IMA POLICY MANUAL
PART IX: SPECIAL LOCAL PROGRAMS
CHAPTER 2: INTERIM DISABILITY ASSISTANCE PROGRAM
Application Denials 2.6.8
The application for IDA will be denied if:
- The applicant does not cooperate with IMA in providing the information needed to determine eligibility;
- Conditions of non-financial eligibility have not been met;
- Income and/or assets exceed established limits;
- The application has been voluntarily withdrawn or abandoned; or
- Funding for the program is exhausted.
The applicant must be notified of the denial, the reason for the denial, and his/her right to a fair hearing.
Application Extension 2.6.9
An applicant should be given an extension of up to 15 days to establish IDA eligibility under the following circumstances:
- A determination of disability is pending with the Medical Review Team; or
- The Medical Review Team has found that additional information is needed to determine disability and the information cannot be provided by the 60th day.
Conditional Denial 2.6.10
Because funding for the IDA program is capped, no new applications can be approved once funding of benefits to current recipients through the end of the fiscal year reaches the funding level. Applicants denied benefits because funding is exhausted will be placed on a waiting list and approved for benefits when funds are available. A notice of conditional denial must be sent. Applicants who have been denied benefits and placed on the waiting list, will be re-considered for benefits in the order in which they applied, based on the date of application.
A notice indicating a decision to deny an application for IDA benefits must be issued by the 60th day after the date of application. If the applicant is denied benefits, the notice must include the reason for the denial and provide information on the applicant's right to a fair hearing. If the application is approved, the notice must be issued by the 60th day from the date of application, or within 10 days of establishing eligibility, if eligibility is established after the 50th day from the date of application. An approval notice should indicate the effective date of the approval, and notify the applicant of his/her right to request a fair hearing.
IDA recipients must recertify for benefits within 12 months of their month of approval and every 12 months thereafter. The following eligibility requirements must be redetermined and re-verified at the IDA review:
- Residency,
- Income,
- Resources, and
- Status of the SSI claim.
IDA recipients are not required to submit new medical information to continue IDA eligibility.
If the recipient provides all information needed to re-determine eligibility, confirming that s/he continues to meet all financial and non-financial eligibility requirements, the SSR will recertify IDA benefits for an additional 12 months.
Food stamp cases that are certified in conjunction with the IDA review should be certified for twelve months to coincide with the next IDA review. SSI-related (SR) Medicaid does not need recertification, if the customer retains his/her IDA eligibility.
IDA recipients must report, within 10 days, changes that affect their eligibility for benefits. If the change will result in an increase in the customer's benefits, the SSR will make the change for the following month. If the change will result in a decrease in the customer's benefits, the SSR will make the change for the month following expiration of the timely notice period.
If the recipient fails to attend an IDA review or fails to provide verifications needed to confirm continuing eligibility, the SSR must send timely and adequate notice of the agency's intent to terminate IDA. If the recipient does not respond within 15 days, the SSR should terminate IDA benefits for the next available month. The recipient's Medicaid eligibility period should be reset to recertify Medicaid in three months. If the recipient is getting food stamps also, and reported a change that required verification to continue Food Stamp eligibility, but failed to provide the information, the SSR must send a written request for the information and timely and adequate notice prior to terminating Food Stamps. The SSR should not terminate Food Stamps because the customer failed to attend the IDA review.
If the recipient reports (and verifies when necessary) a change at the IDA review that results in termination of IDA and affects the person's eligibility for other program benefits also, the SSR should re-evaluate his/her eligibility for those programs.
Except as noted previously in “Period of Eligibility,” IDA benefits may not continue once SSA has made it final decision on the customer’s SSI claim.
Notices of IDA termination must meet all requirements listed in Part VIII: Chapter 10, Case Maintenance, Notice of Adverse Action.
