Disability Terms and Definitions

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. Blind Work Expenses (SSI) If you are blind, when we determine your SSI eligibility and payment amount we do not count any earned income that you use to meet expenses in earning the income. Representative Payee Individual appointed by the Social Security Administration (SSA) to manage the cash benefits of a recipient of SSI or Social Security benefits, or both. DWB Disabled Widows (Widowers) Benefits. Title II benefit category for widows or widowers based on a deceased spouse's social security payments. DHO Disability Hearing Officer. Conducts in person hearings. Next appeal is to a federal Administrative Law Judge (ALJ). Impairment-Related Work Expenses (IRWE) The provision that permits the exclusion from earnings of the costs of items and services which are needed in order for a disabled individual to work, which are paid for by the individual, and which are necessarily incurred by that individual because of a physical or mental impairment. Medicaid provider A professional or medical facility who is enrolled as a provider for the Medicaid Program by entering into a contract with the Medicaid Program to provide medical services to Medicaid eligible recipients. By entering into this contract the professional has agreed to abide by all rules and regulations governing the Medicaid Program. ADA Title I: Employment Title I requires employers with 15 or more employees to provide qualified individuals with disabilities an equal opportunity to benefit from the full range of employment-related opportunities available to others. 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. Own Occupation (Own Occ) Under this definition, an insured will be considered disabled only if he or she is unable to perform the duties of his or her occupation.

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	Did You Know?
	Ambulatory Care is all types of health services which are provided on an outpatient basis All types of health services which are provided on an outpatient basis, in contrast to services provided in the home or to persons who are inpatients. While many inpatients may be ambulatory, the term ambulatory care usually implies that the patient must travel to a location to receive services which do not require an overnight stay.