Adults with Disabilities: Qualifying for DDD Benefits in NJ

August 21, 2019
Adults with Disabilities: Qualifying for DDD Benefits in NJ

If you’re the parent or caregiver of a loved one with developmental disabilities who is 18 or older, you may be wondering how your child (or other loved one) will access special state-provided services as an adult. This is because when an individual with developmental disabilities turns 21, the way he or she receives certain state benefits changes.

Perhaps you and your child just moved to New Jersey or your child is aging out of the System of Care (also known as PerformCare, which, together with the state of NJ, administers and funds services for children 21 and under who have developmental disabilities). Maybe your child never accessed services when he or she was younger, but now services are required. Whatever the case, you now need to know how to qualify for DDD services as an adult in NJ. These services can include assistive technology, in-home supports, day habilitation, therapies, supported employment, residential services, and much more, depending on your loved one’s level of need.

NJ DDD Eligibility for Adults

The first thing you need to know is that qualifying for DDD services as an adult in NJ is a different process from the one you may have gone through to ensure your loved one qualified for services as a child. Individuals with developmental disabilities who are 21 or older receive state services from the Department of Developmental Disabilities rather than through PerformCare.

Unfortunately, your child’s qualification doesn’t simply roll over on his or her 21st birthday. Even if your child qualified for benefits as a child, you’ll still need to navigate the process again when your loved one with developmental disabilities becomes an adult. However, you should be aware that there is an important exception. Prior to 2013, the DDD administered services to children as well. Thus, the agency was tasked with determining children’s eligibility for DDD services. So, if your child was born before January 1, 1997 AND was (as a child 21 or younger) deemed eligible to receive DDD services prior to January 22, 2013, he or she is “grandfathered in,” meaning he or she continues to maintain DDD eligibility upon turning 21 with no new application required.  Everyone who isn’t grandfathered in will need to go through the application process. It can be tricky, but we’re here to help. We’ll review the steps you should take and where to turn when you need help.

The NJ DDD Eligibility Application Process

According the state of New Jersey, to receive DDD services, your child must be determined to meet the functional criteria of having a disability. Your child must be eligible for Medicaid and must be a verifiable primary resident of the state of New Jersey. All of this is proven through an application and supporting documents and records. Let’s first break down these three points:

  1. Functional Criteria: To meet the criteria and qualify for DDD services as an adult in NJ, your child (or loved one) must have a chronic developmental disability (which can be physical and/or intellectual) that manifested (developed) prior to age 22 and is a lifelong condition. This condition or combination of conditions must substantially limit your child in at least three of these areas of life activity:
  • self-care
  • learning
  • mobility
  • communication
  • self-direction
  • economic self-sufficiency
  • the ability to live independently

This can be frustrating for some families, whose children may be profoundly limited in two areas, but only mildly limited in others, thus preventing them from qualifying. Fortunately, SCARC can still offer your family services—more on that below.

  1. Medicaid Eligibility: Because there are several ways to initiate Medicaid eligibility, be sure to visit Medicaid Eligibility and DDD and read about the different paths to eligibility. Most commonly, individuals with developmental disabilities receive SSI (Supplemental Security Income) which automatically makes them eligible for Medicaid. This program pays a monthly benefit to children and adults with disabilities who have limited income and resources. If your loved one does not yet receive SSI, your first step should be to apply. You can learn about the program and apply at your loved one does not meet the income requirements for SSI, you should apply for Medicaid directly. You must complete an application for Medicaid for your child or loved one as his or her designated authorized representative. You’ll apply using your adult child’s own financial and employment records, not yours, so your income as a parent or relative does not affect your loved one’s ability to qualify for Medicaid. To learn more about the application process and access the checklists and forms you’ll need to apply, visit NJ FamilyCare Aged, Blind, Disabled (ABD) Programs.

    If you need help with this step, please contact SCARC or DDD’s Medicaid Eligibility Helpdesk: [email protected].

  2. State Residency: Hopefully, this is the easy one. You must be able to prove that your child is a resident of the state. You’ll need photocopies of your child’s birth certificate and social security card (or proof of citizenship or green card) as well as one of the following:
  • Voter registration card
  • Pay stub
  • W2 form
  • Real-estate tax bill
  • If in military, permanent change of station orders to NJ

If you need assistance with this step or don’t have one or more of the above forms of documentation, please contact us or the DDD for assistance.

The NJ DDD Eligibility Application

As the caregiver, you can complete the application that will determine if your loved one will qualify for services through the DDD as an adult in NJ. However, he or she must sign his or her name (you’ll sign as a witness). In addition to the application, documents should also be included as needed to prove that your child or loved one meets the functional criteria for eligibility. Part B of the application lists both required and “helpful” (but not required) documents to be included with the application. Be sure to provide photocopies only and retain all originals.

It’s important to note that an individual must be 18 years of age or older to be evaluated by the DDD for functional eligibility for services, so you can begin the process well before your child turns 21 (when he or she becomes eligible to receive services from the DDD). What’s more, your loved one can begin receiving transition-assistance services from the DDD after he or she turns 16.

The completed Application for Eligibility, including all signed forms and related documentation, must be mailed to the Community Services Office that serves the applicant’s county of residence, and addressed to Division of Developmental Disabilities Intake.

Application Questions or Problems with DDD Eligibility Process

According to the DDD, if you have questions about whether or not you/your loved one meets the criteria to be eligible for DDD-funded services or need assistance completing the application, you can contact the Community Services Office that serves the county in which your loved one lives. A DDD intake worker will talk with you about your situation and, if needed, guide you through the application process. You can also contact the office if your loved one is deemed ineligible, or while you’re waiting for a decision to be made. The DDD may be able to offer resources and services even if your loved one has not received his or her determination.

SCARC’s Assistance with NJ DDD Eligibility

Of course, you can also contact us here at SCARC and we’ll be happy to help you! We can provide you with a range of supports and services even if your loved one isn’t eligible for NJ DDD benefits or hasn’t received his or her decision. No matter where you are in the process—whether you’re waiting for the results, have been denied, or haven’t even begun filling out the application—we can help! Contact SCARC today for more information and support about services for individuals with developmental disabilities.