Michigan State Disability Assistance (SDA) Program Structure, Benefits, and Eligibility

Category: Government Benefits and Programs

The Michigan State Disability Assistance (SDA) benefit is a state-funded cash assistance and supplemental income program administered by the Michigan Department of Health and Human Services for disabled persons, seniors (aged 65 or older), or caregivers of disabled persons.  Caregivers are typically required to be a live-in family member or paid helper and must not qualify as Home Help agents to be eligible for State Disability Assistance (SDA).

State Disability Assistance (SDA) benefits are dispensed on a semi-monthly (bi-weekly) basis but may also be paid in addition to federal disability benefits such as Retirement, Survivors, and Disability Insurance (RSDI) and Supplemental Security Income (SSI).

​As a supplemental income benefit to federal disability, payments are made four (4) times per year in March, June, September, and December.  The current benefit amount for individual cash assistance recipients is $246.00 per month.  States may reduce benefit levels based on budgetary restraints

State Disability Assistance and SSI Recipients
The State of Michigan opted-in to implement a Mandatory Minimum Supplementation (Michigan Compiled Laws, Chapter 400, Act 280 – Amended by Section 400-10) as a result of the Social Security Amendment of 1972.

​The Mandatory Minimum Supplementation is an optional state payment to recipients of the Supplemental Security Income (SSI) federal disability program who live independently or in the household of another to help maintain basic income levels.

Basic income levels as defined by the state’s own minimum standard of living (also known as a “needs standard”) establishes an applicant’s financial need, eligibility, and benefit amount.  Individuals whose income fall below the state’s “needs standard” as a measure of poverty, and meet other specified requirements are eligible for State Disability Assistance (SDA) supplemental benefits.
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The Social Security Amendments Act of 1972 which established the Supplemental Security Income (SSI) program in January 1974 authorized state payments as a supplement to the basic federal Supplemental Security Income (SSI) payment to needy aged, blind, and disabled persons.  That is, the benefit is payable to all SSI recipients, including children, except those living non-Medicaid certified medical facilities.

It also set forth a provision for a state payment in the form of State Disability Assistance (SDA) which replaced the federal Grants-in-Aid program to former public assistance recipients (if needed to maintain the earlier income level); and, an optional provision to newly eligible persons who were transferred to the federal SSI benefit.

In sum, SSI Recipients are eligible for the State Disability Assistance (SDA) supplement if the "needs standard" of the respective state indicates that their needs are greater than their Supplemental Security Income (SSI) payment plus other countable income.

Federal Supplemental Security Income (SSI) regulations apply to income and asset exclusions and limitations apply to the State Disability Assistance (SDA) supplemental benefit.

Table 1.
Optional state supplementation payment levels, effective January 2011 (in dollars).
(Source: Social Security Administration, Office of Income Security Programs, State Information)
The state supplementation payment is added to the federal payment.  Countable income is deducted first from the federal payment.  Any income that remains to be counted after the federal payment has been reduced to zero is then deducted from the state supplementary payment (SSA, 2011).

Combined Federal and State

State Supplementation Benefit Amount

Living Arrangement	State Code	Individual	Couple	Individual	Couple
Living Independently	-	688.00	1039.00	14.00	28.00
Living in the household of another	-	458.67	692.66	9.33	18.66
​Domicilliary care	D	​761.00	​1522.00	87.00	511.00
​Personal care facility	E	​831.50	​1663.00	157.50	652.00
​Home for the aged	F	​853.30	​1706.60	179.30	695.60
Living independently with an essential person	G	​1026.00	​1370.00	14.00	21.00
​Living in the household of another with an essential person	H	​684.00	​913.34	9.33	14.00
​Medicaid facility	I	37.00	​74.00	7.00	14.00

DEFINITIONS:
Living independently.
Includes all eligible recipients who are not included in any other state living arrangement, recipients residing in facilities where Medicaid is not paying more than 50 percent of the cost of care, and recipients residing in publicly operated emergency shelters throughout a month.

Living in the household of another.
Includes recipients with no essential person who are residing in a federal Code B living arrangement.

D: Domiciliary care.
Includes recipients residing in licensed nonmedical facilities that provide room, board, and supervision. The state certifies which recipients are residents requiring this level of care.

