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West Virginia Income Maintenance Manual Chapter 13

West Virginia Income Maintenance Manual Page 19 Chapter 13 Determining Disability, Incapacity, and Blindness

13.7.1.B.3 Initial Medical Report – Blindness When an application is made for Medicaid due to incapacity or disability based on blindness, the Worker: • Determines the ophthalmologist (MD/DO) of the client's choice who is an approved Medicaid provider; • Makes an appointment with the ophthalmologist and notifies the client in writing of the date and time; • Completes form DFA-RT-6 in duplicate with "Eye Examination and Report on the Enclosed Form" checked. The original is sent to the ophthalmologist, and a copy is filed in the case record; and, • If the appointment is with an ophthalmologist, form DFA-B-13 is enclosed with the DFA- RT-6. The DFA-B-13a is a report form for the ophthalmologist. 13.7.1.B.4 Initial Medical Report, Incapacity and Disability Sources of initial medical reports are listed in order of priority. The exception is, under some circumstances, when incapacity or disability is being established, medical reports are first requested from the Social Security Administration (SSA). See Section 13.7. If the SSA reports are not available, the Worker then obtains the reports as found below. ➢ Medical Information Available in the Case Record The Worker should first consult the case record and review available medical information. ➢ Medical Reports from Children with Special Health Care Needs Program (CSHCN) and the PAS-2005, Patient Medical Evaluation In the following situations, the only initial medical reports needed are those available in the case record: • The applicant is currently receiving services from the CSHCN. In this case, copies of these medical reports are submitted to the MRT. • The applicant is residing in, or planning to enter, a nursing home.