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West Virginia Income Maintenance Manual Chapter 13

West Virginia Income Maintenance Manual Page iii Chapter 13 Determining Disability, Incapacity, and Blindness

13.7.3 ADDITIONAL MEDICAL REPORTS ........................................................................24 13.7.4 FAILURE TO KEEP MEDICAL APPOINTMENTS ...................................................24 13.7.4.A Initial Medical Examination ...............................................................................25 13.7.4.B Appointments for Medical Examinations Requested by the MRT ......................25

REFERRAL TO THE MEDICAL REVIEW TEAM (MRT) ............................................26 13.8.1 THE MEDICAL REVIEW TEAM (MRT)....................................................................26 13.8.1.A MRT Composition.............................................................................................26 13.8.1.B MRT Responsibilities ........................................................................................26 13.8.2 THE MRT REFERRAL AND THE FFM ....................................................................27 13.8.2.A Content and Organization of Material Submitted ..............................................27 13.8.2.B Cases Submitted to the MRT for Reevaluation .................................................27 13.8.2.C Division of Rehabilitation Services (DRS) Referrals ..........................................28 13.8.2.D Fair Hearings ....................................................................................................28 13.8.2.E Notifying the MRT of Eligibility Related Information ..........................................28 13.8.3 Processes for Pending MRT Referrals ....................................................................28 13.8.3.A Responsibilities of the Sending Local Office .....................................................28 13.8.3.B Responsibilities of the Receiving Local Office ..................................................29 13.8.3.C Procedures Related to Hospital Workers ..........................................................29

APPLICATION PROCESS WHEN SSA DETERMINATION OF DISABILITY IS INVOLVED ...............................................................................................................................31 13.9.1 APPLICANT IS CURRENTLY RECEIVING RSDI, BASED ON HIS OWN DISABILITY ...........................................................................................................................31 13.9.2 SSA DECISION PENDING ......................................................................................31 13.9.3 PROCEDURE WHEN DISABILITY IS DISALLOWED BY THE SSA PRIOR TO MEDICAID APPLICATION ....................................................................................................32 13.10 ACTION FOLLOWING THE RECEIPT OF THE FINAL MRT DECISION ...................33 13.10.1 SSI-Related Medicaid and Medicaid Work Incentive (M-WIN) ..............................33 13.10.1.A Client Is Blind or Disabled .............................................................................33 13.10.1.B Client Is Not Blind or Disabled ......................................................................33 13.10.2 WV WORKS ........................................................................................................34