E: Personal care facility.
Includes recipients residing in licensed nonmedical facilities that provide general supervision, physical care, and assistance in carrying out the basic activities of daily living. The state certifies which recipients are residents requiring this level of care.

F: Home for the aged.
Includes recipients residing in nonmedical facilities for the aged. The state certifies which recipients are residents requiring this level of care. Such care situations include, but are not limited to, licensed homes for the aged.

G: Living independently with an essential person.
Includes recipients with an essential person who are not living in the household of another. Children under age 18 are excluded. Payment levels for essential person apply only to cases converted from the state rolls in 1974.

H: Living in the household of another with an essential person.
Includes recipients converted from the 1973 state rolls who reside in another's household and it is determined that they need assistance from someone considered essential to their well-being. There are no longer any recipients receiving payments for living in the household of another with an essential person.

​I: Medicaid facility.
Includes recipients residing in a federal Code D living arrangement.

State Disability Assistance (SDA) as an Interim Benefit
State Disability Assistance (SDA) is also an available benefit to eligible claimants while federal disability claims are pending for initial approval or appeal.  In most cases, approval for federal disability benefits is a long, complicated process causing applicants to experience financial hardship in addition to their medical crisis.  This state-administered general assistance (GA) benefit may provide some relief.

State Disability Assistance (SDA) is available to SSI and SSDI applicants based on similar medically-determinable and income/asset criteria.  Claimants who apply for State Disability Assistance (SDA) will be required to file a claim for federal disability benefits and may be required to reimburse the state once the claim has been approved.

Federal Disability Claims Processing Procedures (SSDI and SSI)
It is important to know some general information about program structures and claim processing procedures for all disability claims before applying for State Disability Assistance (SDA).  Claimants who apply for State Disability Assistance (SDA) should have a basic understanding of eligibility guidelines while waiting on approval or as a supplement to federal disability benefits to assess their ability to qualify for State Disability Assistance (SDA).

The first step is to know the federal definition of “disability” before making a claim for benefits.
According to the Social Security Administration, the law defines disability as “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve (12) months.”

When an individual applies for disability the claim is processed by a local Social Security Administration (SSA) field office.  The field office verifies non-medical eligibility requirements including age, marital status, employment, citizenship and residency, and Social Security coverage information.  For SSI, the field office verifies income, resources, and living arrangement information.  The completed application and related forms are forwarded to the Disability Determination Service (DDS) to establish eligibility for benefits.

The Michigan Disability Determination Service (DDS) is a federally-funded state agency that determines the initial and continuing eligibility for benefits for the following programs:

• Social Security Disability Insurance (SSDI)
• Supplemental Security Income (SSI)
• Medicaid Assistance (MA)
• State Disability Assistance (SDA)
• The Office of Retirement Services (ORS) disability retirement program

The Office of Retirement Services (ORS) serves all State of Michigan employees including state police, judges, and public school employees covered under state employee retirement programs.  Claims for retirement benefits are initially processed by the Michigan Disability Determination Service (DDS) where medical evidence is reviewed, and recommendations are made to the Office of Retirement Services (ORS).

The Michigan Disability Determination Service (DDS) began processing all disability claims received from county offices (e.g. local Department of Health and Human Service and Social Security offices), effective July 1, 2015.

Upon receipt of the claim, the case is assigned to a medical examiner and the process of case development begins.  That is, medical evidence is developed to make the initial determination about whether the claimant is blind or disabled under the law.

Medical evidence is developed in several ways:

1. The Michigan Disability Determination Service (DDS) obtains evidence from the claimant’s medical sources (ordering clinical records from treating health care professionals and hospitals listed on the application).
2. If clinical information is unavailable or insufficient to make a determination, a consultative examination (CE) may be arranged for the claimant to be examined by an independent medical provider.
3. Additional information is requested from the claimant’s medical sources as required by the DDS adjudicative team.

Medical evidence is developed (collected) to give rise or substantiate the disability claim.  After case development is completed, an adjudicative team consisting of medical or mental health consultants and the disability examiner in the Michigan Disability Determination Service (DDS) makes the eligibility determination.  Approved claimants are referred to a State vocational rehabilitation agency such as Michigan Rehabilitation Services (MRS) where appropriate.

