Categorical relationship for people over age 65 is simply established by verifying age through a driver’s license or birth certificate [317:35-5-3]. A client doesn’t need to be on SSI or RSDI to establish categorical relationship. (This is different than the requirement to apply for RSDI or other income for which a client is eligible for medical [317:35-5-42(a)(1)] or applying for SSI for the SSP [340:15-1-5(a)].

Policy says that establishing categorical relationship by disability [317:35-5-4(1) (a), (b) OR (C)] or blindness [317:35-5-5] should first come from the Social Security Administration (SSA) through either SSI or RSDI. SSI will stop making a decision on disability or blindness when the client’s income or resources are over their standards. The closure of SSI does not automatically mean the client stopped being eligible for ABD-related benefits through DHS. The standards on the Appendix C-1, Schedules VI, VII, VIIA and VIII are all higher than the SSI standards.

So if SSI closes, check the closure /denial code using “m SDX” in IMS. If the code is for income or resources, determine if the client still meets the DHS standards. If the income and/or resources are over our standards, benefits will need to be removed, closed or denied. If the income/resources are within our standards, the case can stay open as long as the client retains categorical relationship. If SSI isn’t going to renew the disability or blindness decision, how do we determine if the client still meets categorical relationship?

Refer to article IMS: State Data Exchange (SDX) Payment Status Codes.

The Level of Care Evaluation Unit (LOCEU) makes the disability decision when Social Security won’t make the decision. [317:35-5-4(2)] LOCEU’s procedure is that when SSI closes for income or resources they will use SSI’s disability/blindness decision for 12 months from SSI’s closure date. This means workers just need set a reminder (Outlook calendar, post-it note, etc.) to send the paperwork to LOCEU. Refer to article Aged, Blind, Disabled (ABD): Level of Care Evaluation Unit (LOCEU).