2 Nonfinancial Eligibility

DHA Case No. MTI 208493 (Wis. Div. of Hearings and Appeals July 14, 2023) (DHS) ↓ Download PDF To be recoverable, an overpayment must be caused by the recipient’s error—overpayments caused by agency error are not recoverable. In this case, the petitioner misread a notice of FoodShare benefits ending, believing all her benefits were ending. In fact, […] Read more

DHA Case No. MDD 208783 (Wis. Div. of Hearings and Appeals August 15, 2023) (DHS) ↓ Download PDF In making a disability determination, the Disability Determination Bureau (DDB) applies a 5-step test. Step 5 considers whether the individual can adjust to types of work the individual has not performed in the past, considering his or […] Read more

DHA Case No. MDD 208892 (Wis. Div. of Hearings and Appeals August 22, 2023) (DHS) ↓ Download PDF In making a disability determination, the Disability Determination Bureau (DDB) applies a 5-step test. Step 5 considers whether the individual can adjust to types of work the individual has not performed in the past, considering his or […] Read more

DHA Case No. SSO 208238 (Wis. Div. of Hearings and Appeals June 22, 2023) (DHS) ↓ Download PDF Wisconsin pays a state supplement to SSI recipients who are Wisconsin residents. In this case, the state SSI office claimed an overpayment because the Social Security Administration coded the petitioner as a California resident from December 2021 […] Read more

DHA Case No. MKB 200031 (Wis. Div. of Hearings and Appeals January 14, 2021) (DHS) ↓ Download PDF Mosaic Down Syndrome and non-mosaic Down Syndrome are treated differently under the Social Security disability rules. The latter is listed as a severe impairment and automatically meets the requirements; the former is not. So for mosaic Down […] Read more

DHA Case No. MKB 207607 (Wis. Div. of Hearings and Appeals April 28, 2023) (DHS) ↓ Download PDF To qualify for the Katie Beckett Medicaid program, a child must meet the Social Security standards for childhood disability, which requires “a disabling impairment … that causes marked and severe functional limitations.” In this case, the child […] Read more

DHA Case No. MDD 207614 (Wis. Div. of Hearings and Appeals April 24, 2023) (DHS) ↓ Download PDF To be eligible for the MAPP program, the applicant must meet the SSI definition of disability. This disability determination considers the applicant’s functional capacity to do various kinds of work. In this case, the applicant was 30 […] Read more

DHA Case No. BCS 207530 (Wis. Div. of Hearings and Appeals April 6, 2023) (DHS) ↓ Download PDF Wisconsin law provides that able-bodied adults who refused to cooperate in establishing the paternity of a child without good cause are ineligible for MA. In this case, the petitioner refused to identify the father of her child […] Read more

DHA Case No. BCS 207290 (Wis. Div. of Hearings and Appeals February 10, 2023) (DHS) ↓ Download PDF An applicant must be a U.S. citizen or qualifying lawful immigrant to be eligible for Medicaid. In this case, the petitioner applied for MA and was initially approved, but Homeland Security soon notified the agency that the […] Read more

DHA Case No. MDD 207161 (Wis. Div. of Hearings and Appeals March 27, 2023) (DHS) ↓ Download PDF A disability determination for the MAPP does not involve the usual “substantial gainful activity” test, but that is only the first step in a 5-step analysis that often comes down to “residual functional capacity” to perform different […] Read more

DHA Case No. MDD 206834 (Wis. Div. of Hearings and Appeals March 28, 2023) (DHS) ↓ Download PDF To be eligible for MAPP, an applicant must meet the SSI definition of disability. In this case, the petitioner was a 64-year-old woman with a high school diploma; diagnoses including Bipolar Disorder, ADHD, PTSD, torn rotator cuff, […] Read more

DHA Case No. MKB 200405 (Wis. Div. of Hearings and Appeals January 6, 2021) (DHS)  ↓ Download PDF The final step in the disability determination process for the Katie Beckett program is determining if the child has “marked limitations” in two of six domains or an “extreme limitation” in one. In this case, the DDB […] Read more

DHA Case No. MKB 200264 (Wis. Div. of Hearings and Appeals January 11, 2021) (DHS)  ↓ Download PDF The final step in the disability determination process for the Katie Beckett program is determining if the child has “marked limitations” in two of six domains or an “extreme limitation” in one. In this case, the DDB […] Read more

DHA Case No. MDD 199954 (Wis. Div. of Hearings and Appeals January 14, 2021) (DHS) ↓ Download PDF If the Social Security Administration makes a finding of no disability for an SSI or SSDI application within 12 months of a state Medicaid application, that finding is generally binding on the state. In this case, the […] Read more

DHA Case No. MDD 200680 (Wis. Div. of Hearings and Appeals February 10, 2021) (DHS) ↓ Download PDF In making a disability determination, the Disability Determination Bureau (DDB) applies a 5-step test. Step 5 considers whether the individual can adjust to types of work the individual has not performed in the past, considering his or […] Read more