DHA Case No. FCP 212098 (Wis. Div. of Hearings and Appeals April 26, 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 claimed to have sent verification of assets being below $2,000 in December—via ACCESS and, a […] Read more

DHA Case No. MGE 211532 (Wis. Div. of Hearings and Appeals April 19, 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 applied August 8 and Income Maintenance did nothing until September 19, well beyond the 30-day […] Read more

DHA Case No. FCP 211586 (Wis. Div. of Hearings and Appeals March 26, 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 told the petitioner not to apply for MA until after the functional screen was completed, […] Read more

DHA Case No. FCP 211142 (Wis. Div. of Hearings and Appeals March 19, 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 filed an application October 10, but the agency never told his authorized representative of the […] Read more

DHA Case No. MDV 210958 (Wis. Div. of Hearings and Appeals March 13, 2024) (DHS) ↓ Download PDF The fair market value of real estate may be established by assessment, statements from realtors, or a comparative market analysis. In this case, the agency relied solely on the fair market value estimate it found on Zillow […] Read more

DHA Case No. FCP 211190 (Wis. Div. of Hearings and Appeals February 12, 2024) (DHS) ↓ Download PDF When applying for Family Care, Income Maintenance and the ADRC have 30 days to make their determinations of financial and functional eligibility. In this case, the petitioner was disenrolled November 1 due to excess assets, which her […] Read more

DHA Case No. FCP 210296 (Wis. Div. of Hearings and Appeals March 5, 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 agency denied the application in August after erroneously counting a burial asset. In October, after the […] Read more

DHA Case No. CWA 209367 (Wis. Div. of Hearings and Appeals January 4, 2024) (DHS) ↓ Download PDF Community Waivers enrollment can be backdated if agency error causes unreasonable delay. In this complicated case, the petitioner was first enrolled in IRIS during the pandemic as a 17- or 18-year-old under his mother’s name. His mother […] Read more

DHA Case No. CWA 210997 (Wis. Div. of Hearings and Appeals January 17, 2024) (DHS) ↓ Download PDF It is the guardian’s responsibility to complete a Medicaid renewal and to keep DHS informed when circumstances change. In this case, the petitioner changed guardians but neither guardian informed the agency, which then sent the renewal notices […] 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