If you receive a notice that your Medicaid waiver services are being cut, suspended, or reduced, you have a federal right to stop it immediately. This is called "Aid Continuation."
The Law (Goldberg v. Kelly): The Supreme Court ruled that the state cannot cut your lifeline benefits without a "Fair Hearing" first.
Your Tactical Steps:
The 10-Day Rule: You must file your Appeal and request a Fair Hearing within 10 days of the notice date. Do not wait.
The Magic Words: In your request, you must explicitly write: "I request Aid Continuation pending the outcome of the hearing." This forces the state to keep your services fully active until a judge decides.
The Trap: The state often uses "form letters" or generic reasons like "budget constraints." This is illegal. Under 42 C.F.R. § 431.210, they must give a specific individual clinical reason. If they used an algorithm to cut you, they have violated federal law.
Do not just appeal—demand proof of the clinical data they used to override your doctor's orders. Summary: If your Medicaid or other critical benefits in Connecticut have been abruptly terminated or reduced, you are not alone. This guide provides immediate, actionable steps to challenge these decisions, protect your rights, and ensure continuity of care, especially for brain injury survivors affected by the ABI Waiver. We expose the systemic issues and empower you with the tools to fight back. Checklist for Immediate Action:1. Do NOT Panic: Gather all correspondence related to the termination.2. Contact Legal Aid/Advocacy Groups: Reach out to organizations specializing in disability rights and Medicaid appeals immediately.3. Request a Fair Hearing: You have a right to appeal. File for a fair hearing within the specified timeframe (usually 60-90 days).4. Maintain Records: Document every call, letter, and interaction.5. Seek Interim Benefits: In some cases, benefits can continue during the appeal process. Inquire about this. Documentation Guide: Termination Notice: The official letter stating benefit termination/reduction. Medical Records: All relevant diagnoses, treatment plans, and physician statements, especially those related to your brain injury and need for ABI Waiver services. Financial Records: Proof of income, assets, and expenses. Correspondence: Copies of all letters, emails, and notes from phone calls with DSS or other agencies. Witness Statements: Testimonies from caregivers, family, or support staff regarding your needs and the impact of benefit loss.Call Script for Department of Social Services (DSS) or Managed Care Organization (MCO):'Hello, my name is [Your Name] and I am calling regarding the termination/reduction of my [Medicaid/ABI Waiver/other benefit] benefits. My case number is [Your Case Number]. I received a notice dated [Date of Notice]. I am requesting information on how to file an immediate appeal and request a fair hearing. I also want to inquire about continuing my benefits during the appeal process. Please provide me with the exact steps and any forms required. I am documenting this call, and I would like to know your name and employee ID. 'Additional Resources: Link to Connecticut Legal Services Link to National Disability Rights Network Information on the ABI Waiver regulations and your rights.* Details on how to report suspected fraud or retaliation. Remember, your voice matters.