DDD and Medicaid Eligibility

Navigating New Jersey DDD and Medicaid

Navigating special needs law and services for individuals with Intellectual/Developmental Disabilities (I/DD) can be a complicated and daunting experience. Accessing government benefits is key to receiving needed day to day services. Our Team is here to advocate and guide you in order to receive the level of services needed.

Functional Eligibility

An individual is functionally eligible for DDD services in New Jersey, if the individual has a severe, chronic disability of an individual which:

• Is attributable to a mental or physical impairment or combination of mental or physical impairments
• Manifests in the development years, prior to age 22
• Is likely to continue indefinitely
• Results in substantial functional limitations in three or more areas of major life activity:
  • Self-care
  • Receptive and expressive language
  • Learning
  • Mobility
  • Self-direction
  • economic self-sufficiency, and
  • capacity for independent living
• Reflects the need for a combination and sequence of special interdisciplinary or generic care, treatment or other services which are of lifelong or extended duration and are individually planned and coordinated.

Medicaid Eligibility

In order to qualify for DDD benefits in New Jersey, the individual must be found eligible for Medicaid benefits under any available program, including SSI-linked Medicaid, NJ Family Care, NJ Workability, Managed Long Term Services and Supports ("MLTSS"), Community Care Program or the Supports Program.

Strict financial requirements surround access to governmental benefits. If the beneficiary with a disability has “too much money” in their own name, they may be disqualified from all services.

Supports Program

The Supports Program provides supports to individuals living in their own home or with family members. The level of supports is based on the outcome of the NJCAT.

Community Care Program

The Community Care Program provides services to individuals who meet the specified level of care for Intermediate Care Facility for Individuals with Intellectual and Developmental Disabilities ("ICF/IDD") as assessed through the "NJCAT". These individuals also select services from the menu above with a higher level of funding based on the NJ Comprehensive Assessment Tool ("NJCAT").

NJ Comprehensive Assessment Tool (NJCAT)

The NJ Comprehensive Assessment Tool ("NJCAT") is a mandatory assessment tool used to determine DDD eligibility and the funds allotted to support the person’s individual budget. The assessment evaluates support needs in Self-Care, Behavior and Medical. NJCAT reassessments are completed every 5 years or sooner if needs have changed.

The NJCAT is an extremely important assessment that can be very challenging to complete. We are here to assist you in understanding the assessment and to provide tips to be sure you present the individual's needs accurately to receive a budget that will support their needs.

Ask a Special Needs Attorney

Many families have limited experience working with attorneys. Learn more about Who We Are and What We Do.

Wealth Preservation Services

Porzio’s Wealth Preservation attorneys serve New Jersey families with offices in Morristown NJ, Princeton NJ, and New York City. We provide legal counsel on Estate Planning, Elder Law, Asset Protection Planning, Special Needs Planning, Wills and Trusts, Powers of Attorney, Health Care Powers, Living Wills, Probate, Estate Administration, Estate and Trust Litigation, Guardianship, and Tax Planning to families in Bergen County, Essex County, Hudson County, Hunterdon County, Mercer County, Middlesex County, Monmouth County, Passaic County, Somerset County, Sussex County, Union County and Warren County.