Did you know that you have the right to challenge the decisions that are made by OPWDD, Social Security, Medicaid, private insurance, etc.?
Waiver Eligibility/Waiver Service Denials
Have you or your loved one been denied Waiver services? You have the right to challenge/appeal any OPWDD decisions. Learn more about how to request a hearing to appeal OPWDD’s determination here.
Additionally, a new program called the Independent Intellectual and Developmental Disabilities Ombudsprogram (IDDO) can act as a resource and advocate for individuals and families as they navigate OPWDD’s programs and services. Some of the things they can support are:
- Explaining the front door or first step in obtaining OPWDD services
- Supporting you with advocacy
- Helping people obtain documents for the OPWDD eligibility and service authorization process
- Education about self-direction
- Counseling on complaints, grievances and fair hearings
- Providing resources and referrals
Find out more here.
Social Security Denials
The process of applying for Social Security can be a long and complicated one. What happens when you or your loved one completes the application process and is denied these benefits? If a member or their Representative disagrees with an initial Social Security or SSI decision, check out the following resources to learn how to appeal decisions:
- https://www.ssa.gov/apply/appeal-decision-we-made
- https://opwdd.ny.gov/providers/benefit-development-resource-toolkit-supplemental-security-income
- https://www.ssa.gov/forms/ssa-561-u2.pdf
- https://www.ssa.gov/apply/appeal-decision-we-made/request-reconsideration
If you need assistance navigating denial or unfavorable decisions, your Care Manager can support you with this. If you have concerns about your Care Management services, check out this resource for guidance on what to do next: LIFEPlan Grievance Process