426-2        ELIGIBILITY REQUIREMENTS FOR INTERIM ASSISTANCE

To be eligible for Interim Assistance, an individual must:

• Meet all APA eligibility criteria except for receipt of SSI Supplemental Security Income;
   

• Apply for SSI Supplemental Security Income;
   

• Appear likely to meet Social Security disability requirements and be determined disabled by the Division, or be age 65 or older; and
   

• Agree to repay Interim Assistance from retroactive SSI Supplemental Security Income benefits by completing an Interim Assistance Reimbursement (IAR Interim Assistance Reimbursement) authorization form.

These eligibility requirements are explained below.

426-2 A.   APPLICANTS MUST BE ELIGIBLE FOR APA EXCEPT FOR A FINAL ELIGIBILITY DECISION BY SSI Supplemental Security Income

With the exception of a final eligibility decision by SSI Supplemental Security Income, all other APA eligibility requirements apply to the determination of eligibility for IA Interim Assistance.  This means that the caseworker must make a full eligibility determination before Interim Assistance can be approved.  For blind or disabled applicants who are not eligible for Social Security disability benefits, a temporary disability or blindness decision must be made in accordance with the procedures described in this chapter.

426-2 B.   CONCURRENT SSI Supplemental Security Income APPLICATION

Interim Assistance is available only to APA applicants who are required to apply for SSI Supplemental Security Income benefits; IA Interim Assistance payments will not be made to APA applicants who have countable income or resources in excess of SSI Supplemental Security Income program limits and are therefore not required to apply for SSI Supplemental Security Income benefits.

To receive Interim Assistance, proof must be obtained that the applicant has submitted a signed SSI Supplemental Security Income application to the Social Security office.

Because of the similarity between SSI Supplemental Security Income and APA eligibility criteria, the identification of potentially SSI Supplemental Security Income-eligible applicants is relatively simple.  If the client appears to be APA eligible, and to have countable income within the applicable SSI Supplemental Security Income limit, the client may be eligible for SSI Supplemental Security Income and must file for SSI Supplemental Security Income if he or she does not already have an active claim.  If an applicant has income which changes from month to month and which is in some months within SSI Supplemental Security Income limits, he or she must apply for the SSI Supplemental Security Income program and may receive IA Interim Assistance payments until Social Security makes a final decision on the SSI Supplemental Security Income application.

When an APA applicant is identified as potentially SSI Supplemental Security Income-eligible, the applicant has 30 days from the APA application filing date to contact SSA and file an SSI Supplemental Security Income claim.  The contact establishes a “protected filing” date for SSI Supplemental Security Income benefits, and consists of an oral or written request for benefits.  This request for SSI Supplemental Security Income benefits may be made in person, by mail, or by telephone.

The SSI Supplemental Security Income application process requires that an SSI Supplemental Security Income applicant must have an interview with an SSA Field Office Claims Representative before a signed application for SSI Supplemental Security Income benefits can be accepted.  Once the interview is completed, an applicant must submit a signed application to a SSA office within 60 days of the date of the SSI Supplemental Security Income interview, unless SSA determines there is good cause for a delay.

If, without good cause, an APA applicant does not submit a signed SSI Supplemental Security Income application to a Social Security office within SSA's 60-day time limit, the APA application will be denied.  If the individual wishes to reapply once the application has been denied, he or she must complete a new APA application. 

426-2 C. INTERIM BLINDNESS OR DISABILITY DETERMINATION

The APA program uses the same definitions of disability and blindness as SSI Supplemental Security Income.  The Division will obtain and use medical and other information to determine whether an applicant is likely to meet the SSI Supplemental Security Income disability/blindness criteria, and is eligible for Interim Assistance.  These determinations are made as follows:

1. APA applicants who are eligible to receive Social Security disability insurance benefits

Persons who receive SSA disability payments, and persons who have been determined eligible to receive SSA disability benefits but are serving their five-month waiting period, meet the blindness/disability criteria for IA Interim Assistance.  These individuals are not required to have a medical exam or an assessment by the Division’s Medical Reviewer, as described below.

2. Blind APA applicants required to submit an AB #3 Review Report on Aid to the Blind form

An individual who is blind must be examined by a physician skilled in diseases of the eye or an optometrist, as specified in Manual Section 425-2A.  The results of this examination must be provided on a Review Report on Aid to the Blind (AB #3 Review Report on Aid to the Blind) form,.  If a medical provider refuses to complete the AB #3 Review Report on Aid to the Blind form, the caseworker should advise the applicant to go to a different provider for completion of the form.

The AB #3 Review Report on Aid to the Blind form must be checked “Yes” or “No.”  A “Yes” is evidence of blindness for Interim Assistance.  A “No” shows ineligibility for Interim Assistance.  When determining blindness for Interim Assistance, only the AB #3 Review Report on Aid to the Blind form needs to be completed.  The caseworker will accept the judgment of the medical provider as noted on the AB #3 Review Report on Aid to the Blind.  It is not reviewed by any other authority.

If Interim Assistance is not approved, the APA application must be pended for an eligibility decision from the SSI Supplemental Security Income program so that eligibility for regular APA and Medicaid can be determined.

