Legal Aid Helps Lorain County Family in Need
Clients benefit from expertise of numerous Legal Aid attorneys
Jeanne Baker knew she needed help; brain surgery had compromised her son Gene’s independence and ability to take care of himself. Gene, 31, had been born with cerebral palsy, and now Ms. Baker found it impossible to be both at work and at home to care for him. She applied for a Medicaid nursing assistance waiver, which provides professional home health care and other benefits for qualifying applicants, but was denied.
“We were very worried because we knew he needed someone with him and we did not know where to turn,” says Ms. Baker.
Deborah Dallmann, staff attorney in Legal Aid’s Lorain County Office, explained her client’s situation: “Without the waiver, Gene would end up in a nursing home. Legal Aid was [Ms. Baker’s] last hope.” Ms. Dallmann joined forces with her colleague Karla Perry, Legal Aid’s supervising attorney for public benefits cases. Ms. Dallmann and Ms. Perry developed a strategy to obtain the much-needed waiver for Gene.
Ms. Baker’s original request for a Medicaid waiver was denied because Gene was ineligible for skilled physical care (care ordered by a physician’s prescription and provided by licensed medical professionals seven days a week). Ms. Dallmann and Ms. Perry represented Gene at a second hearing, where the original determination was still ruled to be valid. However, Gene’s condition had worsened in the time since the original hearing.
Instead of denying the claim and forcing Gene to go through the entire reapplication process, the hearing officer ordered a reassessment. The new information provided by doctors confirmed that Gene’s condition had deteriorated to the point where skilled care was necessary, and the waiver was granted. “It has lifted a great weight off my shoulders knowing my son is being cared for while I am away at work. Gene is now getting the care he needs and his spirits are much better,” says Ms. Baker. “Sometimes administrative issues can be like a whole other language, making it important to have representatives that can guide clients to meet the criteria,” says Ms. Perry. “Clearly this was one of those situations.”