The case is forwarded back to the appropriate Social Security Administration (SSA) field office.  Approved claims are processed to complete non-medical development, compute benefit amounts, and begin paying benefits.  Denied claims are retained in the field office in case of appeal.  Claimants have twelve (12) months from the date of filing to make an initial appeal.

Appeals and unfavorable determinations are handled by the Michigan Disability Determination Service (DDS).  Requests for a redetermination hearing after an appeal is denied is handled by an administrative law judge (ALJ) in the SSA Office of Hearing Operations (OHO).  Claimants may submit additional information not provided in the original filing or appeal to the administrative law judge (ALJ).  A decision will be made based on the evidence of record and new evidence presented at the hearing.

If additional information is needed by the administrative law judge (ALJ), the hearing office will coordinate evidence with the Disability Determination Service (DDS) or contact medical sources directly.  An administrative law judge (ALJ) may issue subpoenas requiring production of evidence during the discovery process or testimony at a hearing.

How long does it take to get disability In Michigan?
Claims processing guidelines established the Standard of Promptness (SOP) rule which requires up to a ninety (90) day eligibility determination for State Disability Assistance (SDA) claims and twelve (12) months for all other state disability claims.

Social Security Disability Insurance (SSDI)

• Claimants must be incapacitated (unable to work) for one (1) year due to a serious mental or physical disability to be eligible for benefits.
• Claimants and their employers must have paid Social Security taxes for an adequate number of fiscal quarters prior to the onset of disability.
• Benefits are paid to insured claimants who are determined to be disabled due to illness or injury that is expected to last a minimum of twelve (12) consecutive months or that is expected to end in death.  You are an insured claimant if you worked long enough (accumulated a specified amount of work credits that equate to a minimum of seven (7) consecutive years of employment) and paid into the Social Security trust fund through employment taxes.
• Certain disabled dependents of insured claimants are also eligible for SSDI benefits.  See the Death & Burial section for more information on Social Security Death Benefits.
• Claimants must be severely disabled to meet eligibility criteria.
• Claimants are not subject to means-testing (income and asset requirements).

Supplemental Security Income (SSI)

• Claimants are subject to means-testing (income and asset requirements) as SSI benefits is a needs-based program.
• Claimants are not required to have participated in the workforce (no previous employment requirement).
• Claimants must be incapacitated (unable to work) due to a serious mental or physical disability that is expected to last a minimum of twelve (12) consecutive months or expected to end in death to be eligible for benefits.
• Benefits are payable to indigent (low-income or no income and limited resources) disabled adults and children (under age 18) with mental and/or physical impairments causing marked or severe functional limitations.  Disability in children must also be expected to last at least twelve (12) months or end in death.
• Claimants who are approved for SSI benefits automatically qualify for Medicaid and Supplemental Nutrition Assistance Program (SNAP) benefits.  Approved SSI recipients may apply for a Bridge Card through the Michigan Combined Application Program (MICAP).  A link is provided below.

If your application for SSI or SSDI has recently been denied, the online appeal request is a starting point to request a review of the decision about your eligibility for disability benefits.
If your application is denied for:

• Medical reasons, you can complete and submit the required Appeal Request and Appeal Disability Report online.  The disability report asks you for updated information about your medical condition and any treatment, tests or doctor visits since the decision was made. A link is provided below.
• Non-medical reasons, you should contact a local Social Security Office to request the review. You also may call toll-free at: 1-800-772-1213, to request an appeal.  People who are deaf or hard of hearing can call toll-free TTY at: 1-800-325-0778.

State Disability Assistance (SDA) Medical and Vocational Requirements
The State Disability Assistance (SDA) and Medicaid (MA) programs have the same medical and vocational eligibility criteria.  It is possible to receive State Disability Assistance (SDA), however, and not be eligible for Medicaid (MA).

A claimant’s disability (mental or physical impairment) must be medically-determinable.  That is, medical evidence must establish the anatomical, physiological, or psychological abnormalities through clinical diagnosis, laboratory imaging techniques (e.g. CT Scans, MRI), and medical documentation.  Statements about mental and physical symptoms are insufficient.

Medical Criteria

• The Social Security Law has a list of impairments and a description of the evidence needed to evaluate the disability.
• Benefits are payable when the claimant’s impairments meet or equal the listed body system and medical evidence criteria.

