D.C. Code § 4-204.07

Current through codified legislation effective September 18, 2024

Section 4-204.07 - Interim Disability Assistance

(a) The purpose of the Interim Disability Assistance ("IDA") program is to provide temporary financial assistance to adults with disabilities while their application for Supplemental Security Income ("SSI") is pending. The eligibility criteria are designed to qualify individuals who have a high likelihood of receiving SSI.

(b) Applications for IDA shall be approved or disapproved by the Mayor with reasonable promptness. Other aspects of the application process, including good-cause exceptions to the application-processing standard, shall be determined by rules established by the Mayor. The monthly grant amount shall be the same as that for a family size of one for an individual or 2 for a couple under the Temporary Assistance to Needy Families program, as determined under § 4-205.52.

(c) For the purposes of IDA, the term "disability" shall have the same meaning as that employed by the Social Security Administration ("SSA");

(d)

(1) An individual shall be eligible for IDA if the individual is:

(A) A United States citizen or an alien who meets the alien eligibility requirements for SSI under title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, approved August 22, 1996 (110 Stat. 2260; 8 U.S.C. §§ 1601-1646 );

(B) A resident of the District of Columbia, as determined under § 4-205.03;

(C) Financially in need, as determined under the rules established by the Mayor;

(D) Ineligible for a category of cash assistance in which there is federal financial participation, except that an individual who has applied for Social Security Disability Insurance ("SSDI") or Supplemental Security Income may be eligible during the period that the SSDI or SSI application is being processed; and

(E) Determined by the Department of Human Services ("DHS") to meet the definition of disability.

(2) An otherwise eligible individual may not receive assistance unless the individual:

(A) Applies to the Social Security Administration for SSI benefits and maintains or pursues an active SSI application, motion for reconsideration, or request for hearing before an Administrative Law Judge, subject to the limitations of paragraph (3) of this subsection;

(B) Signs an Interim Assistance Reimbursement Authorization form in accordance with subsection (e)(2) of this section;

(C) Provides a social security number or verification of application for a social security number; and

(D) As a condition of eligibility, an applicant for or recipient of IDA shall cooperate with an entity designated by the Mayor to provide case management and legal advocacy in the SSI application and appeal process.

(3)

(A) An otherwise qualified individual's period of eligibility for IDA benefits shall begin in the month following the month in which his or her application for SSI was filed with the Social Security Administration.

(B) An otherwise qualified individual's period of eligibility for IDA benefits shall end either at the end of the month in which the Social Security Administration begins payment of SSI benefits, or at the end of the month in which an Administrative Law Judge issues a decision denying the IDA recipient's SSI application following a hearing pursuant to 20 C.F.R. § 416.1429.

(C) Repealed.

(D) If the decision of the Administrative Law Judge is a denial, the Department of Human Services shall immediately make a determination whether to refer the individual for appropriate vocational rehabilitation services.

(E) If an IDA recipient requests a fair hearing to contest the termination of his or her benefits, any IDA benefits paid pending the outcome of the fair hearing shall terminate as of the last month of the period of eligibility, as defined in this section, regardless of whether the fair hearing process is complete.

(4) If an applicant for IDA has previously been determined by the Social Security Administration ("SSA") not to satisfy the disability requirements for SSI, DHS will evaluate disability in the same manner as under the Medicaid program, as provided in 42 C.F.R. § 435.541. The applicant shall be ineligible for IDA unless he or she:

(A) Alleges a disabling condition different from, or in addition to, that considered by SSA in making its determination;

(B) Alleges more than 12 months after the most recent SSA determination denying disability that his or her condition has changed or deteriorated since that SSA determination, alleges a new period of disability which meets the durational requirements of the Social Security Act, and has not applied to SSA for a determination with respect to these allegations; or

(C) Alleges less than 12 months after the most recent SSA determination denying disability that his or her condition has changed or deteriorated since that SSA determination, alleges a new period of disability which meets the durational requirements of the Social Security Act, and has applied to SSA for reconsideration or reopening of its disability decision.

