Applying for Determination of Eligibility
For children with developmental disabilities
Applications for eligibility for developmental disability services for children under age 18 must be submitted to PerformCare, the single access point into the New Jersey Children's System of Care (CSOC).
The application materials below may be downloaded and printed out for completion by hand. You may also call PerformCare at 1-877-652-7624 to request that the application materials be mailed to you. Please refer to the instructions below for guidance on completing the required application forms and submitting the required supporting documentation.
Atención: Por el momento, la solicitud de elegibilidad en internet para los servicios de discapacidad intelectual o del desarrollo está disponible únicamente en inglés. Si le resulta más cómodo leer y escribir en español, por favor imprima y complete los formularios de solicitud disponibles en español que figuran a continuación.
Special notice for young adults ages 18 to 21
Applications on behalf of individuals who have turned 18 years old or older must be submitted to the Department of Human Services (DHS) Division of Developmental Disabilities (DDD). CSOC will honor determinations of eligibility and provide developmentally disability services made by DDD for individuals between the ages of 18 and 21. Eligibility for services from CSOC ends the day before an individual's 21st birthday. Please visit the DHS DDD website for more information on DDD's application forms and process.
Downloadable instructions and guidelines
Please review these forms and use them as a guide for submitting your application.
- Getting ready checklist (PDF).
- Citizenship and residency requirements (PDF).
- Timeframes for Clinical Assessments Submitted for Developmental Disability Eligibility Determination (PDF).
Para descargar la solicitud de elegibilidad en español, haga clic aquí.
These forms are specific to children up to age 18 and have additional instructions to assist families and their advocates in applying for eligibility. Many of the changes are based on feedback from families and community representatives that occurred in 2013. Please note that the requirements for eligibility under NJ statute have not changed. These updated forms are designed to make the eligibility process for children easier to understand.
Application forms: required
- Form A: Applicant information and declaration (PDF).
- Form B: Child adaptive behavior summary (CABS) (PDF).
- Form C: Documentation checklist (PDF).
- Form D: HIPAA privacy practices acknowledgement (PDF).
Forms A through D listed above are required, along with appropriate medical and other documentation as identified in the forms.
If you wish to name additional individuals who may speak with PerformCare about the status of your application, please use this form:
- Third-party release (PDF).
The completed application forms and supporting documentation should be mailed to PerformCare at the following address:
PerformCare New Jersey
Attention: DD Eligibility Unit
300 Horizon Drive, Suite 306
Robbinsville, NJ 08691
For those who prefer, this application is also available to complete online, with real-time tracking of your application status.
Please review all the forms and materials above before completing the application online.
What to expect after you apply
Once PerformCare receives your application, it will be sent to the DD Eligibility Unit to confirm that all required forms and documents are included. After an initial review of the application, you will receive a letter to explain what is still needed if your application is missing any documents and/or other information needed to make a decision.
From the date that an application has been submitted, the family has up to one year to submit necessary documents (if the youth is under age 18 years old). After one year, you will need to submit a new application.
A decision will be made within 60 days after the DD Eligibility Unit has all the information they need.
If the child is eligible for services, you will receive an eligibility letter from PerformCare. If the child does not appear to be eligible, the application materials will be sent for further review. This second review, if necessary, may extend the decision beyond 60 days.