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West Virginia Income Maintenance Manual Chapter 18

West Virginia Income Maintenance Manual Page 9 Chapter 18 WV WORKS Activities/Requirements

• Is needed at home to care for a disabled family member who resides in the home and is not a full-time student; and • Medical documentation must be provided to support the need for the parent to remain in the home to care for and monitor the disabled family member; and • No one else is available to provide this care; and • Such care will not be necessary for more than six months, or the family has made other care arrangements that will be completed within six months, or the family is attempting to make other care arrangements, including application for a Medicaid waiver program. 18.2.3.C Late Onset of Incapacity Participants who experience the onset of a temporary incapacity after the 55th month of WV WORKS may qualify for a one-time extension of up to six months while undergoing treatment for the injury or illness. The Case Manager must obtain a decision of incapacity from the Medical Review Team (MRT), and the decision must indicate that the individual will be able to engage in gainful employment following the period of incapacity. The MRT process must be started immediately upon receiving notice of the illness or injury so that a decision may be obtained from the MRT before the participant reaches his 60th month of benefits. Failure of the participant to accept or continue treatment for the illness or injury before the extension begins will result in denial of the request. Failure to cooperate following the beginning of the extension period will result in case closure. If it is determined by the MRT or a doctor’s report that the individual will be temporarily unable to engage in gainful employment for a period of time on or following his 60th month of eligibility, he may qualify for an extension of up to six months. The number of months granted will depend on the length of time that the MRT has determined him to be unable to engage in a gainful activity. The local office will be responsible for monitoring the medical status of the participant each month. 18.2.3.D Disabled Disabled is defined as unable to engage in gainful employment, as determined by a medically qualified professional. Because WV WORKS participants must be referred to the MRT if unable to participate for longer than a six-month period, it is assumed that an individual who states he is disabled will already have medically established his disability by the 55th month of TANF/WV WORKS