Law Tips: What’s New in Medicaid for the Disabled Law?

“Most Medicaid disability applicants are very ill, frustrated, and overwhelmed by the application process. The assistance of an attorney who is knowledgeable in this area can be an invaluable resource for an applicant.”  This expert viewpoint of Jane Langdon Null, Indianapolis Elder Law attorney,  is expressed as a part of her ICLEF presentation on the Indiana Medicaid for the Disabled Law. Following is a portion of her instruction aimed at assisting practitioners in maintaining reliability in this area:

Recent Changes in the Indiana Medicaid for the Disabled Law

Until recently, Indiana made its own disability determinations and would not accept determination of disability from the Social Security Administration; however, Indiana procedures were recently changed so that an individual currently receiving disability benefits through the Social Security Administration will automatically meet the disability definition for Indiana Medicaid and will not need to submit medical documentation to the Medicaid Medical Review Team (MMRT).

Upon applying for Medicaid Disability, the Eligibility Specialist will verify through the State Data exchange with the Social Security Administration whether the applicant is currently receiving Supplemental Security Income (SSI) or Social Security Disability (SSDI). If the applicant alleges to be  receiving Social Security benefits on the basis of disability, but it is not verifiable through the data exchanges, the applicant can obtain proof of disability status from the Social Security Administration.  This verification must be directly issued by the SSA, must be current within 30 days, and must specify receipt of benefits on the basis of the individual’s disability. See ICES 2412.30.00.

An individual who has been determined by the SSA to not be disabled, will not meet the Medicaid definition of disability unless the condition has worsened since the SSA denial or the individual has had onset of a new condition not considered by the SSA. In this situation, medical information must be submitted to the MMRT for a decision.

This is a significant change in the Indiana Medicaid Disability arena. This new procedure will eliminate the need to gather additional medical records and physician’s statements when an individual has already gone through the arduous Social Security Disability process. However, I have concerns about how a Social Security Disability denial will negatively impact a potential Indiana Medicaid Disability recipient.

The Social Security Administration denies many disability applicants and the appeals process can be overwhelming. Presumably, many individuals shy away from going forward with the lengthy Social Security Disability appeals process even though they have a good chance of winning on appeal. With a recent Social Security denial on record they will be unable to apply for Medicaid Disability in Indiana unless they can show that since the previous denial from Social Security disability their condition has worsened or they have experienced the onset of a new medical condition.

I appreciate Ms. Null’s overview of the current status of Indiana Medicaid Disability law and hope you were able to glean a few pointers from this material.  She offered this concluding viewpoint that sums up the challenge faced by practitioners as you strive to be that invaluable resource for your clients. “The Indiana Medicaid program is very complex and constantly changing. To practice in this area requires a thorough knowledge of the rules and ICES provisions, as well as an understanding of the case processing system.”

If you wish to obtain CLE in this arena, including the full presentation by Ms. Null and other experts in the field, “Medicaid, SSI and VA Benefits” is currently available as a Video Replay or as an Online / On Demand Seminar, Click Here.

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Our Law Tips Faculty Member:
Ms. Jane Langdon Null currently has her own law practice on the north side of Indianapolis. In addition, she is “Of Counsel” with Fechtman Law Office. Her practice focuses on elder law issues, including guardianship, advance directives, Medicaid planning and application, wills and trusts, probate estate administration and nursing home residents’ rights. In addition to traditional elder law issues, she provides assistance with determining and locating the most appropriate type of care for her clients, ensuring quality care, and coordinating service providers.

About our Law Tips blogger:
Nancy Hurley, Law Tips blogger, has long-standing connections with Indiana lawyers.  She was formerly a member of the ISBA and IBF staffs for over 30 years. Nancy’s latest lifestyle venture is with ICLEF. We plan to utilize her exceptional writing and interviewing skills while exploring how her Indiana-lawyer background fits with ICLEF’s needs.  When she isn’t ferreting out new topics for Law Tips, her work can be found in our Speaker Spotlight blogs, postings on the ICLEF Facebook page, Twittering and other places her legal experience lends itself.

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ICLEF • Indiana Continuing Legal Education Forum, Indianapolis, IN

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