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MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD requested period, unless it is apparent SSA's decision is based on a disability different from that of the Medicaid period. When SSA determines a customer is disabled, use the SSA disability onset/start date as proof of blindness/disability for any months covered by the onset date. If the SSI disability onset date is greater than the SSA application date, deny all months prior to the onset date including months not covered by SSA determination. If the SSI disability onset date is the same as the SSA application date and Medicaid is requested for months prior to the SSI application date request a disability determination by sending a Disability/Incapacity Determination Request Form (3304) to the Division of Health Care Financing and Policy (DHCFP) district office. Health Insurance for Work Advancement (HIWA) Applicants - Prior SSI recipients and/or current or prior Social Security Disability Insurance recipients, whose benefits ended for a reason other than loss of disability, do not need a new disability determination unless SSA’s decision was based on a disability different from what is presented to the Division. If the disability is different or their SSI or RSDI benefits ended for loss of disability, a new disability decision is needed. If a person has never received SSI or RSDI benefits, they must provide a determination or other verification of their disability. Example: Medicaid application date 10/20/2009 with prior medical request for three (3) months. Customer applied for SSI on 10/30/2009. SSI is approved with an onset date of 11/10/2009. 10/2009 and all prior medical months would be denied for no disability and no 3004 would be requested. Example: Medicaid application date 3/20/2010 with prior medical request. Customer applied for SSI 04/10/2010 and is approved with an onset date of 4/01/2010. Approve 4/2010 ongoing and send a 3004 to DHCFP district office for 3/2010 and prior medical months requested. D-340.2 Division of Health Care Finance and Policy (DHCFP) Disability Determination Submit a completed Home and Community Based Services Waiver Eligibility Status Form NMO-3010, completed Incapacity/Disability determination Questionnaire Form, and the release page of the Application for Assistance, directly to DHCFP Central Office at 1100 E. Williams Street, Suite 101, Carson City, NV 89701 requesting a disability decision for the month’s assistance is requested. The Home and Community Based Services Waiver Eligibility Status Form NMO-3010 must include dates of service and provider information. • Examinations will only be required when deemed necessary by DHCFP. Katie Beckett and Nevada’s Medicaid Home and Community Based Waivers needing a DHCFP determination are to be routed to the appropriate DHCFP district office rather than central office. • DHCFP will notify the staff of a disability decision on the Home and Community Based Services Waiver Eligibility Status Form NMO-3010. D-340.1 MAABD APPLICATION PROCESSING Non-Financial Verification Division of Social Services Medical Assistance Manual 14 Aug 25 MTL 11/25