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West Virginia Income Maintenance Manual Chapter 13

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

13.10.2.A Parent Is Incapacitated .................................................................................34 13.10.2.B Parent Is Not Incapacitated ...........................................................................34 13.10.2.C WV WORKS Good Cause for Not Participating in Work Activities .................34 13.10.2.C.1 Individual Is Incapacitated ........................................................................34 13.10.2.C.2 Individual Is Not Incapacitated ..................................................................35 13.10.3 ACTION WHEN THE MRT DECISION CONFLICTS WITH THE SSA DECISION35 13.10.4 ACTION WHEN THE WORKER AND SUPERVISOR DISAGREE WITH THE MRT’S DECISION TO DENY .................................................................................................35 13.11 CLIENT’S RIGHTS IN THE DETERMINATION PROCESS ........................................36 13.11.1 CLIENT’S RIGHT TO AN ADDITIONAL MEDICAL REPORT ..............................36 13.11.2 PROCEDURE AFTER THE CLIENT’S DECISION TO REQUEST AN ADDITIONAL MEDICAL REPORT ........................................................................................36 13.11.3 CLIENT’S RIGHT TO AN MRT RECONSIDERATION .........................................37 13.11.4 CLIENT’S RIGHTS IN THE FAIR HEARING PROCESS .....................................37 13.12 PROCEDURES WHEN SSA FINAL DISABILITY DECISION IS MADE AFTER MEDICAID APPROVAL ...........................................................................................................38 13.12.1 CLAIM DISALLOWED .........................................................................................38 13.12.2 CLAIM APPROVED .............................................................................................38 13.13 REEVALUATION OF DISABILITY, INCAPACITY OR BLINDNESS ..........................39 13.14 REAPPLICATIONS ....................................................................................................40 13.15 ESTABLISHING DISABILITY AND FITNESS FOR EMPLOYMENT FOR THE SNAP PROGRAM ...............................................................................................................................41 13.15.1 INTRODUCTION .................................................................................................41 13.15.2 ESTABLISHING A CLIENT AS DISABLED ..........................................................41 13.15.3 ESTABLISHING A CLIENT AS UNFIT FOR EMPLOYMENT ...............................42 APPENDIX A: PRESUMPTIVE MEDICAL APPROVAL – SSI-RELATED MEDICAID AND M- WIN, AGE 18 OR OLDER.........................................................................................................44 APPENDIX B: PRESUMPTIVE MEDICAL APPROVAL – SSI-RELATED MEDICAID AND M- WIN, UNDER AGE 18 ...............................................................................................................48 APPENDIX C: PRESUMPTIVE APPROVAL – WV WORKS ....................................................53