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Disability is a condition of eligibility for three Medical Assistance (MA) categories.
SSI-MAO
Disability is one of three conditions (aged, blind, or disabled) that allow a person to qualify for SSI-MAO. To meet the disability condition, a person must be:
Determined disabled under the rules for the Supplemental Security Income (SSI-Cash) program, or
Diagnosed with a serious mental illness (SMI) by the Arizona Department of Health Services (ADHS).
ALTCS and ALTCS-FTW
A person must be medically in need of long-term care services as determined by the Pre-Admission Screening (PAS).
Freedom To Work
The customer must be determined to have a disability by the Disability Determination Services Administration (DDSA) to qualify for Freedom To Work under the Basic Coverage Group (MA402).
A person must be determined to have a severe impairment by the Disability Determination Services Administration (DDSA) to qualify for Freedom To Work under the Medically Improved Coverage Group (MA402).
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Term |
Definition |
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Disabled |
Unable to engage in any substantial gainful activity because of a medically determinable physical or mental impairment, which can be expected to result in death or last for a continuous period of 12 months or more. |
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Severe impairment |
A medical condition that significantly limits a person’s physical or mental abilities to do basic work activities. |
For ALTCS or FTW-ALTCS:
A Pre-Admission Screening (PAS) decision showing that the customer has been determined to be medically in need of long-term care.
For SSI-MAO:
Records from SSA showing the person is receiving Social Security Disability payments, or has been determined to have a disability.
An SMI Determination Summary Report or SMI Eligibility Outcome form that includes a SMI determination of functional inability to live in an independent setting or risk of serious harm to self or others.
See How to Interpret the SOLQI for more information.
For FTW:
Records from SSA showing the person is receiving Social Security Disability payments, or has been determined to have a disability.
See How to Interpret the SOLQI for more information.
Records from DDSA showing the person has been determined to have a Severe Impairment.
When a customer has not been determined to have a disability and needs to be referred to DDSA, see How to Complete a DDSA Referral.
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Program |
Legal Authorities |
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ALTCS SSI-MAO FTW |
42 CFR 435.540; 42 CFR 435.541 AAC R9-28-402 (ALTCS) AAC R9-22-1501 (SSI-MAO) 42 USC 1396a(a)(10)(A)(ii)(XV) (FTW) ARS 36-2950 (FTW) AAC R9-28-1320 (FTW only) |