What is considered a disability in Michigan?
Body systems indicated in the Social Security Administration's Listing of Impairments are subject to revision and promulgation and must be extended by the Commissioner or may no longer be eligible after effective dates.  A link is provided below to the official listing, effective dates, and required evidence per each impairment.

Social Security Law and Regulations Listing of Impairments
Criteria applicable to claimants age 18 or over and children under age 18 where appropriate:

• Low birth rate and failure to thrive
• Musculoskeletal system
• Special senses and speech
• Respiratory disorders
• Cardiovascular system
• Digestive system
• Genitourinary disorders
• Hematological disorders
• Skin disorders
• Endocrine disorders
• Congenital disorders that affect multiple body systems
• Neurological disorders
• Mental disorders
• Cancer (Malignant Neoplastic Diseases)
• Immune System disorders

Vocational Criteria

• The Social Security Law contains vocational criteria contained in cases in which the claimant’s impairment fails to meet or equal the medical criteria, but the mental or physical capacity to perform basic work-related activities is limited.
• The remaining or equal capacity to perform work is assessed along with age, education, and past work experience to determine eligibility for disability benefits.

Funding for State and Federal Disability Claims
Social Security Disability Insurance (SSDI) is 100% federally-financed through Title II funds as required by the Social Security Act of 1935.  SSDI benefits are not appropriated in state budgets.  Recipients who qualify meet the minimum work requirements and have paid into the trust fund through employer Social Security tax known as the Federal Insurance Contributions Act (FICA).

Supplemental Security Income (SSI) is a federal income supplement program for indigent aged, blind, and mentally or physically disabled to provide for their basic needs.  The flat-grant (set monthly benefit) approach is designed to meet the minimum needs of eligible recipients.  Benefits are financed through general tax revenues as required by the Title XVI section of the Social Security Act of 1935.

State Disability Assistance (SDA) is 100% state-funded per each fiscal year, through the Department of Health and Human Services (DHHS) Annual Appropriations, “boilerplate” language.  The current allocation is set forth in DHHS FY2015, 2014 Public Act 84, Article X.

State Disability Assistance (SDA) Eligibility Requirements
To qualify for State Disability Assistance (SDA) claimants must meet the following criteria:

• The claimant must receive other disability-related benefits (i.e. Retirement, Survivor’s, and Disability Insurance (RSDI), Supplemental Security Income (SSI), or Medicaid (based on a disability or blindness).
• The claimant must reside in a qualified special care facility such as a Home for the Aged, County Infirmary, Adult Foster Care Home or Substance Abuse Treatment Facility.
• The claimant must receive or is qualified for services through the Michigan Commission for the Blind, Michigan Rehabilitative Services (MRS), or is eligible for special education services such as the Individualized Education Program (IEP).
• The claimant is certified by a MDHHS Family Independence Specialist as unable to work due to mental or physical disability that is expected to last at least 90 days from the onset of the disability.  In order to receive a medical certification of disability from a MDHHS specialist/examiner, you must submit medical evidence of your disability from an authorized healthcare provider for review.
• The claimant has a Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) case pending approval.  If not, you are required to file a disability claim with the Social Security Administration while receiving State Disability Assistance (SDA) benefits.
• Claimants must be a parent/caregiver of a minor disabled child. (Parents/caregivers of minor disabled children do not qualify as Home Help providers.
• Claimants must be terminated from the Family Independence Program (FIP) cash assistance benefits due to lifetime limits.

​State Disability Assistance (SDA) Income and Assets Test
The State Disability Assistance (SDA) benefit is a means-tested program.  That is, it is need-based in addition to the basic criteria of having a disability.  Therefore, earned and other sources of income and countable assets will be considered in determining eligibility and benefit limits.  Gross income includes monies earned in the labor market (job employment), self-employment, and other sources of income (i.e. child support, rental payments, disability payments, or unemployment insurance).  Having these forms of income does not necessarily disqualify you for State Disability Assistance (SDA) benefits but may reduce the amount of benefits you receive.

When calculating assets, claimants should also distinguish between real property and personal property.  Real property includes real estate such as your homestead (property you own and occupy), rental property, or land and anything permanently attached to it.  Personal property includes retirement accounts (i.e. IRAs), investments, or life insurance policies.

