What is the Social Security DAC – Disabled Adult Child Program?
Can you keep Medi-Cal?

Caretakers & Parents

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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

Caretakers & Parents

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#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. 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.

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

 Pickle Amendment Screening Questions?

 

Resources & Links 

 

DAC #Retirement – Survivor Benefits

Who can get survivors benefits based on a spouses or parents work records?

Children can get benefits at any age if they were disabled before age 22. Publication 10084

Adults Disabled Before Age 22

An adult disabled before age 22 may be eligible for child’s benefits if a parent is deceased or starts receiving retirement or disability benefits. We consider this a “child’s” benefit because it is paid on a parent’s Social Security earnings record.

The “adult child”—including an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild—must be unmarried, age 18 or older, have a disability that started before age 22, and meet the definition of disability for adults.

Example: A worker starts collecting Social Security retirement benefits at age 62. He has a 38-year old son who has had cerebral palsy since birth. The son will start collecting a disabled “child’s” benefit on his father’s Social Security record.

It is not necessary that the adult child ever worked. Benefits are paid based on the parent’s earnings record.

  • An adult child must not have substantial earnings. The amount of earnings we consider “substantial” increases each year. In 2020, this means working and earning more than $1,260 a month.
Certain expenses the adult child incurs in order to work may be excluded from these earnings. For more information about work and disability, refer to Working While Disabled: How We Can Help.

What if the adult child is already receiving SSI benefits or disability benefits on his or her own record?

An adult child already receiving SSI benefits or disability benefits on his or her own record should still check to see if benefits may be payable on a parent’s earnings record. Higher benefits might be payable and entitlement to Medicare may be possible.

How do we decide if an adult “child” is disabled for SSDI benefits?

If a child is age 18 or older, we will evaluate his or her disability the same way we would evaluate the disability for any adult. We send the application to the Disability Determination Services in your state that completes the disability decision for us. ssa.gov 

Applying for SSI payments or SSDI benefits and how you can help

You can apply for SSI payments or SSDI benefits for your child by calling Social Security toll-free at 1-800-772-1213 or by visiting your local Social Security office. Nolo.comPublication 10026

Links & Resources

Adult Disability Report

disability secrets.com  

disability-benefits-help.org/adult-child  

Insure Buy International Medical Coverage

InsuBuy International Medical Coverage – Instant Quotes & Enrollment

#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

 

 

Supplemental Security Income (SSI) Basics.

webcast— download the slides here, read the Chapter Summary here, or view the recording here.

Here are additional NCLER resources that you may find helpful:

You can find additional training materials on the NCLER Website.

#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. What does “work that exists in the national economy” mean?
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

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 & CareGivers

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

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Life Insurance Buyers Guide

NAIC Life Insurance Buyers Guide

How much  life insurance you really need?

Video Insurance Unnecessary Cost?

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
 

17 comments on “DAC Disabled Adult Child – Keep Medi Cal – Retirement

  1. Hello, I am 25, I live in San Francisco CA, and as of July 2020, I already was awarded SSI.

    However, I found out I was potentially eligible for Disabled Adult Child DAC, as I have no work history besides 2 weeks spent working at a Dunkin Donuts at age 19, and have been disabled well before 22 years of age.

    The current 2 disabilities I have that have made me eligible for SSI I have had since I was 12 and 17 years old, and my mom has been getting retirement benefits from the SSA for 4 years, and my dad has been receiving retirement benefits from the SSA for well over a year now, before I even turned in my application for SSI Supplemental Security Income that has since been approved.

    However, when I first moved to San Francisco in 2018, I was told my father could no longer claim me as a dependent if I wanted to receive EBT or General Assistance Cash benefits, since I now receive SSI,

    I don’t get any cash benefits and only receive $16 in EBT.

    In order to apply for DAC, will my father have to claim me as a dependent again?

    Do you know more about the DAC application process?

    The SSA told me it must be done over the phone. Is that true?

    I was wondering what this means, I found it on another website,

    “The Social Security Administration (SSA) will calculate the child’s benefit by looking at the disabled parent’s average indexed monthly earnings (AIME) and primary insurance amount (PIA) to come up with the amount of the child’s monthly benefit check, and then reduce it if the sum of the benefits for the disabled parent, the children, and spouse combined goes over the family maximum.”

    Can you please explain a little better what “Primary insurance amount is,” and what the family maximum is in the state of California, if you know the answer?

    After that, I have one more question I wanted to ask after you’re done answering that question I just mentioned if you can.

    Please and thank you.

    • All the “Google” research I just did, yes it appears that you must call Social Security. Non COVID, you could have visited them in person. See new material above as I did extensive updates to this page to answer your question.

      You might also check with the Attorney’s listed above too.

      • Both my parents receive retirement benefits from the SSA, my mother for 4 years, my dad for over a year, way before the date of my application was even started or turned in

        1. Do DAC and SSDI require separate applications?

        I was already approved for SSI, but when I applied for SSI, I had a social worker help me, she filled out the application for me and claimed it was an application for both SSI and SSDI.

        She never gave me the chance to review the application before she sent it, I was only just recently able to get it. She knew I’ve had Major Depression since I was 12, and PTSD since I was 17, and knew my parents were in their 60’s.

        So when I found out I was eligible for DAC, I was very upset to see that she left the page blank that asks for my parents social security numbers, and left most of the page blank.

