Developmental Disabilities
Administration
Eligibility Overview
January 11, 2023
What is a Developmental Disability?
Per RCW 71A.10.020(5) The disability must:
• Originate before the individual turns eighteen,
• Continue or be expected to continue indefinitely, and
• Constitute a substantial limitation to the individual.
388
-823-0015
How does the state of Washington
define developmental disability?
Becoming a DDA client
An applicant becomes enrolled with the
DDA by meeting criteria used to determine
if they have a developmental disability and
substantial limitations. This criteria is in
WAC.
Once enrolled with the DDA, a person can
request services, though they do not
have to.
388-823-0115
If I am eligible to be a client of DDA,
will I receive DDA services?
Basic Determination Process
1. Applicant or representative submits application
forms and required evidence
• Request for DDA Eligibility Determination (14-151)
• Consent
(14-012)
• Notice of Privacy Practices for Client Confidential Information
(03-387)
• Eligible Conditions Specific to Age and Type of Evidence
(14-459)
A person can go to dshs.wa.gov/dda/service-and-
information-request to have an application mailed to them.
388-823-0020
How do I become a client of the
developmental disabilities
administration?
388-823-0025
Who can apply for DDA eligibility
determination?
388-823-0055
Who is responsible for obtaining the
documentation needed to make my
eligibility determination?
Policy 11.01
Intake and Eligibility Determination
2. A DDA eligibility case worker assists in gathering
evidence if needed
3. A DDA case worker evaluates evidence
– Attestation of Washington State residency
– Evidence of disability onset before age 18
– Evidence of a qualifying condition
– Evidence of substantial limitation (substantial limitation
requirements vary by qualifying condition)
388
-823-0050
For DDA eligibility, who is considered to be
a resident of the state of Washington?
388-823-0075
What if I do not have written evidence that
my disability began before my eighteenth
birthday?
388-823-0080
How does DDA determine whether I meet
eligibility criteria?
How Long Does a Determination
Take?
• The DDA has 30 days from receiving the last piece of
requested documentation before making a determination
• If the DDA has insufficient information to make a
determination and has not received all of the requested
documentation, eligibility may be denied after 90 days from
the date of application
388-823-0090
How long will it take to complete a
determination of my eligibility?
388-823-0100
What is the effective date of my
eligibility determination?
Required Documentation
1. Diagnosis of an eligible condition that is not
expected to improve or go away
2. Evidence that the condition was present prior
to age 18
3. Evidence of substantial limitations varies by
condition
– IQ scores
– Physical assistance needs
– Adaptive functioning test scores
388-823-0055
Who is responsible for obtaining the
documentation needed to make my
eligibility determination?
Age and Eligibility
Eligible Conditions by Age 0 - 3 4 - 9 10 - 17
18 and
over
One Developmental Delay X
Three or more Developmental Delays X X
Intellectual Disability (ID) X X X
Cerebral Palsy X X X
Epilepsy X X X
Autism X X X
Another neurological, or
other condition similar to ID
X X X
Intellectual Disability
• Diagnosis of Intellectual Disability (ID) by a
licensed or certified school psychologist
• Full Scale Intelligence Quotient (FSIQ) of 69 or
below (depending on the test used)
• Adaptive functioning tested at more than two
standard deviations below the mean
388-823-0200
How do I show that I have intellectual disability as an
eligible condition?
388-823-0210
If I have intellectual disability, how do I meet the
definition of substantial limitations?
Cerebral Palsy
• Diagnosis by a licensed physician of
• Cerebral palsy
• Quadriplegia
• Hemiplegia
• Diplegia
• Symptoms that existed prior to age three and
impair control of movement
• Need for direct physical assistance in 2 or more:
• Toileting
• Bathing
• Eating
• Dressing
• Mobility
• Communication
388-823-0300
How do I show that I have cerebral palsy as an eligible
condition?
388-823-0310
If I have cerebral palsy, how do I meet the definition of
substantial limitations?
388-823-0760
What evidence do I need to show my need for direct
physical assistance?
Epilepsy
• Diagnosis of epilepsy or seizure disorder by a
qualified professional
• Seizures are not controlled
• Adaptive functioning tested at more than two
standard deviations below the mean
388-823-0400
How do I show that I have epilepsy as an eligible
condition?
388-823-0410
If I have epilepsy, how do I meet the definition of
substantial limitations?
