DHA Case No. MDV 38/56284 (Wis. Div. Hearings and Appeals May 6, 2003) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, the community spouse requested an increase […] Read more

DHA Case No. MRA 145788 (Wis. Div. Hearings and Appeals Apr. 5, 2013) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” The institutionalized spouse may also allocate income to children […] Read more

DHA Case No. MRA 9/41969 (Wis. Div. Hearings and Appeals Dec. 9, 1999) (DHS) ↓ Download PDF Federal law defines “institutionalized spouse” as someone who is either: (a) in a medical institution and whose spouse is not in a medical institution, or (b) receiving Community Waivers services and whose spouse is not in a medical […] Read more

DHA Case No. MRA 70/21384 (Wis. Div. Hearings and Appeals Mar. 30, 1998) (DHS) ↓ Download PDF The Medicaid Eligibility Handbook defines a “community spouse” as someone who is both married to an institutionalized person and not living in a medical institution for 30 or more days. In this case, the petitioner resided in a […] Read more

DHA Case No. MRA 10/59183 (Wis. Div. Hearings and Appeals Sep. 23, 2003) (DHS) ↓ Download PDF At the time of this case, the Medicaid Eligibility Handbook provided that a retirement fund was not countable if the applicant was receiving periodic payments from it. “Retirement funds” included individually owned IRAs. In this case, the petitioner […] Read more

DHA Case No. MRA 20/20606 (Wis. Div. Hearings and Appeals Mar. 30, 1998) (DHS) ↓ Download PDF The Medicaid Eligibility Handbook defines a “community spouse” as someone who is both married to an institutionalized person and not living in a medical institution for 30 or more days. In this case, the petitioner resided in a […] Read more

DHA Case No. MRA 183762 (Wis. Div. Hearings and Appeals Mar. 9, 2018) (DHS) ↓ Download PDF Wisconsin law generally provides that non-trust income is treated as the income of the “person in whose name the payment is made.” In this case, the petitioner purchased an irrevocable qualified annuity; the petitioner was the owner and […] Read more

DHA Case No. MRA 216768 (Wis. Div. Hearings and Appeals Mar. 6, 2025) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, a previous fair hearing decision had […] Read more

DHA Case No. MGE 218218 (Wis. Div. Hearings and Appeals Aug. 6, 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 and […] 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 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

DHA Case No. MRA 215653 (Wis. Div. Hearings and Appeals Dec. 20, 2024) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, ALJ Kelly Cochrane summarily ordered the […] Read more

DHA Case No. MGE 208717 (Wis. Div. Hearings and Appeals Nov. 26, 2024) (DHS) (decision on cost motion) ↓ Download PDF Under the Wisconsin Equal Access to Justice Act (WEAJA), petitioners who prevail in a fair hearing are entitled to an award of costs unless the agency’s action was “substantially justified.” In this case, the […] Read more