In early March of this year, I was half-listening to a Milwaukee AM radio segment on government benefits when a caller’s voice stopped me cold. She was calm — almost eerily so — describing how her employer had denied her workers compensation claim after a forklift accident, how her family’s income had essentially evaporated, and how she had spent nearly a year trying to get Medicaid coverage sorted out. When the segment ended, I reached out to the station and tracked down the caller. Her name was Janine Mendez, 65, a warehouse supervisor from Milwaukee’s south side. She agreed to meet me at a diner on West Burnham Street two weeks later.
What Janine shared over the next two hours was not a simple success story. It was something more complicated and, I think, more useful: the account of a working person who did almost everything right and still spent nearly a year in bureaucratic limbo. Her experience illuminates gaps in the Medicaid system that affect thousands of low-income workers in Wisconsin — particularly those whose income fluctuates month to month.
The Injury That Started Everything
Janine had worked in warehouse logistics for nearly two decades. She was supervising a loading dock shift on a Thursday morning in late October 2024 when a forklift clipped a shelving unit and sent a pallet of metal brackets down onto her left shoulder and upper back. She was taken by ambulance to Froedtert Hospital. The diagnosis: a torn rotator cuff and two compressed vertebrae.
The workers compensation claim her employer filed on her behalf was denied in December 2024. The employer’s insurance carrier argued that she had not followed proper safety protocol — a claim Janine disputes to this day. The denial meant no wage replacement payments, no covered medical bills, and no clear timeline for appeal resolution.
With her husband at home caring for their three children — the youngest still in high school — Janine had been the household’s primary earner. Her base pay was approximately $47,000 a year, but overtime and weekend shifts routinely pushed her monthly take-home above $4,200. Without that income, the family was suddenly looking at savings that would run out in about six weeks.
The Medicaid Application: Where the Confusion Began
Janine’s first call to Wisconsin’s ACCESS public benefits portal came in January 2025. She told me she spent two hours on the phone that first day just trying to understand whether her family qualified. The answer, it turned out, was not straightforward.
Wisconsin’s BadgerCare Plus program — the state’s primary Medicaid vehicle — covers families and individuals with incomes at or below 100% of the Federal Poverty Level, according to the Wisconsin Department of Health Services. For Janine’s household of five, that meant an annual income limit of roughly $35,140. But calculating her income was the problem: her wages had been irregular for years, with some months reaching $5,100 and others falling below $3,500 depending on shift availability.
When Janine submitted her first application in January 2025, the state’s system calculated her income based on her prior 12 months of wages — which still showed earnings well above the eligibility threshold. She was denied. The letter she received cited “household income exceeding program limits” and gave her 90 days to appeal or reapply with updated documentation.
“I read that letter four times,” she told me. “I kept thinking, that money is gone. I’m not working. Why are they counting money I’m not getting anymore?”
The Second and Third Applications — and What Finally Worked
Janine reapplied in March 2025 with three months of bank statements showing her income had effectively dropped to zero since the injury. That application stalled for six weeks before a caseworker contacted her to request additional paperwork: a letter from her employer confirming she was on unpaid medical leave, documentation of the workers comp denial, and proof of her husband’s non-employment status.
Gathering those documents took another three weeks. Her employer was slow to provide the leave confirmation letter. The workers comp denial documentation had been sent to an old mailing address. And proving that her husband was not earning income — because he had never formally been employed — required a written self-attestation form that Janine did not know existed until a DHS phone representative mentioned it almost in passing.
The third application — submitted in June 2025 with the complete documentation packet — was approved in September 2025. Coverage was granted retroactively to June of that year, meaning some of the medical bills that had accumulated over the summer were ultimately reimbursable. But not all of them. Bills from February through May 2025 — roughly $6,400 in out-of-pocket costs — fell into a gap that the retroactive approval did not cover.
SNAP Benefits: A Parallel Struggle
Alongside the Medicaid fight, Janine also applied for SNAP benefits in February 2025. For a household of five with no current earned income, the maximum monthly SNAP allotment in Wisconsin would have been $1,051, according to USDA Food and Nutrition Service guidelines for fiscal year 2025. She was approved for SNAP on her first application — a contrast to the Medicaid experience that she found almost disorienting.
“SNAP took two weeks,” she told me, almost laughing. “Medicaid took eleven months. I don’t understand how they’re run by the same government.”
The family received $874 per month in SNAP benefits — below the maximum because of a modest amount of interest income from a savings account that the state counted against their allotment. That money, Janine said, covered groceries but not much else. The family leaned on a local food pantry at St. Vincent de Paul on West Forest Home Avenue to fill the gaps.
Where Things Stand Now — and What Janine Wishes She Had Known
When I spoke with Janine in late March 2026, her workers comp appeal was still pending — more than 16 months after the original denial. Her shoulder surgery, covered retroactively through BadgerCare Plus, had been completed in November 2025. She was in physical therapy twice a week and had not yet returned to work. Her doctors estimated she might be cleared for light-duty tasks by mid-summer 2026, though a return to full warehouse duties was uncertain.
The $6,400 in uncovered medical bills from the coverage gap remained unpaid and had been sent to a collections agency in January 2026. Janine was working with a nonprofit credit counseling service to negotiate those balances down.
The navigator she referenced was a staff member at the Wisconsin Institute for Health Innovation, a Milwaukee-based organization that helps residents navigate public benefits applications. According to Benefits.gov, free enrollment assistance for Medicaid is available through certified application counselors in every state — a resource that is available but not prominently advertised by state agencies during the application process itself.
Janine is not bitter, exactly. She is clear-eyed in a way that comes from having gone through something that cannot be undone. She told me she still thinks about the people who might have given up somewhere in those eleven months — people without her stubbornness or her ability to stay organized under pressure.
I left the diner on West Burnham Street that afternoon thinking about what it actually costs a person — not in dollars but in time, sleep, and dignity — to access benefits that exist specifically for moments like the one Janine found herself in. The programs worked, eventually. But the distance between “eventually” and “when it was needed” is where real harm lives. Janine’s story does not have a tidy ending. Her appeal is still open. Her bills are still in collections. She is still healing. That is the honest version of how this goes for a lot of people — and it is worth saying clearly, without softening it.
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