To qualify for State Disability Assistance (SDA) personal property assets must meet the $3000 asset threshold.  As a note, real property assets cannot exceed $250,000 in value for any other “cash assistance” program administered by MDHHS.  However, certain assets are omitted from the State Disability Assistance (SDA) eligibility requirement.
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Please use this information as a guide to how you may qualify for the Michigan State Disability Assistance (SDA) program but only a MDHHS Medical Examiner or Benefits Specialist can accurately determine eligibility for SDA benefits.

​Disability Determination
You are considered disabled and eligible for State Disability Assistance (SDA) if:

• You receive disability-related benefits.
• You reside in a Special Arrangement Facility.

You obtain certification from MDHHS medical consultants deeming you unable to work due to a mental or physical disability for at least ninety (90) days.

Asset Limits
The cash asset limit is $3000.  Assets are cash and any other property you own.  A homestead and a personal vehicle are not counted as assets for State Disability Assistance (SDA).

Cash Assets include:

• Cash-on-hand
• Bank and credit union accounts
• Investments
• Retirement Plans
• Trusts

Income
Most earned and unearned income is counted.  Income is considered when determining the amount of SDA you are eligible to receive.

Examples of countable income are:

• Wages
• Self-employment income
• Rental income
• Social Security benefits
• Veteran's benefits

Residency Requirements
The following residency requirements apply:

• Must be a U.S. citizen or legal alien.
• Must reside in Michigan.
• Must not be receiving cash assistance from another state.

Helpful Supplies and Equipment for Caregivers

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State Disability Assistance (SDA) Application Process
You may apply for State Disability Assistance on the MI Bridges website or in person at a local Department of Human Services (DHS) office in your area.  Allow sixty (60) to process the application.  It is recommended that applicants print and complete the application form and return it to a DHS Benefit Specialist who can expedite the process.  A link is provided below to MDHHS Applications, Forms, and Publications.
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Rights and Responsibilities
The Michigan Department of Health and Human Services (MDHHS) rules and regulations for income reporting including changes in income, employment, and disability status apply.  State Disability Assistance (SDA) benefits may be required in the Total Household Resources for the Michigan Homestead Property and Home Heating Tax Credits.
 
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​Related Posts:
Death and Burial – Social Security Death Benefits
http://www.canmichigan.com/death-and-burial.html
Disability Resources
http://www.canmichigan.com/disability-resources-michigan.html
 
Links:
State Disability Assistance
https://www.michigan.gov/mdhhs/0,5885,7-339-71547_5526_7766---,00.html   
Cash Assistance Application Process
https://www.michigan.gov/mdhhs/0,5885,7-339-71547_5526_7028---,00.html
Do You Qualify for Michigan State Disability Benefits?
https://www.babutlawssd.com/Articles/Do-you-qualify-for-Michigan-State-Disability-Assistance-benefits.shtml
MDHHS Applications, Forms, and Publications
https://www.michigan.gov/mdhhs/0,5885,7-339-71551_7338---,00.html
MI Bridges
https://www.mibridges.michigan.gov/access/
Michigan Combined Application Program (MICAP)
https://www.michigan.gov/mdhhs/0,5885,7-339-71547_7774-213851--,00.html
State Assistance Programs for SSI Recipients
https://www.ssa.gov/policy/docs/progdesc/ssi_st_asst/2011/mi.html​

Disability Resource Links:
Social Security Disability Evaluation – General Rules
https://www.ssa.gov/disability/professionals/bluebook/general-info.htm
Disability Evaluation Under Social Security
https://www.ssa.gov/disability/professionals/bluebook/evidentiary.htm
Code of Federal Regulations – Listing of Impairments
https://www.ssa.gov/OP_Home/cfr20/404/404-app-p01.htm
Social Security Benefits for People with Disabilities
https://www.ssa.gov/disability/
Benefits Eligibility Screening Tool
https://ssabest.benefits.gov/
Online Appeal Request and Appeal Disability Report
https://secure.ssa.gov/iApplsRe/start
Michigan Rehabilitation Services (MRS)
https://www.michigan.gov/mdhhs/0,5885,7-339-73971_25392---,00.html