Autism
• Evidence of onset prior to age 5
• Adaptive functioning tested at more than
two standard deviations below the mean,
AND
• Diagnosis of Autistic Disorder (DSM.IV.TR
299.00) prior to Feb. 1
st
, 2022, OR
• Diagnosis of Autism Spectrum Disorder
(DSM.5), and
– FSIQ below 85, or a
– Written statement confirming your autism
prevents you from IQ testing
388
-823-0500 How do I show that I have autism as an eligible condition?
388
-823-0510
If I have autism, how do I meet the definition of
substantial limitations?
Another Neurological or Other
Condition Similar to ID
• Diagnosis of a neurological or chromosomal disorder
made by a licensed physician
• Disorder results in intellectual and adaptive skills deficits
– FSIQ of 77 or below (depending on the test used), or
– Academic delays for children under 20, and
– Adaptive functioning tested at more than two standard
deviations below the mean
388-823-0600
How do I show that I have another neurological or other condition similar
to intellectual disability?
388-823-0610
If I have another neurological or other condition similar to intellectual
disability, how do I meet the definition of substantial limitations?
Policy 11.04
Determining Other Condition
Another Neurological or Other
Condition Similar to ID
• What is Another Neurological or Other Condition?
– It must be neurological or chromosomal in nature,
– Have originated before age eighteen,
– Be expected to continue indefinitely without improvement,
– Is not attributable to or is itself a mental illness or emotional,
social or behavioral disorder, and
– Must be known by reputable authorities to cause intellectual
impairment and adaptive skills deficits.
Impact of Unrelated Injury or
Illness on Evidence of Adaptive
Functioning
DDA must be able to determine that the functional
limitations are not a result of:
– Mental illness
– Behavior problems
– Injuries or illness not related to the qualifying diagnosed
condition
– Injuries or illness occurring after age 18
388-823-0740 What evidence do I need of my adaptive skills limitations?
Expiration and Reviews
Eligibility expires
– On the 4
th
birthday
– On the 10
th
birthday if eligible under developmental
delays
388
-823-1000
Once I become an eligible DDA client, is there a time limit to my
eligibility?
388
-823-1005 When does my eligibility as a DDA client expire?
388
-823-1010
When will DDA review my eligibility to determine if I continue to
meet the eligibility requirements for DDA?
388
-823-1030 How will I know that my eligibility is expiring or is due for review?
Expiration and Reviews
Reviews
– At age 19 if the last determination was before age 16
– When there is evidence of insufficient, mistaken, or fraudulent
information
– Before the 18
th
birthday if eligible under the Medically Intensive
Children’s Program
– Before the 20
th
birthday if the current eligibility determination relied
on evidence of academic delays in Broad Reading and Broad
Mathematics
Eligibility Termination
– If you are no longer a state resident
– If you ask
388-823-
1010
When will DDA review my eligibility to
determine if I continue to meet the
eligibility requirements for DDA?
388-823-
1015
What is the definition of "DDA paid
services" in WAC 388
-823-1010(2)?
388-823-
1030
How will I know that my eligibility is
expiring or is due for review?
388-823-
1020
Can DDA terminate my eligibility if I no
longer am a resident of the state of
Washington?
388-823-
1090
If I am already eligible, how do
these new rules affect me?
The Person is Enrolled, Now What?
If the person needs services, they must request them.
They can make a request for services by contacting DDA, or submitting
the request here:
https://www.dshs.wa.gov/dda/service-and-information-request
388
-823-
1010
When will DDA review my eligibility to
determine if I continue to meet the
eligibility requirements for DDA?
388
-823-
1015
What is the definition of "DDA paid
services" in WAC 388-823-1010(2)?
388
-823-
1030
How will I know that my eligibility is
expiring or is due for review?
388
-823-
1020
Can DDA terminate my eligibility if I no
longer am a resident of the state of
Washington?
388
-823-
1090
If I am already eligible, how do
these new rules affect me?
The Person is a Client, Now What?
Intake and
Eligibility
Determined
Eligible
Entitlement
Services through
the Specialized
Unit while going
through the
eligibility process
Person Requests
Services
Case Manager is
assigned to
conduct
assessment
Person does not
need services
Person is assigned
to the No Paid
Services Caseload
Person Requests
Entitlement
Services
Person Requests
Services
Thank You!
