N.Y. Comp. Codes R. & Regs. Tit. 18 §§ 360-5.4

Current through Register Vol. 46, No. 45, November 2, 2024

Section 360-5.4 - Reapplication

Reapplication for MA as disabled is processed as any other reapplication.

(a) When an individual reapplies after he/she has been certified as disabled by an MA-only disability review team, group I or group II, and his/her case is closed for reasons unrelated to a change in disability (e.g., increased pension or other benefits), there is no need for a disability review team evaluation unless:

(1) 12 months or more have elapsed since date of last case closing;

(2) the individual has, in the interim, engaged in a useful occupation; and

(3) the individual has, in the interim, had a significant change in treatment such as major surgery, a stay in a rehabilitation center or a period of diagnostic hospitalization.

(b) Cases reopened as group II in accordance with the instruction listed in this section, without review team review, must be reviewed on the date which had been set before the case was closed. If reapplication of group II cases occurs subsequent to the date set for review by the review team, the agency must secure and transmit any additional data requested at previous review and all required forms previously submitted.

N.Y. Comp. Codes R. & Regs. Tit. 18 §§ 360-5.4