§17-658-5 - Categorical eligibility requirements and verification of those requirements for individuals applying for or receiving financial assistance as disabled individuals.

§17-658-5 Categorical eligibility requirements and verification of those requirements for individuals applying for or receiving financial assistance as disabled individuals.

(a) The categorical eligibility requirement for a disabled individual is that the individual be unable to engage in substantial gainful activity because of a medically determinable physical or mental impairment which may be expected to result in death or which has lasted or may be expected to last for a continuous period of not less than twelve months.

(b) Verification of disability shall be required.

(1) Eligibility for or receipt of SSI or RSDI benefits on the basis of being disabled shall be verification of being a disabled individual.

(2) Certification of disability by the department's aid to the disabled review committee (ADRC) is required in the absence of eligibility for or receipt of SSI or RSDI disability benefits.

(c) Recertification of disability shall not be required if the department's ADRC certifies the individual's condition to be permanent with little chance of significant improvement, and therefore specifies that reevaluation is not necessary or warranted.

(d) Recertification of disability is required if the individual's condition is not permanent, there is a possibility of improvement, or reevaluation is recommended by the department's ADRC.

(1) Reevaluation shall be scheduled as recommended by the ADRC.

(2) If no reevaluation date is indicated, recertification will be scheduled on an annual basis.

(e) The ADRC certification of disability shall be invalid if the individual's application for Social Security benefits (SSI or RSDI) is denied as the result of the individual not meeting Social Security's definition of disabled, provided Social Security and ADRC were evaluating the same medical condition. A Social Security denial based on non-medical criteria or a different medical condition, shall not invalidate an ADRC determination.

        [Eff 3/19/93; am and comp 8/01/94; am 7/16/99 ] (Auth: HRS §346-14) (Imp: HRS §§346-29; 346-30; 346-52; 346-53; 42 C.F.R. §§435.540; 435.541)

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