N.J. Admin. Code § 10:141-1.6

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:141-1.6 - Application process for the services/supports of the Fund

(a) The following process shall be used to apply for assistance under the Fund:

1. An individual shall contact 888-285-3060 for an application to the Fund.

i. Following an initial screening to determine that the prospective applicant meets basic eligibility criteria for the Fund, Division staff will forward application forms to the applicant or designee.

ii. Division staff shall offer assistance to the applicant in completing the application if necessary.

iii. Applications shall be available in alternative formats, upon request.

iv. Requests for applications shall be taken in any commonly accepted form.

2. The applicant shall submit the application on forms provided by the Division. The application shall document identifying information, nature and date of the injury and treatments, corroboration of the injury from a medical doctor or neuropsychologist, request for assistance, including services/support and amount, financial information with supporting data and reasons why services/support cannot be provided by another resource.

3. The application shall be reviewed by Division staff. If the medical documentation does not substantiate that the applicant's disability results from a traumatic brain injury, the Division may take the following actions:

i. Request that the applicant undergo an examination performed by a licensed neurologist, neuropsychiatrist or neuropsychologist and submit a report of such examination to enable the Fund to make a clinical determination of the presence of a traumatic brain injury; and/or

ii. Request any other information or documentation required to determine eligibility. All expenses related to the requested examinations or provision of supporting documentation shall be the sole responsibility of the applicant or parent/guardian, unless financial hardship can be demonstrated. In such cases, the Fund may elect to pay the cost for the requested consultative examination or documentation.

4. Once a complete application is received by the Division, it shall be referred for assessment and follow-up to a case management provider under contract to the Division. The case manager shall:

i. Meet with the applicant and make a recommendation to the Division to approve or disapprove the application;

ii. Identify any other available resources to meet the needs of the applicant; and

iii. Assist the applicant to revise the application and to develop a support plan.

5. All applications, with case manager recommendations, shall be referred by Division staff to the Committee to be reviewed at the first scheduled Cycle Review meeting after the application is complete. The Division shall annually publish a schedule of application deadlines related to Cycle Review meetings.

6. The application shall specify a support plan approved by the applicant (or his or her representative) and the case manager. The support plan shall identify the nature, duration and cost of services/supports.

(b) Beneficiaries who have received supports in the past may reapply as their needs dictate within the financial limits of the Fund.

N.J. Admin. Code § 10:141-1.6

Amended by 49 N.J.R. 1683(a), effective 6/19/2017