Sta

te of New

Jersey

Jon S. C

orzine, Governor

Dep

artm

ent of H

um

an

Services

Clarke B

runo, Acting C

omm

issioner

NEW JERSEYDEPARTMENT OF HUMAN SERVICES, DIVISION OF DISABILITY SERVICES

NJ

WorkA

bilityF

requentlyA

skedQ

uestions(F

AQ

s)

Th

is publication

is fun

ded by G

rant #11P

-93058-2/02T

he C

enters for M

edicare and M

edicaidS

ervices (CM

S)

ww

w.n

jworkability.n

j.gov

If you or you

r agency w

ould like

additional in

formation

,please call:

1-888-285-3036 (option

2)F

or assistance w

ithben

efits plann

ing services,

please call:1-877-659-4672

Q:

What is N

J WorkA

bility (NJW

)?A

:N

J WorkA

bility is a state and federally funded program

that provides Medicaid

health benefits, at a higher income

eligibility level than ever before , to people w

ith disabilities who are w

orking.

Q:

Who is eligible for N

J WorkA

bility?A

.A person m

ust be between the ages of 16

and 64, employed full or part tim

e, and have a perm

anent physical or mental

disability.

Q:

Will I qualify if I am

self-employed?

A:

Yes, self-employed individuals w

ith disabilities are also covered; you just need to provide docum

entation of self-em

ployment and incom

e.

Q:

What does N

J WorkA

bility cover?A

:N

J WorkA

bility covers all the medical and

healthcare services available through M

edicaid. These may include, but are not

limited to, durable m

edical equipment,

outpatient counseling, m

edical transportation, dental and vision care, personal care services, pharm

aceuticals and other m

edical services.

Q:

How

does WorkA

bility apply to a seasonal em

ployee?A

:W

hen the employee is not w

orking, he/she is ineligible for any m

onth where

there is no employm

ent (unless receiving paid sick leave, tem

porary disability paym

ents or workers’ com

pensation). If theperson does not report stopping w

ork as required, and continues to receive benefits during that period, that individual w

ill have incorrectly received benefits w

hich w

ill be subject to recovery.

Q:

If an SSI beneficiary works and exhausts

all SSI work deductions (ending their cash

benefits), do they have to accept and then exceed 1619B

benefits before going on the W

orkAbility program

?A

: If a person is still actively receiving SSI, w

e recom

mend they utilize the SSI 1619B

program

. If an applicant’s SSI eligibility is already term

inated, we do not require them

return to SSA; how

ever, we do ask for their

letter of termination to clarify that

termination w

as due to earnings or work

activity (as opposed to termination because

of no longer being medically disabled). W

e accept the SSA disability determ

ination rather than com

pleting another determina-

tion through the DM

AH

S Disability R

eviewteam

. If SSA says you are no longer dis-abled, w

e have to abide by that decision forone year before the person can re-apply.

16

Q:

How

much can you earn and still be

covered by NJ W

orkAbility?

A:

You can earn as much as $49,020 (gross)

annually and still be fully eligible for M

edicaid coverage through NJ W

orkAbility.

Q:

Do you have to be receiving benefits, such

as Social Security Disability Incom

e (SSDI)

or Supplemental Security Incom

e (SSI)?A

:N

o, as long as you are working and have a

permanent disability (w

hich can be determ

ined by the County B

oard of Social Services &

the Division of M

edical A

ssistance & H

ealth Services Disability

Review

Team).

Q:

What happens if the Social Security

Adm

inistration (SSA) determ

ined I am

not disabled?A

: Your application can be review

ed to see if that decision can be appealed, or if you w

ould be subject to the one year re-application rule.

Q:

Does w

orking mean I am

automatically

considered not to be disabled?A

:N

o, for this program your disability status

is evaluated without consideration of your

work activity. You are assessed as an

individual who is w

orking despite a perm

anent disability.

Q:

What is the application process for

felons/ people with crim

inal records?A

: The application process w

ould include adisability determ

ination that the County

Board of Social Services (C

BSS) w

ouldrequest through the state using recordsand form

s from the correctional facility.

Additionally, if the facility has subm

ittedan application through the Social SecurityA

dministration (SSA

) then the County/

State cannot process a concurrent disabilitydeterm

ination. If there has been a SSAdisability denial, the state is bound tohonor that decision for one year.

Q:

Is Unem

ployment Insurance considered

earned or unearned income?

A:

Unem

ployment insurance benefits are

considered unearned income.

Q:

If I am under 18 years of age, w

orking parttim

e and living with parents or fam

ily, is m

y family’s incom

e considered? A

:E

ligibility will be determ

ined by theC

ounty of Board Social

Services. A parent’sincom

e would be

deemed to the applicant

for those under age 18.The deem

ed amount is

treated as countableunearned incom

e.

52

Q:

If my spouse is not disabled, w

ould their incom

e be counted for my eligibility?

A:

Yes, the income of an ineligible spouse is

evaluated by the process of “deeming” a

portion of the income to the spouse

applying for eligibility. It is counted as unearned incom

e.

Q:

Where do I apply?

A:

If you are interested in applying, call toll free 1-888-285-3036, option 2 for initial screening and inform

ation. Applications

are taken and eligibility determination is

made at your C

ounty Board of Social

Services (CB

SS).

Q:

How

do I find out what services are

covered? How

do I find doctors/providersthat participate?

A:

Contact the M

edical Assistance C

ustomer

Center (M

AC

C) to find services/doctors/

providers. To locate the MA

CC

in yourarea call, 1-800-356-1561. If you areenrolled in a m

edicaid managed care

program, you w

ould contact that HM

O.

Q:

What happens w

hen I’m not w

orking?A

:This needs to be reported to your C

BSS to

determine if your status perm

its continua-tion of benefits, or if your eligibility needsto be suspended to avoid possible repay-m

ent of incorrectly paid benefits.

Q:

Can I use m

y employer health

insurance?A

: Yes, benefits w

ill be coordinated, with

Medicaid being the final or last payer.

Q:

Will the N

JW benefits cover m

y entire fam

ily?A

: N

o, only the eligible individual or eligible couple.

Q:

Can som

eone on WorkA

bility choose a M

edicaid HM

O or m

ust they be on fee-for-service?

A:

NJ W

orkAbility clients m

ay receive fee-for-service or

enroll in one of the M

edicaid HM

Os. In fact, w

e have been encouraging W

orkAbility clients to use

HM

O services to assure greater access to

care. Rem

ember, N

J WorkA

bility is just another route to M

edicaid eligibility - it is not a special program

.

Q:

Is there a rule regarding eligibility for felons or people w

ho have been convicted of a crim

e?A

: Prisoners m

ust no longer be under thejurisdiction of the correctional facility andm

eet all other eligibility requirements of

assistance programs. M

any correctionalinstitutions already w

ork with C

ountyB

oards of Social Service for transitionalscreening and/or applications for program

sthat can be effective upon release.

34