Disability Terms and Definitions

Work Incentives/Employment Support SSA policies that help disability beneficiaries go to work and receive benefits in an attempt to become more independent. Benefit Percentage The benefit payable is usually determined as a percentage of the insured's pre-disability income up to an overall maximum benefit amount. PD Presumptive Disability. Only for SSI claims. Enables an early (presumptive) allowance of benefits for 6 months based on a substantial probability of a final allowance when all required documentation is obtained. A PD can be reversed to a denial, but the claimant does not return the PD benefits. Own Occupation (Own Occ) Under this definition, an insured will be considered disabled only if he or she is unable to perform the duties of his or her occupation. Section 1619(a) Status The special SSI cash benefits provided to disabled individuals who lose eligibility for SSI benefits under the regular rules because they have earnings at the level that is ordinarily considered to represent substantial gainful activity. Plan for Achieving Self-Support (PASS) Under an approved PASS, recipients of federal SSI may set aside income and/or resources over a period of time to reach a goal to become financially self supporting. The income and resources set aside may later be used to obtain occupational training or education, purchase occupational equipment, establish a business, etc. Continuation of Medicare Coverage (SSDI) You can receive at least 93 consecutive months of hospital and medical insurance after the trial work period. This provision allows health insurance to continue when you go to work and are engaging in SGA. Section 1619(b) Status The special SSI recipient status for Medicaid purposes provided to working disabled or blind individuals when their earnings make them ineligible for regular or special cash payments. Survivor Benefit The survivor benefit is a lump sum payment that will provide benefits to the insured's eligible waiting period can also be the time period between when a disability occurs and when payments from the disability insurance policy begin. Windfall Offset A provision to prevent a person from receiving monthly SSI and OASDI benefits in excess of the total amount which would have been paid if the OASDI benefits had been paid when they were due rather than retroactively.

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	Did You Know?
	EPSDT stands for Early and Periodic Screening, Diagnosis, and Treatment Program A program mandated by law as part of the Medicaid program. The law requires that all states have in effect a program for eligible children under age 21 to ascretain their physical or mental defects and to provide such health care treatments and other measures to correct or ameliorate defects and chronic conditions discovered. The state programs also have active outreach components to inform eligible persons of the benefits available to them, to provide screening, and if necessary, to assist in obtaining appropriate treatment.