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FUNDING SOURCES
IF MEDICAID IS REQUIRED TO OBTAIN SERVICES, HOW DOES SOMEONE APPLY FOR THESE BENEFITS? To receive Medicaid funded waiver services, a person must be eligible and maintain eligibility for Medicaid benefits. There are four common ways for a person with a disability to obtain Medicaid. The most common is through receiving Supplemental Security Income or SSI, which includes Medicaid benefits. The other three ways are 1) Disabled Adult Child $!# 3TATUS #OMMUNITY -EDICAID AND .EW *ERSEY Workability. For more information about applying for Social Security and Medicaid, go to WWWSTATENJUSHUMANSERVICESDDD SERVICESMEDICAIDELIGIBILITYHTML HOW DOES SOMEONE APPLY FOR DDD ELIGIBILITY? To begin the process, a person can file an application for services at the local DDD office. For the DDD Intake Package Application go to WWWSTATENJUSHUMANSERVICESDDD DOCUMENTS$OCUMENTSFOR7EB)NTAKE 0ACKAGE PDF An intake worker will interview the person and his/her family and gather the information needed to determine eligibility for DDD services. Necessary documentation includes information about the person’s functional abilities, Social Security card, Medicaid eligibility and diagnosis of a disability. In addition, DDD will request written permission to obtain school records, psychological test reports and medical records that assist in determining eligibility. Once all of the necessary information is assembled, DDD will review and send a decision in writing about eligibility. Receiving services depends upon the availability of waiver funding and is not an entitlement. If denied eligibility, the decision can be appealed. WHAT IS THE PROCESS TO APPEAL A DECISION, IF DENIED ELIGIBILITY? In most instances, when a government agency makes a decision to deny a service, the person affected is entitled to appeal the denial of that decision. The notice of denial should include information about how to file an appeal. In DDD, the person will have the opportunity to attempt to resolve the dispute at a settlement conference. If the settlement conference is unsuccessful, the appeal will be referred to the Office of Administrative Law for a hearing before a judge.
IT IS OFTEN WORTH THE EFFORT TO APPEAL AN UNFAVORABLE DECISION. Many times decisions are changed through the appeal process. Individuals are encouraged to seek legal resources through the assistance of advocacy organizations or an attorney.
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