On July 7, 2017, a State Fair Hearing was held at the request of Ms. Kenetria N. Carter. The hearing was requested to appeal the denial of Medicaid benefits due to an unfavorable disability decision. Background Ms. Carter submitted an application on April 17, 2017, to the Philadelphia Regional Office (RO) for Medicaid benefits through the Working Disabled program. On the same day, the RO forwarded the medical records for Ms. Carter to Disability Determination Services (DDS), who has the responsibility of making disability decisions for the Division of Medicaid (DOM). DDS notified the RO on May 24, 2017, that Ms. Carter was not disabled for Medicaid purposes. The RO issued a Notice of Adverse Action on May 26, 2017. The RO received a State …show more content…
Carter represented herself at the hearing. Her sister Ms. Mignan Johnson was present at the hearing. Ms. Martha Myers served as the Hearing Facilitator and Ms. Louise Mack was the Hearing Officer. Prior to the taking of testimony, the Hearing Facilitator informed all parties that the hearing would be recorded, and that a CD of the proceedings would be made available upon request. Further, the Hearing Officer explained the beneficiary’s rights, which were also included in the notification letter that the beneficiary received from DOM. These rights were reiterated as follows: 1. The beneficiary has the right to examine at a reasonable time before the date of the hearing and during the hearing the content of the beneficiary’s case record; 2. The beneficiary has the right to have legal representation and witnesses at the hearing; 3. The beneficiary has the right to produce documentary evidence and establish all factors and circumstances why the service should not be denied; Hearing Officer’s Recommendation Re: Kenetria N. Carter; MID #306-05-9815 August 15, …show more content…
Carter that the Working Disabled program is limited to individuals who are working at least 40 hours each month at some type of paid activity, and who meet the disability criteria. Findings According to Section 4733 of the Balanced Budget Act of 1997, the Working Disabled program is limited to individuals who are working and also meet the Supplemental Security Income (SSI) disability criteria, except for the application of “substantial gainful activity” (SGA) criteria. Although an individual must be working for purposes of the Working Disabled program, the fact that the individual is working is not to be considered in making the disability decision. After the hearing, Ms. Carter’s case was forwarded to DDS for review. DDS adopted the federal decision dated July 20, 2017, stating that Ms. Carter was not disabled for Medicaid purposes. Until this unfavorable disability finding is changed by DDS, DOM must abide by the DDS decision. Accordingly, the RO’s decision is supported by substantial evidence.
The Americans with Disabilities Act (ADA) “prohibits discriminating against an individual in the selection process” (Moran, 2014, p. 32) due to a potential disability. A disability can be defined as a mental or physical condition that can result in some sort of handicap. As a result, the employer may be required to accommodate the people who are considered as disabled, to help them perform his or her job duties.
Having a physical disability may effect a persons ability to work and therefore they would need income support and “out
be described. Jurisdictional requirements for this case as well as the reasons why it was heard at
The Plaintiff’s estate was sequestrated in Federal Magistrates Court on May 12 2009, for failure to pay Council court costs [10]. An application by the Plaintiff for an extension in time to appeal this sequestration was
In March of 1970, in the case of Goldberg v. Kelly, the US Supreme Court confirmed that individuals who are denied certain government benefits have a constitutional right to a fair hearing before an impartial decision-maker. In accordance with the Mississippi Code § 43-13-116, individuals are allows the opportunity to request in writing a fair hearing in order to appeal decisions of denial, termination, suspension or reduction of eligibility and covered services.
According to Gary Dessler, “employers with 15 or more workers are prohibited from discriminating against qualified individuals with disabilities with regard to applications, hiring, discharge, compensation, advancement, training, or other terms, conditions, or privileges of employment. It also says that employers must make ‘reasonable accommodations’ for physical or mental limitations unless doing so imposes an ‘undue hardship’ on the business.” It not only prohibits discrimination in employment but also outlaws most physical barriers in public accommodations, transportation, telecommunications, and government services.
In order to pay worker with disabilities below the federal minimum wage employers must first obtain a special minimum wage certificate from the Wage and Hour Division of the U.S. Department of Labor, which can be done online. The U.S. Department of Labor defines a person with a disability as “one whose earning or productive capacity is impaired by a physical or mental disability, including those relating to age or injury.” So essentially, the law states that the worth of a person with a disability is determined by how many shirts they can hang in one minute.
We have all experienced a day when physical or mental exhaustion has seemed to consume the whole of our body, making us feel incapable of performing simple activities such as getting out of bed, taking a shower, etc. Now, imagine being forced to cope with this on a daily basis. Millions of Americans suffer disabilities, both physical as well as mental that prevent them from performing normal day-to-day activities, one of which includes working. “The Social Security Administration (SSA) defines disability in terms of ability to work,” so why has there been an increasing amount of individuals denied disability benefits without personally meeting with an examiner. This along with the fact that there is a steady 2.5 million new applications
This is partly because other disability programs have more stringent rules on what substantiates a compensable disability, and they place higher limits on employments for recipients.
Mr. Williams submitted his application for Medicaid benefits on August 5, 2015. The Gulfport Regional Office (RO) forwarded a Disability and Blindness Report to Disability Determination Services (DDS), who has the responsibility of making disability decisions for the Division of Medicaid (DOM), on August 13, 2015. DDS notified the RO on October 16, 2015, that Mr. Williams was not disabled for Medicaid purposes. The RO issued a Notice of Adverse Action on October 23, 2015.
Remias met the VIDES and placed on the DD Waiver waiting list. His has a priority 1 status with a score of 20. He will receive a DD Periodic Support
The VIDES was met and Amaris remains on the DD waiver waiting list. Her priority changed from 2 to a 1 due to mother’s health problems.
On September 21, 2012, ACEDS Case Action Update/Display documented by Social Service Representative, Richard Gordon stated that Ms. Williams arrived to the agency to apply for Supplmental Nutrition Assistance Program (SNAP) benefits, and Medicaid for her child only. During the visit, CARE interface revealed that Ms. Williams had an open Medicaid case in Maryland (#47403882500). Maryland Social Services also reported that she was employed by CPR Medical as of August 9, 2012, and paid bi-weekly $850.00. Ms. Williams also reportedly received unearned monthly income from SSI in September 2012 in the amount of $440.34, and in October 2012, in the amount of $370.54. As a result, Ms. Williams was denied expedited Foodstamps pending paystubs and her application was marked as "pending."
The State of Georgia states specific information about employment of individuals with physical disabilities. Specifically stated is the following:
EMPLOYMENT UPDATE: Client is temporarily exempt from WECARE/FEDCAP as per doctor note. CM requested for the client to submit an update doctor note stating her disability. CM also advises the client to provide HRA with a copy.