In an Initial Decision of the New Jersey Office of Administrative Law, Administrative Law Judge Laura Sanders held that transfers by a Medicaid applicant to her adult disabled children were exempt transfers that did not subject the Medicaid applicant to a penalty period. M.K. v. Division of Medical Assistance and Health Services and Somerset County Board.. read more →

In an opinion that breaks sharply with established practice, the New Jersey Supreme Court ruled that an application by a divorced spouse to pay child support for a disabled child into a special needs trust should be granted where the proponent shows that it is in child’s best interest to do so.  This is a.. read more →

A federal district court judge in New Jersey granted a Medicaid applicant’s motion for a preliminary injunction, thereby enjoining the State from counting an annuity owned by her husband as an available resource in determining her eligibility for Medicaid. Flamini v. Velez, Civil No. 1:12-cv-07304 (D.N.J. July 19, 2013) Elizabeth Flamini entered a skilled nursing.. read more →

John Landy and Margaret Sauchelli are elderly persons who purchased promissory notes and subsequently applied fur Medicaid benefits. New Jersey’s Department of Human Services (DHS) declared Landy arid Sauchelli to be ineligible and denied their applications. In doing so, the agency ruled that the promissory notes were countable resources that made both Landy and Sauchelli.. read more →

A Medicaid applicant who made payments to her daughter for more than four years and claimed those payments were made to cover the cost of monthly payments for her mentally ill daughter’s rent could not prove the payments were made for a purpose other than to qualify for Medicaid because she did not prove that.. read more →

A federal district court in New Jersey holds that an annuity purchased by the spouse of a Medicaid applicant with the couple’s countable resources which exceeded the resource limit under Medicaid is not a transfer for less than fair market value for purposes of Medicaid eligibility. Carlini v. Velez (U.S. Dist. Ct., D.N.J., No. 12-7290 (JEI/KMW),.. read more →

Fully Developed VA Claims The Department of Veterans Affairs (VA) has implemented a new process designed to expedite claims for VA benefits having all information required by the agency and all required supporting  evidence. The new process, officially titled in 38 CFR §20.1509(a) as the “Expedited Claims Adjudication Initiative-Pilot Program,”  is unofficially called the Fully.. read more →

New Jersey appeals court ruled that a Chancery court’s order holding that certain trust expenditures “shall not” act to deprive the beneficiary of any Medicaid benefits should a Medicaid application be made, exceeded the court’s subject-matter jurisdiction because New Jersey’s Medicaid agency, the Division of Medical Assistance and Health Services (DMAHS), was the single state.. read more →

In recent years, applicants for Medicaid benefits in New Jersey have been incorrectly denied eligibility as a result of including as “countable income” the applicants’ Veterans Administration Improved Pension (“VAIP”) benefits awarded pursuant to 38 U.S.C. § 1541(d)(1) for unreimbursed medical expenses (“UMEs”). New Jersey’s Medicaid agency, the Department of Medical and Health Services (“DMAHS”),.. read more →

On Saturday, April 27, 2013, I presented a session on the impact of elder law issues on divorce mediation at the 2013 Annual Divorce Mediation Seminar by the New Jersey Association of Professional Mediators. The topics covered in my session included Social Security, including retirement, disability and survivors benefits, Supplemental Security Income benefits, Medicare, Medicaid,.. read more →

The Department of Veterans Affairs (VA) is causing Medicaid applicants to be incorrectly denied benefits due to the way the federal agency is reporting the VA pension benefit to state agencies for the purpose of determining Medicaid eligibility. In that regard, the VA is issuing letters to state Medicaid agencies which breakdown the VA benefit.. read more →

In the event of a Medicaid denial as a result of an unauthorized transfer or gift to a third party, one avenue of redress that may be available to a Medicaid applicant is to seek a waiver of the penalty based upon the “undue hardship” exception in the Medicaid regulations. The standards under which a.. read more →

