Restoring Hope

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Martin Aladi, Bronx

Scott, a 22-year-old man with developmental disabilities, is covered by Medicaid’s Aged, Blind, or Disabled program.  After Scott’s mother died, his brother Martin Aladi became his legal guardian.  Martin is a young man too, busy with his own life, who was laid off from his job as a security guard and is now training to be a realtor.  Martin is doing a good job taking care of Scott, but it has been hard for Martin to navigate the health care system. 

When he learned that Scott might lose his Medicaid coverage, Martin sought out help from a CHA Advocate at BronxWorks.  “I didn’t know what to do, I felt hopeless,” Martin said. “Scott goes to programs and I was scared he would have to stay home all day.  He is mentally challenged and autistic.  I was going to a lot of different places to see who could help me.  Finally, a case worker told me about BronxWorks.” 

At BronxWorks, Martin met with a CHA Advocate.  Multiple issues affected Scott’s eligibility for coverage, which would have been difficult for anybody to handle without their help.  First, when their mother died, each brother received a check for $20,000 from their mother’s life insurance, triggering a determination that they had too much income to qualify for Medicaid.  Second, the local Department of Social Services said that Scott had failed to re-certify, but Martin had dropped the recertification forms off at the office in person. Finally, the office did not have the necessary forms showing that Martin was Scott’s guardian.

The CHA Advocate promptly requested a Fair Hearing, which is the process used to appeal a denial of Medicaid eligibility.  Over the next few weeks, she worked closely with Martin to prepare bank statements, proof of income, and other documents showing that Scott had re-certified and that his coverage should not be discontinued.  At the hearing, they were also able to clear up the confusion about Scott and Martin’s income. Ultimately, the Fair Hearing officer ruled in Scott’s favor, and Scott remained on Medicaid and was able to access his day treatment and other programs available to him because of his developmental disability.

 “I could not have done it without CHA,” Martin said.  “If anybody has a problem like I did, I would tell them to stop by and see if my CHA advocate could help because she did a very good job with my case.”