PDF
Word
Form W-1130 Acquired Brain Injury (Abi) Waiver Request Form - Connecticut
What Is Form W-1130?
This is a legal form that was released by the Connecticut State Department of Social Services - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the Form W-1130?
A: Form W-1130 is the Acquired Brain Injury (ABI) Waiver Request Form.
Q: What is the purpose of Form W-1130?
A: The purpose of Form W-1130 is to request a waiver for Acquired Brain Injury (ABI) services in Connecticut.
Q: Who needs to fill out Form W-1130?
A: Individuals or their legal representatives who are seeking Acquired Brain Injury (ABI) services in Connecticut need to fill out Form W-1130.
Q: Is there a deadline for submitting Form W-1130?
A: There may be a deadline for submitting Form W-1130, and it is best to check with the Connecticut Department of Social Services for specific guidelines.
Q: What happens after I submit Form W-1130?
A: After submitting Form W-1130, the Connecticut Department of Social Services will review the request and determine if the individual is eligible for the Acquired Brain Injury (ABI) waiver.
Q: Can I appeal if my Form W-1130 request is denied?
A: Yes, if your Form W-1130 request is denied, you have the right to appeal the decision.
Form Details:
- Released on July 1, 2016;
- The latest edition provided by the Connecticut State Department of Social Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form W-1130 by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Social Services.
Download Form W-1130 Acquired Brain Injury (Abi) Waiver Request Form - Connecticut
1
2
