Page 2154

West Virginia Income Maintenance Manual Chapter 26

West Virginia Income Maintenance Manual Page 30 Chapter 26 Medicaid Work Incentive (M-WIN)

26.11.2 CHANGE IN INCOME AND DEDUCTIONS A change in income and/or deductions between redeterminations does not result in ineligibility for the coverage group. An income change is not used to increase the premium amount. However, the premium amount may be decreased based upon a reported income change. 26.11.3 REDETERMINATION OF DISABILITY The Department of Human Services (DOHS) cannot determine that a client who participates in the program is no longer disabled solely due to his employment or earned income, including self-employment income. At the time of the twelve-month redetermination, the Worker must ensure that the client continues to meet the disability requirement for the new period of eligibility. The client must be a current RSDI recipient or there must be a valid MRT decision that extends into the new eligibility period. MRT reevaluations will be completed at the time specified by the MRT. MRT Evaluation Period Example: At redetermination in January 2016 for a new eligibility period to begin February 2016, the Worker discovers that the last MRT evaluation covers the period from April 2015 through March 2016. Because part of the new eligibility period through March 2016 is covered by an MRT evaluation, the disability requirement is met. RSDI Stopped Example: At redetermination, the Worker discovers that the client’s RSDI was stopped. The Worker must NOTE: When the information is submitted to MRT for the reevaluation of disability, an evaluation for Medically-Improved eligibility must be requested at the same time. If the individual is determined no longer disabled, he is evaluated automatically as Medically-Improved. NOTE: Retirement, Survivors and Disability Insurance (RSDI) cost-of-living adjustments (COLA) are disregarded in determining income eligibility until the new Federal Poverty Level (FPL) limits become effective.