Am I Eligible for OPWDD Services? A Quick Overview
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1. What’s Required for Eligibility?
To determine eligibility, OPWDD reviews your developmental disability based on New York State law. You will need to submit documents like:
- A psychological report showing IQ and adaptive behavior scores.
- Medical or specialty reports supporting the diagnosis.
- A social/developmental history showing the disability started before age 22.
A care manager or your local DDRO (Developmental Disability Regional Office) can assist you in gathering and submitting this information.
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2. Three-Step Review Process:
The eligibility process includes up to three review steps to ensure a fair and thorough evaluation:
Step 1: OPWDD checks if your application is complete. You’ll be notified if you need more documents, if you are eligible, or if your case needs further review.
Step 2: A committee of clinicians evaluates your application and may request more information. You’ll receive a written decision.
Step 3 (If Needed): If you disagree with the decision, you can request a third review by an independent committee, and even a Medicaid Fair Hearing if necessary.
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3. Required Documents Checklist:
- Psychological report with IQ scores
- Adaptive behavior assessment (if IQ is above 60)
- Medical or specialty reports
- Social/developmental history report
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4. Diagnostic Evaluation:
A diagnostic evaluation is crucial for determining the nature of your disability. It may include tests like:
The Wechsler Intelligence Scales
The Vineland Adaptive Behavior Scales
Other standardized tests approved by OPWDD
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Need Help?
Contact your local OPWDD office or visit their website for a complete list of requirements and acceptable tests.