GIS 14 MA/014:Tracking Group II Disability End Dates

To: Local District Commissioners, Medicaid Directors

From: Judith Arnold, Director
Division of Eligibility and Marketplace Integration

Subject:Tracking Group II Disability End Dates

Effective Date: Immediately

Contact Person: Local District Support Unit
Upstate (518) 474-8887 NYC (212) 417-4500

The purpose of this General Information System (GIS) message is to remind local departments of social services (LDSS) of the need to track Group II disability end dates in the Welfare Management System (WMS). This applies to all disability determinations with a Group II approval. It is necessary for all upstate districts to track the end date for Group II Disability through the WMS by using the Anticipated Future Action(AFA)code 414(Re-evaluation of Disability)and entering the Group II disability end date in the date field.

GIS message 10 MA/003, "Tracking Group II Disability End Dates", directed districts to cease the use of other tracking methods and to use the AFA code and rely on the Benefit Issuance Control Systems (BICS) report WINR 4137, "Undercare-Notice of AFA", to alert them of an impending end date for disability. When AFA code 414 and the disability end date is entered in the WMS, a BICS report is generated four months prior to the disability end date, giving local districts ample time to gather medical evidence, have the disability determination performed and enter the new Group II disability end date in the WMS. This process helps districts maintain current proof of disability for the client file.

Additionally, the AFA code 414 must be used for tracking the disability end date for an MBI-WPD program recipient who is in an SSDI 36-month Extended Period of Eligibility (EPE) or who has transitioned to the MBI-WPD program from the SSI 1619(b) program. The Social Security Administration (SSA) medical diary date is the disability end date to track for SSI 1619(b). For the SSDI 36-month EPE, the disability end date is the end date for the EPE.

Upstate districts should be entering the Group II disability end date in WMS for any Medicaid-Only SSI-related or MBI-WPD case with a State Disability Review Team Certificate that is approved Group II or for MBI-WPD recipients with an SSA disability end date as described in the previous paragraph. Districts are to use AFA code 414 and enter the Group II disability end date in the appropriate field.

For New York City, SSI-related recipients with a Group II disability end date determined by the Disability Services Program (DSP) will have Employability Code 74 (Group II Disability) and the Group II disability end date automatically entered in WMS. For disability determinations performed by the SDRT, the Employability Code 74 and Group II disability end date must be manually entered by a worker upon return of the disability certificate to the submitting office.

In the event of a county-to-county move (Luberto) from upstate to New York City, when the individual's data is transferred to the new county, WMS will translate the AFA code 414 to the downstate Employability Code 74 and autofill the associated disability end date. For an individual moving from New York City to upstate, WMS will translate the Employability code 74 to the AFA 414 code and auto-fill the associated date. For moves from one upstate county to another upstate county, the AFA code 414 and associated date will transfer.