Childhood Disability Assessment

Mr. Williams applied for Supplemental Social Income (SSI), on August 3, 2015. The Office of Appeals verified with the SSA that Mr. Williams received an unfavorable disability decision, and he currently has a pending claim. Until this unfavorable disability finding is changed by the SSA, DOM must abide by the SSA decision. Accordingly, the RO’s decision is supported by substantial

After the hearing, Ms. Carter’s case was forwarded to DDS for review. DDS adopted the federal decision dated July 20, 2017, stating that Ms. Carter was not disabled for Medicaid purposes. Until this unfavorable disability finding is changed by DDS, DOM must abide by the DDS decision. Accordingly, the RO’s decision is supported by substantial evidence.

The appeal is considered untimely because the notice denying the Appellant’s application for MA benefits was sent to her on May 5, 2016, and her Guardian’s request for an appeal was not received by the Department until September 14, 2016, one-hundred and three (103) days after the timeframe to appeal had expired. It is the Notice from the Department that

In your letter you claim that you submitted a Step II appeal on 01/15/2017, which was never received at Central Office. You were then allowed to resubmit your Step II Appeal and your time frames were reset. You state that to reset the timeframe is not in policy.

The DDS proposes allowance for this claimant with an EOD of 8/1/2014. The evidence in file shows a later onset date is warranted and the claimant was not insured for title II benefits at the time the disability began.

The claimant was a 49 year old female who alleged disability because of post-traumatic stress disorder (PTSD), panic disorder, and major depression. She reported that she had difficulty with her personal care because of problems with a knee and thighs. She had difficulties with mobility and with doing house chores. She also had blurry vision and difficulties with memory, concentration, understanding and following directions, and completing tasks. She was anxious being around people. It seemed that she did not speak English and needed a translator. She used to work as a teacher assistant with the Head Start Program (no dates submitted) and as a janitor with a cleaning company in 2002.

Out of the 14 schools 361 boys were assessed, at 8 months a follow up assessment completed on the control group which consisted of 154 boys and 139 intervention group participants representing an overall retention. Those who did not complete the follow-up assessments were more active on weekdays and weekends. No significant differences for body composition were noted and no intervention effects were noted for their BMI, waist circumference or body fat percentage. Changes in BMI, waist circumference, and body fat for those classified as overweight/obese at baseline were all in favor of the intervention group. Of the 19 participants who improved their weight status, 13 were in the intervention group; of the 9 participants who regressed to an unhealthier weight status, only 1 was in the intervention group. Results concluded no major changes on activity or moderate to vigorous physical activity, but participants stated drinking less sugary drinks and less screen time than the control group (Dally et al., 2016).

Per the Case Information (Case Data tab) and the Medical Evaluation/Case Analysis (07/20/2017), the Comparison Point Decision (CPD) date was 06/11/2014; however, the Disability Determination

Please confirm. I don’t want to assume what the analyst mean by “Please provide exception memo to override denial.” Claim#132587959900 will apply additional money when refreshed. However, COB/OHI is preventing the money from paying out. But, Yolanda thinks that this note maybe the result of an untrained representative working Iowa appeals. An CLIA will look in the system like the screen shoot below. Could you please advise why the representative was not able to reprocess the appeal?

Sharon is an 8 year old girl, experiencing aggressive outbursts towards her grandparents at home.

Alleged disability: cerebral palsy, severe seizures controlled with five medications, restrictive lung disorder (has 1 ½ lung), ventilator dependent (had tracheostomy), visual/hearing impairment, and severe cognitive impairment (he is 11 years old with cognitive skills of a 3 month old infant). He required “help with all aspects of daily living” and daily nursing care provided by a home health agency.

The Kaufman Assessment Battery for Children (KABC) is a standardized test that assesses intelligence and achievement in children aged two years, six months to 12 years, six months. The K-ABC was developed to evaluate preschoolers, minority groups, and children with learning disabilities. It is used to provide educational planning and placement, neurological assessment, and research. The assessment is to be administered in a school or clinical setting and is intended for use with English speaking, bilingual, or nonverbal children. There is also a Spanish edition that is to be used with children whose primary language is

Autism is a complex disability, as the way it manifests in each child differs in severity across numerous characteristics. Children diagnosed with autism qualify to receive special services and a “free, appropriate public education in the least restrictive environment” under the federal legislation, Individuals with Disabilities Education Act (Hunt & Marshall, 2012, p. 15). Autism was added to IDEA in 1990 as a new disability category. The legislation defines autism as “a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3 that adversely affects a child’s educational performance” (Hunt & Marshall, 2012, p. 301). The “Rules for the Provision of Special Education” from the State Superintendent of Public Instruction of Washington state also outlines eligibility and individualized education programs for children diagnosed with autism (Rules for the Provision of Special Education, p. 11 & 46). Furthermore, the DSM diagnoses autism when a child shows “qualitative impairments” in social interaction, communication, and “restricted repetitive and stereotyped patterns of behavior, interests and activities” (Hunt & Marshall, 2012, p. 302).

There must also be clear evidence of "clinically significant impairment" in social, academic or occupational functioning.

In part, interest in impairment has been spurred on by a shift towards the evaluation of disability. According to the Individuals with Disabilities Education Act (IDEA, 2004), “disability” refers to a physical or mental condition that limits a person’s movements or restricts the individual in one or more of the major life activities. Assessment of disability had an almost Cinderella effect on the appreciation of impairment in medical, educational and mental health conditions (Üstün & Kennedy, 2009). Prior to that, many diseases, disabilities and disorders had never been placed on public health priority lists. When the interest and the need for assessing disability entered into the equation, as is the case for example in determining eligibility for Special Education services ) beyond symptoms and test scores evaluators began to scramble to piece together valid and reliable methods to assess disability. Despite the fact that the concept of disability in mental and educational disorders has been well known, the frequency and outcome of these disabilities has never been well defined or carefully,