Person over age 65 who needs to reopen to a disability waiver, DHS-7759D

Reopening someone who is 65 years or older
to a disability waiver (DHS-7759D) 2-23

(NOTE: DHS recommends using Google Chrome on a desktop computer to complete this form.)

Lead agencies complete this form when someone 65 years or older needs to reopen to a disability waiver.

A person who was enrolled on a disability waiver before age 65 may reopen to BI, CAC or CADI after age 65 if all of the following criteria are met:
• He/she meets the eligibility requirements for the waiver
• The Elderly Waiver (EW) does not or no longer meets his/her needs
• He/she receives approval from DHS.

For more information, see the CBSM – BI, CAC, CADI and DD waiver general processes and procedures – 65 years of age section.

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