DPSS ePolicy

Terms and Descriptions

Disability

A physical or mental impairment that prevents an individual from engaging in a Substantial Gainful Activity (SGA).  The impairment is expected to result in death or is expected to last for a continuous period of 12 months or more.  Title 22 of the California Code of Regulations (CCR), Section 50223 (a) (1) defines a disabled individual as one who meets:

1. Social Security Administration's (SSA) disability requirements for Title II Retirement, Survivors and Disability Insurance (RSDI); or
2. Title XVI Supplemental Security Income (SSI) disability requirements; or
3. SSI Disabled Child requirements, if they are a child.

Substantial Gainful Activity (SGA)

Term used to describe a level of work activity and earnings.  Work is “substantial” if it results in the individual engaging in significant physical or mental activities or a combination of both.  If an applicant/beneficiary earns more than a certain amount and is doing productive work, it is generally considered that they are engaging in substantial gainful activity and would not be eligible for disability benefits.

Presumptive Disability (PD)

PD allows applicants with certain disability impairments to receive immediate MC coverage.  The individual is presumed disabled until a formal disability evaluation is conducted by DDSD-SP.

Urgent Case Request for Emergency Disability Evaluation

The Urgent Case request is used to ask DDSD-SP to expedite the disability evaluation process when the individual has an emergent need for medical treatment.

Disability Re-examinations 

Federally mandated medical re-examinations that must be conducted to determine if a MC beneficiary who was previously declared disabled by DDSD-SP continues to meet federal disability guidelines.