(e)

(1) For any month or period of months in which an IDA recipient receives both IDA and SSI, the IDA recipient shall repay to the District of Columbia:

(A) The entire amount of the IDA assistance payments received if the SSI benefits received for the same period equaled or exceeded the IDA payment; or

(B) That portion of the IDA assistance payments equal in amount to the SSI benefits received for the same period if the SSI benefits received were less than the IDA payment.

(2) To make repayment in accordance with paragraph (1) of this subsection, an IDA applicant shall sign an Interim Assistance Reimbursement Authorization which:

(A) Permits the Social Security Administration to send the individual's past-due SSI benefit payment to the DHS; and

(B) Permits DHS to deduct from these payments an amount equal to the IDA benefits provided.

(3) Upon receipt of an IDA recipient's past-due SSI benefit, DHS shall calculate, in accordance with paragraph (1) of this subsection, the amount of the benefit due to DHS as repayment and the amount, if any, due the IDA recipient. DHS shall then provide the IDA recipient with a written explanation of this calculation and shall pay any amount due the IDA recipient, in accordance with section 1631 of the Social Security Act, approved October 30, 1972 (86 Stat. 1475; 42 U.S.C. § 1383(g) ) and SSA Interim Assistance regulations, 20 C.F.R. §§ 416.1901 to 416.1922.

(4) Because having a pending SSI application is an eligibility requirement for IDA, if an IDA recipient is determined by the Social Security Administration to meet the disability requirements for purposes of SSI eligibility but withdraws the SSI application prior to payment of past-due SSI benefits, the IDA benefits received by that individual shall be considered an overpayment and that individual shall be liable to the District for repayment of all IDA benefits received.

(e-1)

(1) The amount of a recipient's past-due SSI benefit payment that is due DHS as repayment under subsection (e) of this section shall be deposited into the Interim Disability Assistance Fund established by § 4-204.09.

(2) The amount of an overpayment of IDA benefits that is received from an IDA recipient pursuant to subsection (e)(4) of this section shall be deposited into the Interim Disability Assistance Fund established by § 4-204.09.

(f) The Mayor shall submit to the Council by March 15 of each year a report on the operation of the program for the previous calendar year. The report shall include:

(1) The total number of IDA applicants, the number approved, and the number denied;

(2) The number and percentage of IDA applicants approved for SSI. To the extent possible, the information should be provided for each of the four levels of adjudication (original application, reconsidered application, Administrative Law Judge decision, and Appeals Council of the Office of Hearings and Appeals;

(3) An analysis of the approvals and denials at each level, why the approval percentage is what it is, and what needs to be done to ensure a better match between SSI approvals and DHS approvals; and

(4) Observations on the best practices in other states.

(g) The payment of benefits under this section shall be subject to the availability of appropriations.

(h) The Department of Human Services shall establish eligibility criteria for participants in the Interim Disability Assistance program.

D.C. Code § 4-204.07

Apr. 6, 1982, D.C. Law 4-101, § 407; as added Apr. 3, 2001, D.C. Law 13-252, § 2(b), 48 DCR 673; Oct. 1, 2002, D.C. Law 14-190, § 1902(a), 49 DCR 6968; May 18, 2004, D.C. Law 15-156, § 2, 51 DCR 3393; Sept. 14, 2011, D.C. Law 19-21, § 5092, 58 DCR 6226; Dec. 24, 2013, D.C. Law 20-61, § 5162, 60 DCR 12472.

Sections 3 and 4 of D.C. Law 13-252 provided:

"Sec. 3. The Interim Disability Assistance Amendment Act of 2000 shall be applicable beginning October 1, 2001, unless funds are made available by reprogramming for implementation during the fourth quarter of fiscal year 2001.

"Sec. 4. The Mayor shall provide the Council, no later than November 15, 2001, a report on how to implement a computer system that, at a minimum, would enable the District's Interim Disability Assistance program to interface and directly exchange information with the computer systems of the federal Social Security Disability Insurance and Supplemental Security Income programs. The report shall include a description of at least one proposed computer system, its capabilities and limitations, preliminary cost estimates to obtain the system, and timetables for acquisition and implementation."

Section 5163 of D.C. Law 20-61 provided that § 5162 of the act shall not be construed as affecting the eligibility of an otherwise qualified individual who has a Social Security application pending on Dec. 24, 2013.

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.