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Decision by the Division of Social Services (DSS) to close Medical Assistance


In re: DCIS No. Redacted Redacted

Appearances:
Redacted, Appellant
Nicolette Shuhart, Social Worker Supervisor, Division of Social Services

I.

Redacted (Appellant) opposes a decision by the Division of Social Services (DSS) to close her Medical Assistance case based upon being over the income limit for a household of one (1).

The Division of Social Services (DSS) contends that the Appellant is over the income limit for a household of one (1).

II.

On September 28, 2004, DSS sent to Appellant a Notice to Close Your Medical Assistance, effective after October 31, 2004. (Exhibit 3)

The Appellant filed a request for a fair hearing, dated October 7, 2004. (Exhibit 2). Assistance has continued pending the hearing decision.

The Appellant was notified by certified letter dated November 8, 2004, that a fair hearing would be held on December 6, 2004. The hearing was conducted on that date in New Castle, Delaware.

This is the decision resulting from that hearing.

III.

Ms. Redacted applied for and was receiving medical assistance benefits. At the time of her re-determination she indicated to her social worker that she was receiving $1033.00 in social security disability benefits. DSS then issued a Notice to Close Your Medical Assistance. (Exhibit 3)

Pursuant to DSSM 16230, countable income is used to determine eligibility for benefits. DSSM 16230 defines countable income as earned or unearned income minus any disregards, if applicable. In this case, the Appellant did not receive an earned income deduction (disregard) in the amount of $90.00 because her income was not from employment. (DSSM 16250). Pursuant to DSSM 16230.1.1, DSS is only permitted to utilize gross income, and not net income (after expenses), for purposes of eligibility.

Based upon the information provided, DSS correctly determined that the Appellant's unearned monthly countable income is in excess of the $776.00 income limit for a household of one (1) for adult poverty medical assistance benefits. As a result, the Appellant was properly sent a Notice to Close Your Medical Assistance. (Exhibit 3)

IV.

For these reasons, the decision of the Division of Social Services to close Appellant's Adult Poverty Medical Assistance application is AFFIRMED.

Date: January 26, 2005

MICHAEL L. STEINBERG
HEARING OFFICER

THE FOREGOING IS THE FINAL DECISION OF THE DIVISION OF SOCIAL SERVICES

POSTED
MLS/vmd

cc:
Redacted
Nicolette Shuhart, DSS

EXHIBITS FILED IN OR FOR THE PROCEEDING

  • EXHIBIT #1 - Copy of DSS Fair Hearing Summary consisting of two (2) pages date-stamped October 26, 2004.
  • EXHIBIT #2 - Copy of the Appellant's request for a fair hearing dated October 7, 2004, consisting of one (1) page.
  • EXHIBIT #3 - Copy of the Notice to Close Your Medical Assistance dated September 28, 2004, consisting of four (4) pages.


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