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West Virginia Income Maintenance Manual Chapter 26

West Virginia Income Maintenance Manual Page 33 Chapter 26 Medicaid Work Incentive (M-WIN)

26.12 DETERMINING DISABILITY, INCAPACITY AND BLINDNESS 26.12.1 DETERMINING DISABILITY The Medicaid Work Incentive (M-WIN) client must meet the disability criteria established by the Social Security Administration (SSA). If the client does not receive Retirement, Survivors and Disability Insurance (RSDI) based on disability, disability must be established by the Medical Review Team (MRT). See Chapter 13 for the MRT procedures and requirements for both adults and children. 26.12.2 DETERMINING ELIGIBILITY FOR A MEDICALLY-IMPROVED DISABILITY Eligibility for this group is determined by the MRT. These are clients who no longer meet the RSDI or SSI-Related disability definition due to a medical improvement brought about by treatments such as therapy or medication. Examples of potentially eligible clients are those with severe mental illness, HIV/AIDS, and epilepsy. See Section 26.11.5 for other specific requirements.

NOTE: When the Worker submits information to the 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 for Medically- Improved eligibility.

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Page 2157

Official source

West Virginia Income Maintenance Manual Chapter 26

West Virginia Income Maintenance Manual Page 33 Chapter 26 Medicaid Work Incentive (M-WIN)

26.12 DETERMINING DISABILITY, INCAPACITY AND BLINDNESS 26.12.1 DETERMINING DISABILITY The Medicaid Work Incentive (M-WIN) client must meet the disability criteria established by the Social Security Administration (SSA). If the client does not receive Retirement, Survivors and Disability Insurance (RSDI) based on disability, disability must be established by the Medical Review Team (MRT). See Chapter 13 for the MRT procedures and requirements for both adults and children. 26.12.2 DETERMINING ELIGIBILITY FOR A MEDICALLY-IMPROVED DISABILITY Eligibility for this group is determined by the MRT. These are clients who no longer meet the RSDI or SSI-Related disability definition due to a medical improvement brought about by treatments such as therapy or medication. Examples of potentially eligible clients are those with severe mental illness, HIV/AIDS, and epilepsy. See Section 26.11.5 for other specific requirements.

NOTE: When the Worker submits information to the 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 for Medically- Improved eligibility.