Disability Terms and Definitions

SSI State Supplement A cash benefit authorized by Ch. 49.77 and 49.775, Wis. Stats. This benefit is intended to supplement the federal SSI benefit payment. Eligibility is based on current receipt of federal SSI benefits or special "grandfathered" status as a recipient of the state supplement only. DHU Disability Hearings Unit. A unit in each DDD regional office that conducts in person hearings with disabled beneficiaries who appeal a DDD decision that the individual is no longer disabled. Benefit Percentage The benefit payable is usually determined as a percentage of the insured's pre-disability income up to an overall maximum benefit amount. Elimination Period This is the period of time between the date the disability commences and the beginning of the benefit payment period. It is the period during which an employee must be disabled before payment of benefits begins. It is sometimes referred to as the Qualifying Period. Windfall Offset A provision to prevent a person from receiving monthly SSI and OASDI benefits in excess of the total amount which would have been paid if the OASDI benefits had been paid when they were due rather than retroactively. Section 1619(a) Status The special SSI cash benefits provided to disabled individuals who lose eligibility for SSI benefits under the regular rules because they have earnings at the level that is ordinarily considered to represent substantial gainful activity. Reasonable Accommodation Any change in the job application process, work environment or work process, or modification to the benefits or privileges of employment, that results in equal employment opportunity for an individual with a disability. Section 1619(b) Status The special SSI recipient status for Medicaid purposes provided to working disabled or blind individuals when their earnings make them ineligible for regular or special cash payments. PD Presumptive Disability. Only for SSI claims. Enables an early (presumptive) allowance of benefits for 6 months based on a substantial probability of a final allowance when all required documentation is obtained. A PD can be reversed to a denial, but the claimant does not return the PD benefits. ADA Americans with Disabilities Act The ADA prohibits discrimination on the basis of disability in employment, State and local government, public accommodations, commercial facilities, transportation, and telecommunications. It also applies to the United States Congress.

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	Did You Know?
	SHMO means Social Health Maintenance Organization A managed system of health and long-term care services geared toward an elderly client population. Under this model, a single provider entity assumes responsibility for a full range of acute inpatient, ambulatory, rehabilitative, extended home health and personal care services under a fixed budget which is determined prospectively. Elderly people who reside in the target service area are voluntarily enrolled. Once enrolled, individuals are obligated to receive all SHMO covered services through SHMO providers, similar to the operation of a medical model health maintenance organization (HMO).