What is the Social Security SSI DAC – Disabled Adult Child Program?
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DAC – Disabled Adult Child
Keep Medi Cal & Increased benefits from Parents Retirement Benefits

The DAC – Disabled Adult Child program provides full-scope, no cost Medi-Cal to qualifying adults who receive “Social Security Disabled Adult Child (DAC) benefits.”

An adult is entitled to receive Disabled Adult Child benefits if:

  • that adult is unmarried;
  • has a disability that began before the age of 22
  • and was dependent on his or her parent at
    • the time of application,
    • the time of the parent’s death, or
    • at the time the parent’s own period of disability began Sec. 216. Other definitions

To qualify as a Medi-Cal Disabled Adult Child an individual must be entitled to receive Title II Disabled Adult Child benefits and must have had and lost SSI because of eligibility for these Title II benefits.

Individuals first receive Social Security DAC payments at the time of the retirement, disability or death of a parent.

When this occurs, an individual who is receiving SSI can begin receiving a DAC payment that is higher than the SSI payment rate. This makes the individual ineligible for SSI and for SSI-linked Medi-Cal.

 

Individuals who receive “Social Security DAC” benefits can qualify for full-scope, no cost Medi-Cal if they:

• Received SSI in July 1987 or later;
• Initially qualified for Title II DAC benefits, or qualified for an increase in Title II DAC benefits, on or after June 1, 1987; and
• Would be eligible for SSI now but for either:

° the current receipt of Title II DAC benefits which they first became eligible for while they were receiving SSI, or
° the increase in Title II benefits because of COLAs since they last received both Title II benefits and SSI.

In order for an individual with Title II DAC benefits to continue to receive MediCal with no Share of Cost, the Social Security Title II income is disregarded when calculating Medi-Cal eligibility. Under federal law, the individual is treated for Medicaid purposes as if they were still an SSI beneficiary.

Getting and Keeping DAC Medi-Cal

Any individual described above who qualifies should be able to get Medi-Cal either as a continuing benefit when she loses SSI or, if later, as a new applicant under the Medi-Cal DAC Program. The state periodically sends counties lists of Title II DAC recipients whose SSI/SSP has been or is being terminated.  The counties are required to contact the recipients to see if they need assistance in completing the forms required for the application process.  Eligible individuals should remain eligible as long as they meet all the other SSI eligibility rules.  DAC Program Page 84 – Non Magi Medi-Cal 3.71

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Eligibility Group Requirements*: An individual who was receiving Supplemental Security Income (SSI) benefits and who meets the following:

• Is at least 18 years of age;
• Has blindness or a disability which began before the age of 22;
• Has been receiving Supplemental Security Income (SSI) based on blindness or disability; and
• Has lost Supplemental Security Income (SSI) due to the receipt of Social Security benefits on a parent’s record due to the retirement, death or disability of a parent.

*If the person meets all of the above criteria, they may qualify as a Disabled Adult Child under Section 1634 of the Social Security Act (regarding DAC). This designation comes from the Social Security Administration. Eligibility for Medicaid may continue as long as the person is determined blind or disabled. However, if the person receives income from another source or exceeds the resource limits, they may become ineligible for Medicaid coverage  See the rest of the New Jersey 2 page explanation

Resources & Links

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6 Steps to apply for Social Security #Disability

Pickle Program 

#Pickle Amendment

What is the Pickle Program?what is the pickle program

 

  • When a person receives SSI and one of their parents retires, becomes disabled, or dies, the person switches from receiving SSI to receiving SSDI. Sometimes a person can receive both SSDI and SSI.
  • Getting SSDI usually means you’ll get more money. When that happens, people are sometimes told that they will lose their Medi-Cal coverage, or that they will have to pay a higher share of cost because their income is too high. Some people are even told by staff at the Social Security Administration or Medi-Cal that they will lose their Medi-Cal.
  • The Pickle amendment states that if an individual’s monthly income is over the SSI limit simply because they went from receiving the SSI stipend to the higher SSDI stipend, they maintain their eligibility for Medi-Cal –  Medicaid.   FAQ  2 page flyer
  • The DAC Medi Cal program maintains the status quo with respect to Medi-Cal by continuing to provide categorical Medi-Cal so long as the individual would be eligible for SSI if the individual were not receiving the DAC Social Security payments. The DAC Medi-Cal program, like the Pickle program, also provides protection from loss of SSI-linked Medi-Cal caused by Social Security COLAs. This second part of the DAC Medi-Cal program is sometimes called the Pickle DAC” or “pseudo Pickle DAC program.
  •  The Employment for Disabled Americans Act of 1986 (Public Law 99-643) requires states to continue Medicaid coverage when an individual who became disabled before age 22 and received SSI becomes eligible for SSDI or has an increase in SSDI benefits. Such disabled adult children continue to be considered SSI recipients for Medicaid purposes.
  • Disabled Adult Child (DAC) Medi-Cal Program Benefits
  • A Quick and Easy Method of Screening for Medicaid Eligibility under the Pickle Amendment: 2023 Update

