A Disorganized Paper Trail Often Results in a Denial of NJ Medicaid

HNWAppealing the Denial of Medicaid, Elder Law

By Fredrick P. Niemann, Esq. a NJ Applying for Medicaid Attorney

In New Jersey, Medicaid applications are getting tougher to get approved these days. The State has created a new application form that requires more detail and information. Many families call us to handle their Medicaid application. Often I advise clients that we have to work quickly.

For starters, we have to review and produce 5 years of financial records for Medicaid under its 5 year look back period. You should never wait until the State asks for the documentation because they typically will give you just 10 days to produce it under the threat of a denial for lack of documentation. If Medicaid were to deny our application 5 months after we file it, we can only refile and ask for 3 months of retroactive benefits, losing out on 2 months and subjecting the family to possibly $20,000+ in additional care costs.

So, we have to get right to work. Often a parent’s dementia has caused him or her to be destructive. Mom may have destroyed her furniture, carpet, walls and appliances, all of which over the past several years have been replaced. But what if mom didn’t keep good records of how she paid for the items she purchased?

Then what happens when mom had $50,000 of stock which she cashed in over a 2 year period? What if a child deposits the funds into their own account and then paid for moms expenses from there? My response is that is going to be a problem. Unless we can establish by a clear paper trail that the money was spent for mom, Medicaid will likely assess a penalty – a period of ineligibility.

In fact, that’s exactly what often happens. The child struggles to find receipts showing the repairs and purchases she made. Some of the contractors she hired were paid in cash. Work that was done wasn’t documented clearly. In some cases, additional work was done that was not related to the damage caused by mom.

When a client has a tough time producing documentation to show where the cash from the stock sale went, it’s a problem, especially if that account was not retitled in mom’s name.

Get the picture?

Contact me personally today to discuss your New Jersey Medicaid application. I am easy to talk to, very approachable and can offer you practical, legal ways to handle your concerns. You can reach me toll free at (855) 376-5291 or e-mail me at fniemann@hnlawfirm.com/.


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