PDFWAC 388-823-1010

When will DDA review my eligibility to determine if I continue to meet the eligibility requirements for DDA?

(1) DDA will review your eligibility:
(a) If you are age nineteen and your most recent eligibility determination was completed before your sixteenth birthday;
(b) If you are age nineteen and were determined eligible under another neurological or other condition similar to intellectual disability and have used academic delays as evidence of your substantial functional limitations;
(c) Before authorization of any DDA-paid service if you are not currently receiving paid services and your most current eligibility determination was made before June 1, 2005;
(d) If the evidence used to make your most recent eligibility determination is insufficient, contains an error, or appears fraudulent;
(e) If new information becomes available that does not support your current eligibility determination; or
(f) If you were determined eligible due solely to your eligibility for fee-for-service (FFS) medically intensive children's program (MICP) services and you are no longer eligible for FFS MICP services.
(2) If DDA requires additional information to make a determination of eligibility during a review and you do not provide sufficient information, DDA will terminate your eligibility:
(a) On your twentieth birthday if the review is because you are age nineteen; or
(b) Ninety days after DDA requests the information if the review is because:
(i) You have requested a paid service;
(ii) The evidence used to make your most recent eligibility determination is insufficient, contains an error, or appears fraudulent;
(iii) New information is available that does not support your current eligibility determination; or
(iv) You are no longer eligible for FFS MICP services under chapter 182-551 WAC.
[Statutory Authority: RCW 71A.12.030. WSR 19-14-119, § 388-823-1010, filed 7/3/19, effective 8/3/19. Statutory Authority: RCW 71A.12.030 and 71A.10.020. WSR 18-15-046, § 388-823-1010, filed 7/13/18, effective 8/13/18. Statutory Authority: RCW 71A.12.030, 71A.12.120 and 74.08.090. WSR 14-12-046, § 388-823-1010, filed 5/29/14, effective 7/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.040, and 74.08.090. WSR 14-07-028, § 388-823-1010, filed 3/10/14, effective 4/10/14. Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. WSR 05-12-130, § 388-823-1010, filed 6/1/05, effective 7/2/05.]