WAG 03-18-01-c.

If SSA finds the client "not disabled," the client remains eligible for P3 TA if they appeal the SSA determination.

NOTE: When a noncitizen, age 65 or older, who was legally residing in the U.S. on 08/22/96, is denied SSI due to a finding of "not disabled," determine eligibility for Category 01 assistance. If all other AABD cash eligibility requirements are met, the noncitizen is eligible for Category 01 assistance whether or not they appeal the SSI denial.

There are 3 stages to SSA's appeal process:

  • reconsideration
  • Administrative Law Judge (ALJ) level
  • Appeals Council

The Department accepts the determination of the ALJ as final.

If the client files an appeal and is otherwise eligible, authorize P3 TA until:

  • the client withdraws the appeal with SSA, or
  • the determination of "not disabled" is upheld at the reconsideration level and the client does not file and appeal to the ALJ level, or
  • the determination of "not disabled" is upheld by an ALJ.

When proof is received that the client filed an appeal of SSI's decision of "not disabled" (the initial decision or at the reconsideration level), restore P3 TA retroactive to the month/year of the termination.

If the Appeals Council or District Court send the case back to the ALJ for a new decision, P3 TA eligibility may exist. However, a new P3 TA application is required.