Petitioner erroneously denied Medicaid as “over income” need not reapply but DFCS can deny application on other grounds.
Docket Number: ****** , Decision Date: June 5, 2013
Attachment: Click here to download the decision.
Respondent, the Division of Family and Children Services (DFCS), stipulated that its denial of Petitioner’s application for Nursing Home Medicaid was erroneous. The error was due to a failure to exclude Aid and Attendance Department of Veterans’ Affairs (VA) benefits, which are not counted as income for Medicaid eligibility purposes. Judge Woodard held that Petitioner does not need to reapply because the absence of documentation breaking down her VA benefits (some of which are included as income for eligibility purposes) was due to DFCS’s failure to follow appropriate protocol for obtaining missing information. However, the Court found that Petitioner must meet other eligibility requirements. Reversed and Remanded.