Review the client's ongoing eligibility when they lose their SSI or primary SSA benefits due to a finding of "not disabled" by SSA. If the client does not appeal the finding of "not disabled," cancel the case.

If the client has filed an appeal with SSA and has proof, take one of the following actions based on their situation.

  • For Medical, if the client is otherwise eligible, continue or restore Medical. If the case was canceled 3 months or less, backdate to the month and year of cancellation. If the case was canceled 4 months or more, the client must reapply.
  • For cash, if the client continues to receive SSI and/or SSA during the SSA appeal process, continue cash benefits.
  • For a cash client whose SSI and/or SSA was not continued during the appeal process, SWAP the case to Medical.