New Jersey’s WorkAbility Healthcare Program

Individuals living with disabilities are an essential part of New Jersey’s workforce. New Jersey’s WorkAbility program helps disabled workers, who would otherwise be ineligible for Medicaid, gain access to full Medicaid coverage. This article will walk you through the basics of New Jersey’s WorkAbility program and how to qualify.

What is NJ WorkAbility?

NJ WorkAbility, formerly known as “Ticket to Work,” is a program designed to help workers with disabilities, whose income otherwise renders them ineligible for Medicaid, afford essential medical care. This program covers a variety of services, including medications, medical equipment, personal care assistant services, medical transportation, and other services. In other words, WorkAbility covers anything that would be covered under Medicaid.

Qualifying for NJ WorkAbility

Applications for NJ WorkAbility are made through your local County Board of Social Services. In general, when applying for WorkAbility, the agency considers your age, health status, insurance need, income, and residence. First, you must be a United States citizen or legal permanent resident between the ages of 16 and 64. Further, you must live in the Garden State with no present intention of leaving.

To satisfy the health status requirement, you must be determined to have a permanent disability by the relevant agency. We will discuss this in more detail in the next section. 

Further, you must be able to prove that you work part time, full time, or are self employed. To prove employment, your application must include the following:

• Birth certificate
• Four weeks of pay stubs
• Disability award letter
• Bank statements
• Social security card

Luckily, as of April 1, 2023, NJ WorkAbility no longer imposes an asset limit. This can make the application process much simpler and expands coverage to a wider range of individuals.

Couples can qualify for WorkAbility if they are both permanently disabled and can prove employment through the means described above. However, couples are subject to different income limits than single individuals.

Receiving a Disability Determination

Under New Jersey law, you are disabled if you have an impairment substantially limiting at least one major life activity. Major life activities include a variety of self-help tasks, such as eating, drinking, bathing, walking, and more. To be considered disabled or blind for the purposes of NJ WorkAbility, you will need to get an official determination by the Social Security Administration or DMAHS.

Income for NJ WorkAbility

NJ WorkAbility considers both earned and unearned income when determining eligibility. Earned income includes wages, salaries, and self-employment earnings. Unearned income, on the other hand, includes alimony, SSDI, unemployment, investment income, trust payments, and more. A non-disabled spouse’s income is also considered unearned income for purposes of WorkAbility eligibility.

In general, to qualify for WorkAbility, your unearned income cannot exceed 100% FPL, while your earned income can be up to almost 500% FPL. However, if you have both earned and unearned income, your total income cannot exceed the earned income threshold. Further, certain parts of your income are not counted towards your WorkAbility income. These are known as “disregards.”

There are a number of “disregards” when calculating your income for WorkAbility eligibility. For example, WorkAbility disregards the first $20 of your monthly unearned income. Additionally, WorkAbility does not consider the first $65 of earned income and one-half of the remainder. SSDI and Railroad Retirement System Benefits are also disregarded from your income.

Conclusion

If you are a disabled worker, know that you have options for affordable healthcare even if your income makes you otherwise ineligible for Medicaid. New Jersey’s WorkAbility program will help you access the essential medical services you need.

Aside from educating the people of the Garden State on various Medicaid programs, The Chamberlain Law Firm also helps with planning for long-term care and other estate planning needs. Give us a call today at (201) 273-9763 to schedule a consultation. And, for more Medicaid advice, be sure to check out our Insight Articles.

This article is for informational purposes only. It is not intended as legal advice. In the event you would like to speak with a lawyer about the specifics of your case, contact The Chamberlain Law Firm at (201) 273-9763 to schedule a consultation.