Instructions on how to move from SSI to SSDI and
#
keep Medi Cal & Medicaid 2 pages

 

 

Resources & Links 

 

Survivor Benefits

Disability Qualification Rules 

 

#Disability SSI & SSDI Publications, Resources & Links

 

Social Security Publications relating to Disability, SSI, SSDI

 

FAQ's

  1. What must I do to Qualify?
    1. Must be total & permanent disability
  2. What is Social Security's eligibility process
  3. Where is Social Security's home page for disability
  4. Can I get a Disability "Starter Kit?
  5. Tell me more about the Ticket to Work Program which gives you more choice in obtaining the services one needs to be able to go back to work and achieve your employment goals.
  6. Where can I get more disability information?
  7. Can I get an estimate of my retirement benefits? Sample Calculation
  1. Nolo.com Disability Benefits

 

Medicare Coverage

 

#SocialSecurityDisability
Factors in Evaluating 

Table of Contents

DISABILITY DETERMINATIONS

600. Who qualifies for disability determinations?
601. What is a “medically determinable” impairment?
602. Impairment Lasting or Expected to Last at Least 12 Months
603. Definition of Substantial Gainful Activity
604. Independent Determinations Under the Social Security Act
605. Does SSA make disability determinations on a disability-rating schedule?

MEDICAL EVIDENCE

606. Medical and Other Evidence as Basis for Decision of “Not Disabled”
607. Medical Evidence as Basis for Decision of “Disabled” -- Listing of Impairments

DISABILITY EVALUATION

608. What if your condition does not meet or medically equal a listing?
609. Evaluation Considering Age, Education, and Work Experience
610.
611. Does your employment condition affect a disability determination?

EVIDENCE OF DISABILITY

613. Are you considered disabled if you are receiving treatment for an impairment?
614. Evidence of Disability
615. Categories of Evidence
616. Consultative Examinations
  Compassionate Allowances program identifies claims where the applicant’s disease or condition clearly meets Social Security’s statutory standard for disability.

SUBSTANTIAL GAINFUL ACTIVITY

617. Importance of Substantial Gainful Activity
618. How does work at the substantial gainful activity level affect disability?
619. Definition of “Activity”
620. Significance of Earnings
621. How are your earnings as a self-employed person considered in determining substantial gainful activity?

DISABILITY STATUS CEASES

622. When are continuing disability reviews conducted?
623. When does disability end?

Parents & Care Givers

Check out our webpage on getting your own private disability coverage, in addition to Social Security Disability or SDI State Disability Coverage

 

FAQ's 

 

 

What Parents Need to Know about #Special Needs Trusts

 

Trans America
Special Needs Trust Brochure

Special Needs Trust Brochure

#Nolo Special Needs Trusts

Nolo Special Needs Trust

 

  • FAQ's
  •  
  • When does the trust actually get funded, go into place, become effective?
    • See page 47 of Nolo's book on Special Needs Trusts - The best known way is to specify what assets go into the trust at your demise. Be careful of probate, page 48. See Revocable Living Trusts on Page 50. Where a living trust can fund a Special Needs trust at your passing. See page 140 about actually creating the Special Needs Trust
      • See chapter 2 for what payments and benefits the child can get

DI 10115.000

Childhood Disability Benefits (CDB)

Subchapter Table of Contents
Section  
DI 10115.001 Requirements for Entitlement to Childhood Disability Benefits (CDB)
DI 10115.005 Eligibility for Child’s Benefits Based on Disability
DI 10115.010 Other Childhood Disability Benefits (CDB) Factors of Entitlement
DI 10115.015 Hospital Insurance (HI) Based on Childhood Disability Benefit (CDB) Entitlement
DI 10115.020 Application Forms for Childhood Disability Benefit (CDB)
DI 10115.022 Work Activity and Childhood Disability Benefit (CDB) Entitlement
DI 10115.025 Childhood Disability Benefit (CDB) First Month of Entitlement (MOET)
DI 10115.030 Retroactivity and Childhood Disability Benefit (CDB)
DI 10115.035 Requirements for Reentitlement
DI 10115.040 Childhood Disability Benefit (CDB) Reentitlement & Trial Work Period (TWP) Issues
DI 10115.045 Summary of Evidence and Forms Required for Reentitlement Based on a Disability Which Began After Age 18
DI 10115.050 Termination of Childhood Disability Benefit (CDB) Entitlement
 

View prior versions and HISTORICAL of this page on Archive.org 

Related pages in  SSI – Supplemental Security Benefits Section

[child-pages]
[sibling-pages]

Social Security – Retirement Benefits

  • How are Social Security retirement benefits taxed?
    • How are Social Security Benefits reduced if you are working?
    • Optimum Age to start taking benefits 62 – 70?
      • CPA take on Retirement
  • Survivor – Death Benefits

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