In general, the records for an OPWDD eligibility review would include reports of current or recent psychological testing of the person’s intellectual functioning, a standardized evaluation of the person’s “adaptive” behavior functioning, a social/developmental (or psychosocial) history, and medical reports indicating the person’s health status. For children or adults with special medical conditions, genetic disorders, or neurological impairment, medical records that confirm the diagnosis of these conditions or disorders are required. Educational records (the student’s Individualized Education Program, also called the IEP, and report cards) can be helpful, too. The DDRO staff can answer additional questions, explain the records requirements in more detail, and advise applicants and their representatives about giving permission and requesting copies of evaluations and other records.

What is “provisional eligibility?”

In some cases, based on clinical judgement of a child’s disability and needs, the DDRO may grant a child provisional eligibility. Provisional eligibility means that a child may get OPWDD supports and services for a limited period of time. Before the end of the time period, OPWDD must review updated information about the child’s condition and functioning to see if the child is still eligible for supports and services. The reason that some children have provisional eligibility is that they may have qualifying levels of delays in development that can still change or improve as they grow older. All children with provisional eligibility must be reviewed again before their eighth birthday, but some may be reviewed earlier. The DDRO will decide when the child should be evaluated again, and whether a child who has had provisional eligibility is still eligible for OPWDD supports and services.

What is a “qualifying level of delay in development” for children?

New York State Education Law has standards that explain how to measure the possible kinds and levels of delay that a child under eight years of age may have. These rules help to determine how much the child’s delay affects the child’s ability to live a normal life. This information about the kind and level of delay in development is usually contained in a report that is reviewed for OPWDD eligibility.

Is there any age limit for applying for OPWDD eligibility?

There are no age limits for requesting OPWDD eligibility. Eligibility status can be reviewed from infancy throughout a person’s life. It is important to be aware, however, that a person’s age can affect the ability to find proof that the disability was present before the person reached age 22. As a person gets older, it may become more difficult to find the records and reports from schools, clinics, hospitals, and other settings that could show how a person’s condition met the age requirement for OPWDD eligibility.