32 Miss. Code. R. § 22-3.18.3 - Case Coding

Because the Agency is entitled to incentive payments from SSA based on the period an individual receives SSDI/SSI during the rehabilitation process, care should be taken in properly coding and updating cases. In questioning a client regarding the type of benefit check (SSDI or SSI) that he/she receives, it may be helpful to ask the color of the envelope in which the check arrives. SSDI checks are mailed in draft (tan or brown) envelopes while SSI checks are mailed in blue envelopes. All SSI checks are issued on the first of each month while SSDI checks are staggered throughout the month based on the clients date of birth.

There are occasions when an individual goes from an eligible category to an ineligible category and vice versa. In these cases, the cost of VR services beyond the conversion is not eligible for an incentive payment. For example, an individual drawing childhood benefits on a parents social security number (ineligible) at age 18 is determined to have a disability, and then begins drawing benefits on that disability. At that time, he/she enters an eligible category. An individual is receiving disability benefits (eligible) and, upon reaching age 62 (or current required retirement age) is converted to retirement benefits then becomes ineligible.

Reapplying for Benefits (Childhood Disability Cases):

Childhood auxiliary benefits drawn off a parents record will not continue beyond an individual's eighteenth birthday unless the individual or his/her parents reapply to SSA for continuation of benefits based solely on the individual's own disability. Some individuals may be determined ineligible for continuation of benefits because of stricter guidelines for adult disability. If the client has qualified for SSI benefits based on his/her own disability prior to age eighteen, the Disability Determination Services (DDS) will review the claim when the client attains age 18 to determine if the condition is disabling under adult criteria.

"301" Cases (Medically Improved Recipient Cases Reviewed by DDS):

When the disability status of a current VR client receiving SSDI/SSI payments is reviewed by DDS to determine if the individual has medically improved, a VR counselor may receive a SSA-4290 Form to complete. The SSA-4290 Form is used by SSA to determine if the SSDI/SSI client who has medically improved is in a legitimate VR program.

Even if an individual has medically improved, disability benefits can be continued until the completion of that person's rehabilitation program (typically one year)--provided SSA determines that the person is participating in a legitimate VR program. If SSA determines that the individual has medically improved and is not participating in a legitimate VR program, disability payments will be terminated. Therefore, care should be taken to accurately answer all items on the SSA-4290 Form. All completed SSA-4290 Forms will be routed back to the DDS Examiner to attach to the Medical CDR Denial decision which is forwarded back to the local SSA Claims Representative at the Field Office.

Documentation of SSA Status during the VR Process:

A client's SSDI/SSI status should be documented in the computer system when referral information is entered. If known, enter SSA information at this time or at any time before closure. At the time of closure, the SSDI/SSI status must be entered or updated in the computer system.

On all cases that could potentially draw SSA benefits, counselors should check the individual's record with the local Social Security Office or the Ticket Unit. This includes all individuals whose disabling condition places them in the "severely disabled" classification or where other factors indicate that they are eligible for or are drawing disability benefits. Benefits verification can be obtained from the Ticket Unit, via email, written request, or by calling 601-853-5351.

All cases found drawing SSDI/SSI benefits based on personal disability must have written verification of the benefits in the file.

Notes

32 Miss. Code. R. § 22-3.18.3