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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 January 2021 Subchapter Subject Page ending with Page M0320.000 AGED, BLIND & DISABLED GROUPS M0320.207 22

B. Nonfinancial Eligibility Requirements To be eligible in this protected covered group, the protected SSI disabled child must • have had his/her SSI canceled solely because he/she does not meet

the SSI definition of childhood disability (revised per section 211(a)

of the Personal Responsibility and Work Opportunity Act of 1996);

• continue to meet the SSI childhood disability definition and regulations that were in effect prior to the effective date of the

change in the disability definition (August 22, 1996); and • be under age 18 years. Note: All affected children are now over age 18 years. 1. Disability Determination Referral to Disability Determination Services (DDS) An SSI disabled child is presumed to meet the childhood disability definition in effect prior to August 22, 1996, until he/she reaches age 18 years, unless there is an improvement in the child’s condition. If the child’s condition improves, complete • DDS Referral Form, available on SPARK at https://fusion.dss.virginia.gov/bp/BP-Home/Medical- Assistance/Forms

• the Disability Report Child (SSA-3820-BK), available at http://www.socialsecurity.gov/online/ssa-3820.pdf and • a minimum of 3 signed, original Authorization to Disclose Information to the Social Security Administration forms (SSA-827), available at http://www.socialsecurity.gov/online/ssa-827.pdf or a form for each medical provider if more than 3. “General Authorization for Medical Information” (form #032-03-311) for each medical practitioner reported by the individual on the report. Send the report(s) and authorization forms to the DDS. 2. DDS Decision If the DDS decides that the child continues to meet the childhood disability definition in effect prior to August 22, 1996, the child continues eligible in the protected group of SSI disabled children, provided the child meets the financial eligibility requirements in item C. below. If the DDS decides that the child no longer meets the childhood disability definition in effect prior to August 22, 1996, the child no longer meets the protected group of SSI disabled children. Determine the child’s eligibility in another covered group. If the child is not eligible in any covered group, send an advance notice to the authorized representative and take action to cancel the child’s Medicaid coverage.

C. Financial Eligibility Procedures

1. Assistance Unit Follow the policy and procedures in M0530.