        She answered only one of the questions on the page, meaning she saw the page. But she responded to none of the questions on the page related to DAC and never asked me nor my parents for their SSN’s, despite me having given her a release to speak to them.

        She also claimed I took benzos recreationally when I told her I had been prescribed them, not that I had been taking them recreationally.

        2. Is DAC a type of SSDI?

        3. What are the limits for resources and income not including my SSI in California?

        4. What are the limits for resources and income with DAC in California?

        5. Is it true I can’t get married, unless I want to marry someone who also gets disability if I’m awarded DAC and want to keep it?

        6. Is it true if I still want MediCal on DAC, Id need to continue to abide by SSI rules?

        7. How can I get someone to help me apply for DAC without a similar incident happening like the one I had with the social worker?

        8. Do my parents need to claim me as a dependent for me to get DAC?

        9. What is Collateral Estoppel, the Pickle Amendment, SGA, COLA, and what are ABLE accounts? My parents are trying to get a special trust for me. Do you know much about that and how money can be distributed without problems from the SSA?

        10 How do I switch from SSI to SSDI?

        11 Since I didn’t get SSI till age 24, how do I show I was disabled prior to age 22?

        my Major depression and PTSD is what got me awarded SSI, but for whatever reason, Social Security decided that they could only prove the onset of my disability started at the date of turning in my application, despite them having hundreds and hundreds of pages with diagnoses from many different hospitals and doctors going way back into my childhood

        • #3 & # 4 Resource Limits are on this page

          # 7 I’m not sure really where to find help applying for benefits. Check all the links, citations and resources that we have on this DAC page along with the similar pages in this section.

          # 9 Our information on the Pickle Program is on this page above

          # 9 Here’s our webpage on Special Needs Trusts

          # 9 Under the rules of collateral estoppel, Social Security will not again decide an issue we have already decided in a prior determination or decision, unless there are reasons to believe that the prior finding on the issue was wrong. See also How to Get On.com

          # 2 DAC Screening is listed above under the Pickle Program

          # 10 Applying for SSDI when parent dies or retires is explained above in the Retirement – Survivors section. There is a 15 page adult disability report, but Social Security says you have to call or pre COVID visit their office.

          # 5 I guess being married is an issue with what your family income is. See our resources page.

  2. My son receives DAC. He lives in Florida. If he moves to California, will amount of monthly deposit increase due to COLA?

    TY!

    • I don’t know. It’s beyond my expertise.

      https://howtogeton.wordpress.com/how-to-get-adult-disabled-child-benefits/

      The SSA has numerous criteria you will have to meet In order to receive disability benefits. Calculations are estimates and may not be accurate. Actual benefit amounts may vary substantially.

      Social Security Disability Insurance (SSDI)

      Your SSDI benefits are based on the amount of income on which you have paid social security taxes. Your average earnings are called your Average Indexed Monthly Earnings (AIME). Using your AIME, the SSA will calculate your Primary Insurance Amount (PIA). As of 2014, the PIA is calculated by taking 90% of AIME under $816, 32% of AIME between $816 and $4917, and 15% of AIME greater than $4917. The final PIA amount is the maximum amount of SSDI benefits that you are entitled to.

      Try asking one of the attorney’s above or CA Health Care Advocates. Contact Page

  3. My brother now has a part time job.

    How much can he make without losing his benefits.

    Social Services has given me such a run around he has even lost his benefits

  4. Here’s instructions on how to move from SSI to SSDI.

    How do you do on these Pickle Amendment Screening Questions?

    Screening is as follows:

    Step 1. Ask the individual, “Are you now receiving a social security check?” If the answer is no, the individual is not Pickle eligible. If the answer is yes, go on to step 2.

    Step 2. Ask the individual, “After April 1977, did you ever get an SSI check at the same time that you got social security, or did you get SSI in the month just before your social security started?” If the answer is no, the individual is not Pickle eligible. If the answer is yes, go on to step 3.

    Step 3. Ask the individual, “What is the last month in which you received SSI?”

    Step 4. Look up, in the table below, the month in which the individual last received SSI. Find the percentage that applies to that month. Multiply the present amount of the individual’s (and/or spouse’s) social security (OASDI) benefits by the applicable percentage.

    Step 5. You have just calculated the individual’s countable social security income under the Pickle Amendment. Add the figure that you have just calculated to any other countable income the individual may have. If the resulting total is less than the current SSI income criteria in your state, the individual is Pickle eligible, from the standpoint of income, for Medicaid benefits. (The individual must still satisfy separate Medicaid resource and nonfinancial requirements.)

    Example.

    See below where we gave another website visitor the email address for Medi Cal Eligibility. How about emailing them, showing them how it’s done and see what they say?

    If that doesn’t work, try one of the attorneys listed above on our page, or in the citations, in the upper right of where we got our information.

    Try this website too https://specialneedsanswers.com/

  5. I have been disabled since age two, and on SSI and Medi-Cal since eighteen.

    About two years ago I applied for DAC and Medicare followed.

    Then last year I was no longer receiving Medi-Cal.

    According to this information that you have provided and other websites I have read, I never should of been disconnected from Medi-Cal. The SSA and the County of Los Angeles should have my long term records. I filled six forms for Medi-Cal to different SSA and County offices and seem to get nowhere.

    Am I missing a correct office that I should contact?

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