recipient is no longer eligible for SSI Supplemental Security Income or SSA disability for a reason other than a finding that blindness or disability no longer exists, continued eligibility for APA may exist.  If the individual is otherwise eligible, the case worker must continue APA benefits and refer the client's case to the DDS Disability Determination Service for a new blindness or disability decision.  This is necessary because SSA will no longer review the individual's disability determination, and there will be no eligibility for SSI Supplemental Security Income or SSA disability to form a basis for APA disability.

SSI Supplemental Security Income recipients who become ineligible for an SSI Supplemental Security Income payment because of excess income are put into SSI Supplemental Security Income nonpay status.  Do not confuse nonpay status with the actual closure of an individual's SSI Supplemental Security Income case.  It is not necessary to refer these individuals to the DDS Disability Determination Service unless the individual's SSI Supplemental Security Income claim is actually closed.