Disability Terms and Definitions

Windfall Offset A provision to prevent a person from receiving monthly SSI and OASDI benefits in excess of the total amount which would have been paid if the OASDI benefits had been paid when they were due rather than retroactively. Vocational Rehabilitation Services Those services identified in Rehabilitation Act of 1973, as amended, which are provided in an individualized plan for employment necessary to assist an individual with a disability in preparing for, securing, retaining, or regaining an employment outcome that is consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individual. Substantial Gainful Activity (SGA) The level of work activity used to establish disability. A finding of disability requires that a person be unable to engage in SGA. Licensed Clinical Social Worker (LCSW) Certification by a state as a licensed clinical social worker. Such licensure often requires at least two years experience with a direct client caseload under supervision. Deeming The process by which the income and resources of an ineligible individual are considered to be available to a recipient when determining eligibility or payment amount. DHO Disability Hearing Officer. Conducts in person hearings. Next appeal is to a federal Administrative Law Judge (ALJ). ADA Title I: Employment Title I requires employers with 15 or more employees to provide qualified individuals with disabilities an equal opportunity to benefit from the full range of employment-related opportunities available to others. Supplemental Security Income (SSI): A cash benefit authorized by Title 16 of the federal Social Security Act. Eligibility and benefits are administered by the federal Social Security Administration at field offices throughout each state. Conversion Privilege If included, this option allows employees who are terminating employment to continue some or all of their LTD coverage at their own expense without submitting evidence of insurability. Optional Supplementation The payments made by States to help persons meet needs not fully covered by Federal SSI benefits. The State determines whether it will make a payment, to whom, and in what amount.

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	Did You Know?
	SHMO means Social Health Maintenance Organization A managed system of health and long-term care services geared toward an elderly client population. Under this model, a single provider entity assumes responsibility for a full range of acute inpatient, ambulatory, rehabilitative, extended home health and personal care services under a fixed budget which is determined prospectively. Elderly people who reside in the target service area are voluntarily enrolled. Once enrolled, individuals are obligated to receive all SHMO covered services through SHMO providers, similar to the operation of a medical model health maintenance organization (HMO).