Below, courtesy of the ElderLawAnswers website, is the annual roundup of the top 12 elder law decisions decided by federal and state courts in 2012. The cases were selected based upon readership as measured by the number of readers who “clicked through” to the full story in the website’s Weekly and Monthly e-letters. Links in.. read more →

For years, clients have asked about pension benefits available from the Department of Veterans Affairs (VA). Because of this consistent client interest, I’ve written about VA pension benefits with Housebound or Aid and Attendance Supplement in many blog posts over the years. However, one issue I haven’t blogged about yet involves calculating the amount of.. read more →

New Jersey’s Medicaid rules are complicated, and seem like they’re always changing. One such change in the rules that occurs on a regular basis is the State Medicaid agency’s amendment to the Medicaid program’s “penalty divisor.”  On December 10, 2012, a Medicaid Communication, or notice, was released by the Division of Medical Assistance and Health.. read more →

In the usual case, a transfer of assets, or gift, by a Medicaid applicant made within five (5) years of the date of the Medicaid application will result in the imposition of a penalty, or period of ineligibility for Medicaid. N.J.A.C. 10:71-4.10(a) The length of the penalty period depends upon the value of the gifted.. read more →

(The 15th Annual Elder and Disability Law Symposium was held on October 3, 2012 at the New Jersey Law Center, in New Brunswick, NJ. This year, as in the past few years, I gave the case law update at the opening plenary session by summarizing the top ten (10) or so elder and disability law.. read more →

After John Lopes was admitted to a nursing home, his wife, Amelia, purchased a irrevocable, nontransferable, single premium annuity for $166,878.99 from The Hartford Life Insurance Company. The annuity contract provided for monthly payments of $2,340.83 over a period of approximately six years. In a letter, the annuity company confirmed that no part of the.. read more →

For the past several years, I have represented Thomas Saccone, a retired Newark, NJ firefighter with a severely disabled adult child named Anthony. Anthony lives with his parents, is unable to work, has been found to be totally disabled by the Social Security Administration, and for many years has received Supplemental Security Income (SSI) and.. read more →

Aid and Attendance is a benefit that is available through the Department of Veterans Affairs (VA) to a qualifying veteran whose net worth is not “excessive” and who: is bedridden, or requires the aid of another person to perform activities of daily living, or is a nursing home resident, as a result of mental or.. read more →

A New York appeals court allowed a case for legal malpractice and breach of fiduciary duty to proceed against an attorney who charged more than $44,000 for Medicaid planning work to protect a net estate valued at about $130,000. Sobel v. Ansanelli, (N.Y. Sup. Ct., App. Div., 2nd Dept., No. 2011-11418, Sept. 19, 2012). In.. read more →

Medicaid is a joint federal and state program that provides a funding source to pay nursing home costs for elderly and disabled persons.  The Medicaid program was created under Title XIX of the Social Security Act of 1965, codified in the U.S. Code, Title 42, Section 1396 et seq.  New Jersey’s Medicaid regulations are found.. read more →

A Pennsylvania appellate court held that son is liable for his mother’s $93,000 nursing home bill under the state’s filial responsibility law. Health Care & Retirement Corporation of America v. Pittas (Pa. Super.Ct., No. 536 EDA 2011, May 7, 2012). John Pittas’ mother entered a nursing home for rehabilitation following a car crash in September 2007… read more →

A New Jersey appeals court recently ruled that a Medicaid recipient’s wife is not entitled to an increase in her minimum monthly maintenance needs allowance (MMMNA) because she did not demonstrate that her financial duress was caused by exceptional circumstances. K.L. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., A.D., No. A-3288-10T1,.. read more →

Below is a roundup of the top 10 national elder law decisions for the past year, as measured by the readers of the ElderLawAnswers website. 1. Medicaid Applicant’s Penalty Period Does Not Begin Until Returned Assets Are Spent Down In Marino v. Velez (U.S. Ct. App., 3rd Cir., No. 10-2324, Jan. 10, 2011), the U.S. Court of.. read more →