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West Virginia Income Maintenance Manual Chapter 26

West Virginia Income Maintenance Manual Page 31 Chapter 26 Medicaid Work Incentive (M-WIN)

refer the case to the MRT to establish disability, but completion of the redetermination is not delayed. 26.11.4 UNABLE TO MAINTAIN EMPLOYMENT – INVOLUNTARY Only clients who originally received benefits under the M-WIN coverage group may remain eligible for M-WIN during periods of involuntary loss of employment. Involuntary loss of employment includes, but is not limited to, a layoff or a temporary leave due to health problems. Coverage under this provision may continue from the date of the loss of employment through the duration of the current M-WIN coverage period of eligibility, up to twelve months. At redetermination, the client must meet competitive employment requirements or be evaluated for any other coverage group for which he may qualify. To continue M-WIN when the client does not meet competitive employment requirements, the client must meet the specific criteria below. The client must: • Submit a written request for continued coverage to the local DOHS office within 30 days of the date he becomes unemployed. An authorized representative may submit the request. • Maintain a connection to the workforce during his continued Medicaid eligibility period. He meets this requirement by: o Enrolling in a state or federal vocational rehabilitation program; o Enrolling in or registering with WorkForce West Virginia; o Participating in a transition from school-to-work program; o Participating with an approved provider of employment services. The approved Employment Network (EN) providers are found at the WorkForce West Virginia website; or o Providing documentation from his employer that he is on a temporary involuntary leave. • Continue to be otherwise eligible for M-WIN and does not meet a closure reason in Section 26.11.1 Involuntary Loss of Employment Example: Iris Aster is approved for M-WIN for August 1 through July 31. In October, she loses her job because her employer cannot hold her position open while she is off due to surgery. She notifies her Worker within 30 days of the loss of her employment, verifies enrollment at Division of Rehabilitation Services (DRS), and requests continued coverage. The Worker leaves her M-WIN enrollment open and documents nine