To see if you may be eligible or to apply online, go to access.wi.gov

Application (DDE 2571) (PDF, 288KB) — To apply for Caretaker Supplement benefits.

Request For Fair Hearing, (DHA 28) (PDF, 100KB)— To request a hearing if you don't agree with a decision about your benefits.

Fair Hearing Voluntary Withdrawal (DHA 17) (PDF, 10KB) — If you want to withdraw your request for a hearing.

Other Links

Agency Directory - To find the telephone number and address of your local agency.

Income Limits - To find current income limits.

More information can be found at dhfs.wisconsin.gov/ssi/caretaker.htm.

Legal Services - To find the name and telephone number of who in your area can provide you with legal help.  You may also go to:

• Legal Action of Wisconsin, Inc. web site at badgerlaw.net/Home/PublicWeb/LAW, or

• The Wisconsin Judicare, Inc. web site at www.judicare.org/.