3. Disabled APA applicants required submit an AD #2 Preliminary Examination for Interim Assistance form

An individual who has a disability other than blindness must be examined by a physician or psychiatrist, as specified in Manual Section 425-2A.  The results of this examination must be provided on an, Preliminary Examination for Interim Assistance (AD #2 Preliminary Examination for Interim Assistance) form.  If a medical provider refuses to complete the AD #2 Preliminary Examination for Interim Assistance form, the caseworker should advise the applicant to go to a different provider for completion of the form.

In some cases, the Medical Reviewer may need to ask a medical provider for information.  To assist in this process the caseworker should obtain a completed Authorization for Release of Protected Health Information (Gen 150) form.

Once a completed AD #2 Preliminary Examination for Interim Assistance is received, the caseworker will immediately fax the AD #2 Preliminary Examination for Interim Assistance form, any completed release forms, and any supporting documents to:

Medical Reviewer
Division of Public Assistance
3601 C Street, Suite 814
Anchorage, AK 99503
Phone: (907) 269-0064
Fax: (907) 269-0962

The Medical Reviewer will assess the individual’s disability using the examination results reported on the AD #2 Preliminary Examination for Interim Assistance form and any supporting documents or information, and decide whether the applicant meets SSI Supplemental Security Income disability criteria.

When making a disability assessment, the Medical Reviewer will consider whether the:  

• Applicant’s condition meets the SSI Supplemental Security Income presumptive disability criteria or another impairment category used by Social Security to determine a person’s disability status;
   

• Medical information provided by the applicant or received by the Department documents the applicant’s impairment;
   

• Impairment affects the individual’s activities of daily living;
   

• Applicant can work, including sedentary work;
   

• Impairment has lasted, or is expected to last, for a continuous period of at least 12 months.

Once the assessment is completed, the Medical Reviewer will document the disability decision on the AD #2 Preliminary Examination for Interim Assistance form and advise the caseworker of the approval or denial by fax or e-mail.

•  IA Interim Assistance Disability Approved

If approved, the caseworker will open an Interim Assistance case if the individual meets all other factors of eligibility for IA Interim Assistance.  The APA application is pended for an eligibility decision from the SSI Supplemental Security Income program so that eligibility for regular APA and Medicaid can be determined.  EIS Eligibility Information System notice P105, IA Interim Assistance Approved – APA Held, may be used for this purpose.

•  IA Interim Assistance Disability Denied

If denied, the caseworker will pend the APA application for an eligibility decision from the SSI Supplemental Security Income program so that eligibility for regular APA and Medicaid can be determined.  EIS Eligibility Information System notice P304, APA Held – IA Interim Assistance Denied, may be used for this purpose.

In some situations, an applicant may choose to submit additional medical information after the Medical Reviewer determines the applicant is not disabled.  When this happens, the Medical Reviewer will consider the new information and re-determine the applicant’s disability status.  New medical information may be submitted at any time.

426-2 D.   AGED APPLICANTS

Processing times for SSI Supplemental Security Income applications based on age are usually much faster than for individuals applying based on disability or blindness.  In most cases, the SSI Supplemental Security Income decision for old age cases will be made within the 30-day APA application processing timeframe, and eligible cases can be opened in regular APA coverage.  If, however, no SSI Supplemental Security Income decision is reached within the APA application processing timeframe, aged applicants may receive Interim Assistance pending the SSI Supplemental Security Income eligibility decision.  An interim blindness or disability determination is not required for aged applicants.

426-2 E.   IAR Interim Assistance Reimbursement Interim Assistance Reimbursement AUTHORIZATION REQUIREMENT

APA applicants must sign an Interim Assistance Reimbursement (IAR Interim Assistance Reimbursement) authorization form to receive Interim Assistance benefits.  The IAR Interim Assistance Reimbursement authorization is not, however, an eligibility requirement for regular APA benefits.  The signed IAR Interim Assistance Reimbursement authorization is necessary only if the applicant wishes to receive IA Interim Assistance benefits while waiting for a decision on his or her SSI Supplemental Security Income application.  APA applicants who appear eligible for Interim Assistance must be given the choice of either signing or not signing the IAR Interim Assistance Reimbursement authorization form.

The IAR Interim Assistance Reimbursement authorization may be provided to the APA applicant during the interview process, or if this is not possible, the caseworker may send EIS Eligibility Information System notice, P021, IAR Interim Assistance Reimbursement Authorization Needed, and mail the IAR Interim Assistance Reimbursement authorization form separately to the client at the same time.

When a signed IAR Interim Assistance Reimbursement authorization is received, the caseworker must:

• Complete the bottom portion of the authorization form that is reserved for office use and send the original copy to the appropriate SSA office within 30 calendar days of the date the signed authorization was received by DPA .  (The date the authorization was received by DPA is entered on the form as the date received.)
   

• Enter the date the authorization was received by DPA into EIS Eligibility Information System on the APAS screen.  (The Claims Unit will use this date when calculating an IA Interim Assistance recipient's reimbursement obligation.)

If otherwise eligible, Interim Assistance under this provision begins the month a signed IAR Interim Assistance Reimbursement authorization is received in a DPA office.  APA applicants who do not sign an IAR Interim Assistance Reimbursement authorization are not eligible for Interim Assistance.