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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 9 Chapter 24 Long Term Care

The authorized representative is responsible to the same extent as the client being represented, including confidentially of any information regarding the client provided by the agency and agreeing to the terms of the Rights and Responsibilities. Examples of documents the applicant may submit with the Medicaid application to verify he has designated an authorized representative include, but are not limited to: • Single Streamlined Application (DFA-SLA-1, Appendix C) • Application for Long Term Care Medicaid and Children with Disabilities Community Service Program (DFA-MA-1) • Durable power of attorney (POA) and/or medical power of attorney documentation, unless limited in scope • Court orders designating a guardian or conservator (signed by court) • Healthcare surrogate documentation for an incapacitated applicant (signed by physician and surrogate) 24.4.1.C.6 Agency Time Limits The Worker must give the applicant at least 10 days for any requested information to be returned. The Worker must take eligibility system action to approve, deny, or withdraw the application within 30 days of the date of application. 24.4.1.C.7 Agency Delays If the DOHS failed to request necessary verification, the Worker must immediately send a verification checklist or form DFA-6 and DFA-6a, if applicable, to the client and note that the application is being held pending. When the information is received, benefits are retroactive to the date eligibility would have been established had the DOHS acted in a timely manner. If the DOHS simply failed to act promptly on the information already received, benefits are retroactive to the date eligibility would have been established had the DOHS acted in a timely manner. For these cases, timely processing may mean acting faster than the maximum allowable time. If an application has not been acted on within a reasonable period of time and the delay is not due