Which medical conditions are recognized as disabilities for ABAWD exemptions?
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Executive summary
Federal SNAP rules exempt certain medical and disability-related situations from the ABAWD (able-bodied adults without dependents) time limit: people who receive disability benefits, those with a physical or mental health condition that prevents working 20 hours/week, and caregivers for disabled persons are explicitly listed by state agencies referencing new federal guidance [1] [2]. USDA/FNS has updated ABAWD exception criteria under the 2024–2025 regulatory changes and the One Big Beautiful Bill Act of 2025, and states are implementing screening and verification procedures for medical exemptions [3] [2].
1. What federal guidance now recognizes as “medical” or disability exemptions
USDA/FNS revised the ABAWD exception criteria in rules and guidance tied to the Fiscal Responsibility Act of 2023 and subsequent 2024–2025 rulemaking; that federal package clarifies which health-related circumstances qualify someone for an ABAWD exemption and tightens verification procedures [2] [3]. The reforms explicitly treat individuals “receiving disability benefits” and those with a physical or mental health condition that affects ability to work 20 hours per week as exempt from the ABAWD time limit, per states’ summaries of the new federal standards [2] [1].
2. How states describe the medical/disability categories in practice
State SNAP pages translate the federal rule into operational categories. North Carolina’s guidance lists being “pregnant, receive disability benefits, [or having] a physical or mental health condition that affects your ability to work at least 20 hours per week” as grounds for exemption [1]. Illinois guidance similarly explains that a medical SNAP Work Requirement exemption can be verified by a healthcare professional’s written statement or collateral contact, showing states expect clinical documentation to support exemptions [4].
3. Specific groups called out by federal/state materials
Beyond general “disability” language, implementation documents and change memos list several related categories: persons receiving disability benefits, those who meet criteria for “Disabled Specified Person,” people responsible for care of an incapacitated person, and other narrowly defined groups such as American Indians under the Indian Health Care Improvement Act in certain contexts [2]. These items appear in the federal/state rollout materials that states cite when screening for exemptions [2] [1].
4. Verification: medical statements and proof requirements
State materials indicate medical exemptions will typically require verification: a healthcare professional’s written statement, collateral contact, or other medical verification methods [4]. USDA’s rulemaking updated verification procedures and screening protocols, and states are already instructing caseworkers to document actions and apply exemptions once verifiable evidence is received [2] [4].
5. What sources do not list (limits of available reporting)
Available sources do not provide a single, exhaustive federal list of every named medical condition that automatically qualifies for exemption; rather, they define functional criteria (e.g., unable to work 20 hours/week) and categories like “receiving disability benefits” or “Disabled Specified Person” [2] [1]. Detailed condition-by-condition lists are not present in the quoted state pages or the FNS waiver/implementation summaries provided [3] [2].
6. Practical implications for applicants and workers
States warn that screening will intensify after waiver periods end; many states restarted ABAWD reviews in late 2025 and expect to apply the new exception criteria at recertification or renewal [5] [4]. That means people with medical issues must be prepared to submit documentation promptly for their exemption to be applied before a “countable” month is assigned [4] [5].
7. Competing perspectives and potential administrative friction
Advocates and state materials emphasize exemptions for those clearly unable to meet hours due to disability or caregiving obligations [1] [2]. At the same time, the federal rules tighten verification and raise administrative burdens on states and recipients—risking delays or disputed denials if medical proof is incomplete [2] [4]. This creates a tension between preventing inappropriate exemptions and avoiding unnecessary loss of benefits for medically vulnerable people [2] [1].
8. Bottom line for someone asking “which medical conditions count?”
No single condition list appears in the materials provided; exemptions are defined by status (receiving disability benefits), functional inability to work 20 hours/week because of a physical or mental condition, caregiving responsibilities for an incapacitated person, and related regulatory categories like “Disabled Specified Person” [2] [1]. For a definitive determination in any individual case, states instruct applicants to rely on clinical documentation and their local SNAP office’s screening process [4] [1].
Limitations: this review uses state and USDA implementation pages and memos in the provided search set; those documents outline categories and verification procedures but do not publish an exhaustive, condition-by-condition federal list [3] [2].