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Page 2 of 2 § 10:71-2.5 Application policy and procedure Chapter Notes Case Notes Claims by a Medicaid applicant that the county agency had a duty to obtain certain banking statements relating to her assets was unsupported by law because the regulations were clear that such materials were required to be obtained by the applicant or her agents. This was especially true because the applicant did not state, in any of her applications, that she needed assistance in completing the applications. V.S. v. Bergen Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 08041-16, 2017 N.J. AGEN LEXIS 249, Initial Decision (April 26, 2017). First application for Medicaid eligibility filed by a guardian on behalf of an incapacitated person was properly denied when the guardian was unwilling to provide the verification that was requested of her pursuant to N.J.A.C. 10:71-2.5(b). The administrative law judge (ALJ) remanded a second application filed by the Public Guardian for Elderly Adults of New Jersey (OPG). The OPG was making a substantial effort to provide verification concerning the bank accounts in question but would probably not know the reasons for various withdrawals by the first guardian. The ALJ recommended that the Union County Board of Social Services deny the application for failure to provide verification only in situations where the OPG was able but unwilling to do so. F.F. v. Union Cnty. Bd. of Social Serv., OAL Dkt. No. HMA 16307-13, 2014 N.J. AGEN LEXIS 422, Initial Decision (July 18, 2014). Administrative law judge reversed the Union County Board of Social Services' determination that an applicant was ineligible for Medicaid benefits. The applicant suffered from advanced Alzheimer's disease, and his son, on behalf of the applicant under N.J.A.C. 10:71-2.5(c)1, truthfully stated that he did not have any information about the source of four deposits as reflected in a submission of two years of bank statements. The application, as submitted and explained to the best of his ability and knowledge by his son, met the prudent test of credibility pursuant to N.J.A.C. 10:71-3.1(b). S.Q. v. Union Cnty. Bd. of Social Serv., OAL Dkt. No. HMA 04202-14, 2014 N.J. AGEN LEXIS 419, Initial Decision (July 21, 2014). In connection with its processing of an application for Medicaid filed on behalf of an applicant who was then a patient in a rehabilitation facility, a county welfare agency that was seeking certain financial information had no obligation to contact anyone other than the person, a financial representative at the facility, identified by the applicant as her authorized agent. Thus, it did not matter that the applicant and her family were unaware that additional information had been requested because the agency satisfied its duty to notify the applicant of its requests when it communicated with the facility's financial representative. T.B. v. DMAHS and Union Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 2606-14, 2014 N.J. AGEN LEXIS 933, Final Administrative Determination (May 1, 2014). NEW JERSEY ADMINISTRATIVE CODE Copyright © 2025 by the New Jersey Office of Administrative Law End of Document