Norwalk Medicaid (Title XIX) Attorneys

What to Do if You Are Denied Benefits in Connecticut

Being denied Medicaid (Title XIX) benefits does not necessarily mean your battle is over. You have the right to appeal that denial, and the team of elder law attorneys at our law firm can help you fight for the benefits you deserve.

A denial is not necessarily the fault of the applicant. There are many delays in the system and the state does not always make the correct eligibility determination. However, because the application process is so difficult, many people give up after they are denied. However, there are possible ways to overcome a Medicaid (Title XIX) denial, and our team is there to assert your rights and use every legal means possible to turn your denial into an approval.

Here are some common reasons why the State of Connecticut sometimes turns down Medicaid (Title XIX) applications:

  • Failure to Provide the Necessary Documentation: Not substantiating the facts being asserted on the application with supporting documentation.
  • Failure to Meet Certain Deadlines: Not coming up with requested information or documentation by a set date.
  • Disqualifying Transfer(s) of Assets or Income: A large transfer of funds or assets to a family member or friend prior to applying.
  • Conveying of a Home: Signing over a home to a child prior to applying for benefits.
  • Owning too Much in Assets: An applicant whose asset value exceeds the eligibility limits.
  • Having Too High of an Income: Some applicants have incomes that exceed eligibility limits and are unaware of the ability to use “spend down” provisions to bring their income below the threshold.

If you are denied, you will receive a letter explaining the reason for the denial along with a form that can be filled out to appeal the decision and request a fair hearing. Your lawyer will handle this as a part of the appeal process. At this hearing, your case will be reviewed by a hearing officer to determine if a mistake was made when eligibility determination was made. Your request for a fair hearing should be made no more than 60 days after the date of the notice of denial. Your Medicaid attorney will fill out the appeal form that came with your denial letter, make a copy for your records and send it back to the Connecticut Department of Social Services (DSS) with a return receipt to prove that the DSS received it within the allotted time frame.

During the fair hearing, your attorney can speak for you and explain the mistakes you believe were made by the DSS that resulted in a wrongful denial. Family members and friends are also allowed to appear as witnesses. After the hearing, you will receive a written notice of the hearing officer’s decision. If you are denied again, the letter you receive should contain information on how to appeal the ruling to the state level.

Applicants are often denied Medicaid (Title XIX) benefits because of something that may have been a mere oversight. The complex and extensive application process can foster a great deal of mistakes when completed without the assistance of at attorney. Those mistakes can wind up costing applicants their benefits. But there is hope for those who have been denied. In the state of Connecticut, help is only a phone call away at our law firm. Contact us today at 203-853-4400 for your free consultation. From our Norwalk CT office, we assist residents whom have been denied Medicaid (Title XIX) benefits in Ridgefield, Newtown, Fairfield and communities throughout Fairfield County.

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