49-025 Age and Disability

CAPI

49-025 Age and Disability

Release Date

04/26/2021

Section Heading

Purpose

To convert existing policy for new writing style only - No concept changes

Policy

To be eligible for Cash Assistance Program for Immigrants (CAPI), a legal immigrant must meet all the CAPI eligibility requirements (refer to 49-010: Eligibility for CAPI). One of the requirements is that the person must be aged, blind or disabled, as follows:

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.

Background

The Balanced Budget Act of 1997 (P.L. 104-193) added criteria under which an immigrant could become eligible for Supplemental Security Income/State Supplementary Payment (SSI/SSP) if they:

Are a “qualified alien” (refer to 49-020: Immigration Status) who is lawfully residing in the United States; and
Are determined disabled or blind as defined for SSI/SSP eligibility purposes.

Note: An immigrant can establish SSI/SSP eligibility based on disability or blindness at any age, even on or after attaining age 65.

Definitions

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.

Requirements

When a CAPI applicant/participant alleges that they are disabled, a disability determination is required. When a CAPI applicant/participant alleges disability/ blindness, it must be confirmed by the DDSD. In most cases, the EW may not grant CAPI to an applicant/participant pending a DDSD disability determination.

Verification Docs

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.

Manual Policy and Procedure §49-025

ACIN No. I-07-04, Cash Assistance Program for Immigrants (CAPI) Eligibility for Refugees Discontinued from the Supplemental Security Income/State Supplementary Payment Program, dated January 28, 2004

All County Welfare Director’s Letter (ACWDL) No. 11-11, Referral of Disability Packets to the Disability Determinations Service Division-State Programs, dated February 25, 2011

Administrative Release 5878, 49-010 Eligibility for Cash Assistance Program for Immigrants, dated February 10, 2021

N/A

Administrative Release

Number: 5864 Date: April 26, 2021

If the CAPI Applicant/Participant is Under 65 Years Old and is Currently Receiving Medi-Cal, Then...

The EW must:

Accept the current determination of disability or blindness made during the process of obtaining Medi-Cal benefits and do not submit a disability packet to DDSD.

Note: A current determination is one that has not lapsed due to benefit termination.

If the CAPI Applicant/Participant Alleges Presumptive Disability/Blindness, Then...

The EW must:

Make a Presumptive Disability Determination and provide the applicant with a blank disability packet for completion. Upon receipt, submit the completed disability packet to DDSD for a disability/blindness determination.

If the CAPI Applicant/Participant Appears to be Eligible for SSI/SSP, Then...

The EW must:

Refer applicant/participant to SSA to file an SSI/SSP application. (Refer to 49-030: Ineligibility for SSI/SSP)

If the CAPI Applicant/Participant is Discontinued From SSI/SSP Due to the Expiration of the "SSI/SSP Seven-Year Period of Eligibility", Then...

No DDSD eligibility packet is needed to process CAPI eligibility for applicants/participants 65 years of age or older. These applications are processed like any other CAPI application.
Partial DDSD packet must be initiated if the applicant/participant is under 65 years old and there is an SSI/SSP disability decision (medical re-exam date) at the time of the CAPI application. The medical re-exam date can be determined in one of the two ways:
- Request CAPI applicant/participant to provide an SSA printout showing their medical re-exam date; or
- Prepare and send a partial DDSD packet which consists of a MC 221 LA, Disability Determination Transmittal, only, with the following comment on Field #10:
  
  “Refugee CAPI Case and SSI was discontinued as of (date). Please check for SSI disability status.”
  
  Follow up with DDSD if there is no response to the disability determination request within 30 days.
  
  Note: Deny/suspend the CAPI benefit if DDSD determines that the applicant/ participant is not disabled and document the immigration status of the applicant/ participant and the reason for the denial/ suspension (refer to 49-060: Benefit Suspensions and Terminations).
  
  CAPI benefits issued are not considered an overpayment.
Full DDSD packet must be initiated if the applicant/participant is under 65 years old and SSI/SSP benefits were discontinued because the person was no longer disabled.

If CAPI Applicant/Participant is Determined Eligible for General Relief (GR) Benefits, Then...

Initiate the GR application process while approval/ denial of the CAPI application is pending, if the CAPI applicant agrees to receive GR benefits in the interim.
Require the applicant to sign the SOC 455, Cash Assistance Program for Immigrants State Interim Assistance Reimbursement Authorization form (refer to 49-065: Interim Assistance Reimbursement).

Submission of Disability Packets to the DDSD

When a disability determination is required, the EW must complete and send a full disability determination packet to the State’s DDSD immediately following:

Intake interview;
Annual redetermination; or
The CAPI applicant/participant complies with eligibility requirements to finalize the packet.

The following forms must be completed for the disability packet:

MC 220:
1. Ensure the CAPI applicant/participant has completely and accurately filled all required fields on the form. It must have the following:
  - CAPI applicant’s/participant’s name;
  - Social Security number;
  - Date of birth; and
  - Signature.
2. Provide CAPI applicant/participant a copy of the completed form; and
3. Include in the Disability Packet with annotation as “CAPI” case.
MC 221 LA:
1. Complete the form;
2. Check the “CAPI” box in field #8;
3. Provide comment in field #10 and check the “Presumptive Disability approved” box, if applicable; and
4. Include in the Disability Packet with annotation as “CAPI” case.

MC 221 LA form with sections marked for workers to fill out

C. MC 223:
- Ensure the CAPI applicant/participant has completely and accurately filled all required fields on the form. It must have the following:
  - CAPI applicant’s/participant’s name;
  - Social Security number;
  - Date of birth; and
  - Signature.
- Provide the CAPI applicant/participant a copy of the completed form; and

Include in the Disability Packet with annotation as “CAPI” case.

Presumptive Disability/Blindness Determination

An EW may make a Presumptive Disability Determination while awaiting the formal DDSD’s disability/blindness determination. The Presumptive Disability decision may only be made when the CAPI applicant/participant meets one or more of the DDSD’s 14 specific diagnoses (refer to the Policy section of this document).

Note: CAPI payments based on presumptive disability/blindness:

Cannot be made for longer than 6 months; and
Are not considered overpayments, if the CAPI applicant/participant is ultimately determined to be not blind or disabled.

MC 220, Authorization for Release of Information (06/08)

MC 221 LA, Disability Determination and Transmittal (02/14)

MC 223, Applicant’s Supplemental Statement of Facts for Medi-Cal (10/09)

SOC 455, Cash Assistance Program for Immigrants State Interim Assistance Reimbursement Authorization (01/99)

N/A

Medical Condition List

Go to the Eligibility tab on the Global navigation bar.