The Medical Condition Detail page is used for E&D medical program persons under age 65 and claiming to have a disability. A Batch Interface could create or update an Active Medical Condition at the time of registration or if a consumer is declared disabled by SSA.
NOTE: A Medical Condition is not needed for individuals under 21 on the SED and TA Waivers.
Select Eligibility from Global Navigation. Select Customer Information from Local Navigation. Select Medical Condition from Task Navigation. The Medical Condition List page displays.
Select the appropriate status in the Medical Condition Category drop-down menu.
NOTE: Fields display dynamically on the Medical Condition Detail page based on the Medical Condition Category selected in STEP 2.
Active - A consumer has been determined disabled by SSA or DDS.
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Active Medical Conditions |
Description |
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1619B Blind |
Used to approve medical coverage for a person under the age of 65 meeting 1619B criteria with a benefit type of Blind |
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1619B Disabled |
Used to approve medical coverage for a person under the age of 65 meeting 1619B criteria with a benefit type of Disabled |
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DDS Blind |
Used to approve medical coverage for a person under the age of 65 meeting DDS criteria for a benefit type of Blind |
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DDS Disabled |
Used to approve medical coverage for a person under the age of 65 meeting DDS criteria for a benefit type of disabled |
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Incapacity-Verifiable and at Least 30 days |
Non-Medical Only |
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Medically Improved-Blind |
Used to approve Working Healthy coverage for a person with a benefit type of Blind |
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Medically Improved-Disabled |
Used to approve Working Healthy coverage for a person with a benefit type of Disabled |
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Other Food Assistance Disability |
Non-Medical Only |
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SSA Blind |
Used to approve a medical coverage for a person under the age of 65 with an SSA benefit type of Blind |
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SSA Disabled |
Used to approve medical coverage for a person under the age of 65 with a SSA benefit type of Disabled |
Declared – For Tier 2 MediKan (see note below). The consumer states he/she is disabled (12 months or result in death).
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Declared Medical Condition |
Description |
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12 months or result in death |
Used to record a medical condition for a person without an active or presumptive medical condition |
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Less than 12 months |
Do Not Use |
NOTE: The Medical Condition must remain Declared for MediKan recipients until the consumer is determined disabled by SSA. See the Other Program Assistance page of the User Manual for more information on MediKan data collection requirements.
Presumptive - For Tier 1 Medicaid only: Use only if the consumer has been verified Tier 1 eligible by PMDT.
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Presumptive Medical Conditions |
Description |
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PMD Tier 1 |
Used to approve medical coverage for a person under the age of 65 with a PMD Tier 1 decision |
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PMD Tier 2 |
Do Not Use |
NOTE: Using a Presumptive Medical Condition will result in a Medicaid benefit at EDBC. Do NOT use a Presumptive PMDT Tier 2 Medical Condition for MediKan.
NOTE: Medical Condition changes do not utilize effective dating:
If a Declared or Presumptive Medical Condition changes to Active, edit the original Medical Condition to include an End Date.
In addition to End Dating the condition type, the user nees to add the new Active Medical Condition type.
Click the Add button. The Medical Condition Detail page displays.
Select the consumer from the Name drop-down menu.
Review the Medical Condition Category for accuracy.
Select a Verified Status from the drop-down menu.
Select the appropriate Medical Condition Type from the drop-down menu.
Enter the Begin Date, using the <mm/dd/yyyy> format or the calendar icon, for the first day of the month eligibility is being determined. Records should remain high dated until a change has been completed.
For a Declared, Presumptive, or DDS Medical Condition, the user will enter a Begin Date as the first day of the month of application or the first day of Prior Medical if Prior Medical has been requested, when processing a new application.
For an Active Medical Condition, including 1619B Status, the user will enter the Begin Date as the actual day that SSA deemed the consumer disabled. Refer to EATSS to confirm the actual Disability Begin Date/Disability Onset Date.
When End Dating a Medical Condition, enter the End Date, using the <mm/dd/yyyy> format or the calendar icon, for the last day of the month before the new eligibility is being determined.
NOTE: For an Active Medical Condition, only enter an End Date if it has been verified the consumer has lost disability. Adding an End Date to an Active Medical Condition when the consumer remains disabled can negatively impact Non-Medical disability benefits such as Food Assistance.
Click the Save and Add Another button to add additional records. Otherwise, click the Save and Return button.