DHA Case No. CWA 212224 (Wis. Div. of Hearings and Appeals July 3, 2024) (DHS) ↓ Download PDF Family Care enrollment may be backdated if agency error causes a delay in enrollment. In this case, the ADRC completed the functional screen on October 31 but did not notify IM of the referral until January 10. […] Read more

DHA Case No. CWA 213069 (Wis. Div. of Hearings and Appeals June 28, 2024) (DHS) ↓ Download PDF Family Care enrollment may be backdated if agency error causes a delay in enrollment, but only back to the first date the person was determined functionally eligible, was determined MA eligible, and had signed the enrollment form. […] Read more

DHA Case No. WFC 213597 (Wis. Div. of Hearings and Appeals June 25, 2024) (DHS) ↓ Download PDF The Wisconsin Funeral and Cemetery Aids Program (WFCAP) pays a portion of the cemetery expenses and funeral and burial expenses of indigent recipients of AFDC, W-2 benefits, SSI, or Medicaid under certain circumstances. In this case, the […] Read more

DHA Case No. MAP 212440 (Wis. Div. of Hearings and Appeals April 16, 2024) (DHS) ↓ Download PDF Applicants for Medicaid are given at least 20 days from the date of a request to provide verification, and benefits may only be denied if the applicant has the power to produce the verification. In this case, […] Read more

DHA Case No. MGE 162960 (Wis. Div. of Hearings and Appeals March 6, 2015) (DHS) ↓ Download PDF In a spousal impoverishment case, any assets designated for burial purposes are exempt (as long as the amount is reasonable). In this case, the petitioner designated stocks and an insurance policy as burial funds on his November […] Read more

DHA Case No. FCP 210973 (Wis. Div. of Hearings and Appeals January 16, 2024) (DHS) ↓ Download PDF Family Care enrollment can be backdated if agency error by the ADRC or IM causes unreasonable delay. In this case, the petitioner’s authorized representative failed to complete his renewal: she “apparently left employment with her payee company, […] Read more

DHA Case No. FCP 209929 (Wis. Div. of Hearings and Appeals January 12, 2024) (DHS) ↓ Download PDF Family Care enrollment can be backdated if agency error by the ADRC or IM causes unreasonable delay. In this case, the ADRC sent the Community Waivers referral to IM on June 16, but “for reasons unclear” IM […] Read more

DHA Case No. MGE 209925 (Wis. Div. of Hearings and Appeals January 12, 2024) (DHS) ↓ Download PDF Family Care enrollment can be backdated if agency error by the ADRC or IM causes unreasonable delay. In this case, the petitioner was eligibile on July 6 but not enrolled until July 21 because the ADRC mistakenly […] Read more

DHA Case No. FCP 209869 (Wis. Div. of Hearings and Appeals January 12, 2024) (DHS) ↓ Download PDF In general, the ADRC has 30 days from the date of request to determine functional eligibility or provide notice of a delay; IM has 30 days from the date of application to determine financial eligibility. In this […] Read more

DHA Case No. FCP 209037 (Wis. Div. of Hearings and Appeals November 14, 2023) (DHS) ↓ Download PDF The Department may backdate Family Care enrollment when there is an agency error that causes an unreasonable delay. In this case, the petitioner was found eligible in December of 2022 and the MCO received her enrollment form […] Read more

DHA Case No. MGE 209328 (Wis. Div. of Hearings and Appeals December 5, 2023) (DHS) ↓ Download PDF An application for Institutional MA can be backdated up to three months before the month of application. The MEH provides that an application faxed and received by the agency after business hours counts as filed on the […] Read more

DHA Case No. MDV 209376 (Wis. Div. of Hearings and Appeals October 27, 2023) (DHS) ↓ Download PDF Institutional MA eligibility can be backdated up to three months prior to the the month of application. In this case, the petitioner requested an asset assessment in January 2023 but didn’t apply until May. ALJ Peter McCombs […] Read more

DHA Case No. FCP 208334 (Wis. Div. of Hearings and Appeals July 3, 2023) (DHS) ↓ Download PDF An ALJ may propose that Family Care enrollment be backdated only if the enrollment date was unnecessarily delayed by the ADRC or IM. In this case, the petitioner applied December 29, 2022 and the agency inaccurately processed […] Read more

DHA Case No. FCP 192893 (Wis. Div. of Hearings and Appeals November 5, 2019) (DHS) ↓ Download PDF An ALJ may issue a proposed decision asking the DHS Secretary to backdate enrollment in Family Care if the normal enrollment date was unnecessarily delayed by either the ADRC or Income Maintenance. In this case, both the […] Read more