DHA Case No. MNP 218271 (Wis. Div. Hearings and Appeals Jul. 21, 2025) (DHS) ↓ Download PDF A valid notice must be sent at least 10 days before the adverse action and provide information about the right to appeal, including the right to continue benefits while the appeal is pending. In this case, the petitioner […] Read more

DHA Case No. MGE 216988 (Wis. Div. Hearings and Appeals Jul. 14, 2025) (DHS) ↓ Download PDF The transfer of resources for less than fair market value is a divestment resulting in a penalty period. The penalty (for Institutional MA) begins the first date the applicant applied and would have been otherwise eligible. In this […] Read more

DHA Case No. MGE 217686 (Wis. Div. Hearings and Appeals Jun. 17, 2025) (DHS) ↓ Download PDF Eligibility for Institutional MA can be backdated up to three months before the month of application. In this case, the petitioner applied several times over many months and repeatedly failed to provide required verification by the deadline. Ultimately, […] Read more

DHA Case No. MGE 217517 (Wis. Div. Hearings and Appeals Jun. 12, 2025) (DHS) ↓ Download PDF An asset is unavailable if the member lacks the ability to provide legal access to the assets. In this case, the petitioner’s bank refused to give access to his guardian until the guardian was appointed representative payee by […] Read more

DHA Case No. MDV 216455 (Wis. Div. Hearings and Appeals June 6, 2025) (DHS) ↓ Download PDF An undue hardship waiver of a divestment penalty may be approved if the divested assets are not recoverable and the member would otherwise be deprived of necessary medical care, shelter, or other necessities. In this case, the petitioner’s […] Read more

DHA Case No. MGE 215302 (Wis. Div. Hearings and Appeals Jun. 2, 2025) (DHS) ↓ Download PDF The agency is required to verify income, assets, and divestments, both at application and at renewals. The applicant or member has the primary responsibility to provide verification and resolve questionable information. In this case, the petitioner’s authorized representatives […] Read more

DHA Case No. MGE 216305 (Wis. Div. Hearings and Appeals Mar. 24, 2025) (DHS) ↓ Download PDF Income received in a month is not counted as an asset unless and until it is retained into the following month. In this case, the petitioner applied in September and requested backdating to June and July. She submitted […] Read more

DHA Case No. MGE 216363 (Wis. Div. Hearings and Appeals Feb. 28, 2025) (DHS) ↓ Download PDF A Medicaid applicant must be below the asset limit on the last day of the month to be eligible that month. In this case, the petitioner’s application was denied due to the cash value of a life insurance […] Read more

DHA Case No. MGE 216012 (Wis. Div. Hearings and Appeals Feb. 18, 2025) (DHS) ↓ Download PDF A notice is not adequate if it does not expressly identify the program for which benefits are denied. Also, an application cannot be denied merely because the applicant lacks the power to produce verification. In this case, the […] Read more

DHA Case No. MGE 215891 (Wis. Div. Hearings and Appeals Feb. 4, 2025) (DHS) ↓ Download PDF An ALJ can increase the Community Spouse Resource Allowance (CSRA) if the additional resources are needed to generate income for the community spouse up to the Minimum Monthly Maintenance Needs Allowance (MMMNA). In this case, the petitioner had […] Read more

DHA Case No. MDV 215927 (Wis. Div. Hearings and Appeals Feb. 3, 2025) (DHS) ↓ Download PDF If an irrevocable annuity can be sold on the secondary market, it is a countable, available asset. In this case, the petitioner owned an irrevocable annuity but could still transfer ownership and change the beneficiary and had received […] Read more

DHA Case No. MGE 214684 (Wis. Div. Hearings and Appeals Jan. 2, 2025) (DHS) ↓ Download PDF Royalties are considered unearned self-employment income for MA purposes. The monthly countable income is calculated by prorating the previous tax year’s net income over twelve months. In this case, the petitioner complained that the fluctuating amounts received meant […] Read more

DHA Case No. MDV 137218 (Wis. Div. Hearings and Appeals Feb. 7, 2012) (DHS) ↓ Download PDF When an institutionalized person fails to claim his or her share of a deceased spouse’s estate, it is generally a divestment. In this case, the petitioner’s wife created a revocable trust after his enrollment that included no share […] Read more

DHA Case No. MDV 23/44181 (Wis. Div. Hearings and Appeals 2000) (DHS) ↓ Download PDF A transfer of resources made during the lookback period by the applicant or his or her spouse can be a divestment. In this case, the petitioner’s spouse died before she applied for MA, transferring a POD bank account to beneficiaries other […] Read more