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State of Wisconsin |
HISTORY |
The policy on this page is from a previous version of the handbook.
DDB will attempt to process the disability determination within 90 days of the date it receives the signed application. If the DDB determines that the application needs to be Medically Deffered because the extent of an impairment will not be known until several months after its onset, DDB will notify the applicant in writing that additional evaluation time is necessary.
A DDB disability decision on a SSDI or SSI case generally has binding authority. A Medicare, SSI or SSDI disability certification notice is acceptable verification of disability.
To check on the status of a disability case, call (608) 266-1565 and DDB will connect you with the examiner assigned to the case. Direct procedural or policy questions to Cassandra Quinn at 608-266-8730.
The DDB does not notify the claimant of allowance determination made by DDB.
Claims in the CARES system: For claimants found disabled, DDB will send all the evidence and a completed SSA-831 (Determination of Disability form) to the CARES system. The paper file at DDB will be destroyed after it is confirmed that the information is in CARES.
Claims NOT in CARES (paper claims): For claimants found disabled, DDB will send the paper file with all the evidence and SSA-831 to the IM Agency for storage for future use in the Redetermination Process.
Item 17 on the SSA -831 form indicates whether or not medical re-examination is required for recipients not on SSI or SSDI. A re-examination is required on all allowance cases. A date on the box to the right of item 17, "Diary Type," tells you when DDB wants to review the case again. You may also find it in CARES on the Disability page under Disability Dates. When the Diary Date is earlier than the current date, refer to the instructions that follow under Section 5.7 Redetermination.
Persons found not disabled will be sent a notice by DDB along with forms to apply for a Reconsideration/Hearing. The paper files on denied cases will be kept at DDB waiting for the appeal application.
Claims in the CARES system: DDB will send all the evidence and a completed SSA-831 electronically to the CARES system. The paper folder will be kept at DDB for 60 and then destroyed if an appeal application is not received.
Claims NOT in the CARES system (paper claims): The paper folder will be kept at DDB for 60 and then destroyed if an appeal application is not received.
This page last updated in Release Number: 15-01
Release Date: 06/10/2015
Effective Date: 06/10/2015
The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.
Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.
Publication Number: P-10030