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Wednesday, February 10, 2010

Workers Compensation Countable as Income Despite Special Needs Trust

An injured worker was denied food stamps in NJ because money from a workers' compensation  award was countable as income despite the existence of a special needs trust.

"A special needs trust that effectively exempts assets or income from inclusion in Medicaid eligibility calculation can be established for the benefit of an individual deemed disabled pursuant to 42 U.S.C.A. § 1382c(a)(3). 42 U.S.C.A. § 1396p(d)(4)(A). The disability determination, however, can only be made by the Social Security Administration or the state disability review team, and only based on the definition set forth in the federal statute. See N.J.A.C. 10:71-3.10 to -3.12(a). Hence, the workers' compensation court judgment as to petitioner's disability, issued by a judge in the workers' compensation context, is not dispositive of whether she is "disabled" pursuant to the federal definition. See N.J.A.C. 10:71-3.10. As the Director of DMHS stated, unless and until petitioner is found to be disabled by the Social Security Administration or the state disability review team, she is not entitled to protect her assets through the use of a special needs trust. See Determining Disability and Blindness, 20 C.F.R. § 404.1504 (2009); Determining Disability and Blindness, 20 C.F.R. § 416.904 (2009)."

J.C. v. Division of Medical Assistance and Health Services, et al., Docket No.: a5632-07 Decided: 2010-02-08 
http://lawlibrary.rutgers.edu/courts/appellate/a5632-07.opn.html


Note: N.J.A.C. 10:71-3.10 Disability and Blindness Factors
For purposes of determining medical eligibility for the Medicaid Only program, the disability and blindness standards shall be the same as for the Supplemental Security Income program under Title XVI of the Social Security Act, as amended by Public Law 92-603. 42 N.J. Reg. No. 4.