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West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 10 Chapter 1 Application/Redetermination Process

Program and Form ID Name of Form When to Use Due Date of Additional Information Agency Time Limits SSI Recipients N/A N/A There is no application form. SSI recipients are categorically eligible. Not applicable. The Worker must enter the SDX information for approval within 45 days of the date on which the client first appears on the data exchange, or the referral from SSA or the BMS Buy-In Unit is received. SSI-Related/Aged, Blind and Disabled DFA-2 or

Application for All Programs of Assistance Applicant is being considered for all programs. Additional information related to medical bills is due 30 days from the date of application SSI Age-Related: Eligibility system action to approve, deny or withdraw the application must be taken within 30 days of the date of application SSI Blind-Related: Eligibility system action to approve, deny or withdraw the application must be taken within 60 days of the date of application SSI Disability-Related: Eligibility system action to approve, deny or withdraw the application must be taken within 90 days of the date of application

DFA-SLA-1 with DFA-SLA-S1 Application for Healthcare Coverage with Supplement For a family or when there is more than one individual in the household applying for health care coverage only. DFA-SLA-2 with DFA-SLA-S1 Application for Healthcare Coverage – Short Form with Supplement For a single individual applying for health care coverage only. SSI-Related/Non-Cash Assistance