DPSS ePolicy

Criteria and Description

Aged

65 years of age or older. 

Disabled as an Adult

Age 18 or older and not able to do their previous work or any substantial gainful activity due to any medically determined physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of 12 months or more. 

Note: To determine whether a person can do any other work, the Social Security Administration (SSA) considers a person’s residual functional capacity, age, education, and work experience.

Disabled as a Child Under Age 18

Under the age of 18 and has a medically determined physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and which can be expected to cause death or has lasted or can be expected to last for a continuous period of 12 months or more.

Note: Any child or adult who is engaging in substantial gainful activity when filing a new CAPI application will not be considered disabled.

Statutorily Blind

Has central visual acuity of 20/200 or less in the better eye with the use of a correcting lens.

Presumptive Disability/Blindness

Has noticeable disability/blindness determined by the applicant’s/participant’s doctor or by the Eligibility Worker (EW) as follows: 

• Amputation of two limbs;
  
  
• Amputation of a leg at the hip;
  
  
• Allegation of total deafness;
  
  
• Allegation of total blindness;
  
  
• Allegation of bed confinement or immobility without a wheelchair, walker or crutches, due to a long-standing condition (excluding recent accident or recent surgery);
  
  
• Allegation of stroke (cerebral vascular accident) more than three months in the past and continued marked difficulty in walking or using a hand or arm;
  
  
• Allegation of cerebral palsy, muscular dystrophy, or muscle atrophy and marked difficulty in walking (e.g., use of braces), speaking, or coordination of hands or arms;
  
  
• Allegation of diabetes with amputation of the foot;
  
  
• Allegation of Down's syndrome;
  
  
• Allegation of severe mental deficiency made by another person filing on behalf of the applicant/ participant who is at least seven years old. (Example: A mother filing for benefits for her child states that the child attends (or attended) a special school, or special classes in school, because of mental deficiency or, is unable (or was unable) to attend any type of school, and requires care and supervision of routine daily activities;
  
  
• A child is age six months or younger and the birth certificate or other evidence (e.g., hospital admission summary) shows a weight at birth below 1,200 grams  (2 lbs. 10 oz);
  
  
• Human Immunodeficiency Virus (HIV) infection (accompanied by a medical-source statement regarding manifestations of illness);
  
  
• A child is six months or younger and available evidence (e.g., hospital admission summary) shows a gestational age in weeks at birth weight as follows:
  
  
  • 37-40, less than 2,000 grams (4 lbs. 6 oz.)
    
    
  • 36, 1,875 grams or less (4lbs. 2 oz.)
    
    
  • 35, 1,700 grams or less (3 lbs. 12 oz.)
    
    
  • 34, 1,500 grams or less (3 lbs. 5 oz.)
    
    
  • 33, 1,325 grams or less (2 lbs. 15 oz.) 
     
• A physician or knowledgeable hospice official confirms a person is receiving hospice services due to terminal cancer.
  
  Note: CAPI payments based on presumptive disability/blindness cannot be made for longer than six months.

Terms and Descriptions

Disability Determination Services Division (DDSD)

The State’s Division responsible for making all blindness and disability determinations for CAPI.

Note: A current determination of disability/blindness established for Title II Social Security, SSI/SSP, or Medi-Cal can be used to establish disability/blindness for CAPI.  A current determination is one that has not lapsed due to benefit termination.

Mental Deficiency

Mental impairment, pertaining to persons who depend upon others for meeting personal care needs such as hygiene and for doing other routine activities which grossly exceeds age-appropriate dependence because of mental impairment.

Presumptive Disability Determination

Serious impairments that the applicant is "presumed” to be disabled, such as total deafness or blindness, Down syndrome, or cerebral palsy.

Category and Acceptable Documents

Age

Birth certificate, baptismal certificate, or other religious record of birth indicating the CAPI applicant is at least 65 years of age.  If such records are not available, other evidence (i.e. proof from the United States Citizenship and Immigration Services (USCIS) documentation where the date is noted) may be submitted to establish the applicant’s date of birth.

Note: A driver license or State-issued Identification Card is sufficient evidence of date of birth, only if CAPI applicant claims to be at least age 65 years old and the document was issued within the last three years.  

Disability/Blindness 

• MC 220, Authorization for Release of Information form – applicant/participant must complete and sign this form to authorize the California Department of Social Services and Department of Health Care Services to obtain their information from medical and educational sources, social workers and others.
  
  
• MC 223, Applicant’s Supplemental Statement of Facts for Medi-Cal form – applicant/participant must complete this form if they do not have Medi-Cal.