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Pikula v. Dept. of Social Services

Supreme Court of Connecticut

May 10, 2016

MARIAN PIKULA
v.
DEPARTMENT OF SOCIAL SERVICES

Argued January 25, 2016 officially released

J. Colin Heffernan, with whom, on the brief, was John C. Heffernan, for the appellant (plaintiff).

Patrick B. Kwanashie, assistant attorney general, with whom, on the brief, was George Jepsen, attorney general, for the appellee (defendant).

Rogers, C. J., and Palmer, Zarella, Eveleigh, McDonald, Espinosa and Robinson, Js.

OPINION

EVELEIGH, J.

The plaintiff, Marian Pikula, appeals from the judgment of the trial court dismissing her appeal from the decision of an administrative hearing officer for the defendant, the Department of Social Services (department), [1] denying her application for benefits under the state administered Medicaid program (Medicaid)[2] because her assets, in the form of a testamentary trust, exceeded prescribed Medicaid limits. We conclude that the trial court should not have dismissed the appeal on the ground that the hearing officer correctly determined that the trust was an asset available to the plaintiff. Accordingly, we reverse the judgment of the trial court.

The following undisputed facts, as found by the trial court, are relevant to this appeal. ‘‘In 1989, John Pikula, the plaintiff’s father, executed a will containing a testamentary trust for his two daughters: Dorothy McKee and the plaintiff. When John Pikula died in 1991, the trust became effective and the Probate Court appointed a trustee.’’

The testamentary language creating the trust provided as follows: ‘‘A. Until [the plaintiff] shall die, the [t]rustee shall pay to or spend on behalf of [the plaintiff] as much of the net income derived from this trust fund as the [t]rustee may deem advisable to provide properly for [her] maintenance and support and may incorporate any income not so distributed into the principal of the fund at the option of the [t]rustee.

‘‘B. I hereby authorize and empower the [t]rustee in his sole and absolute discretion at any time and from time to time to disburse from the principal for any of the trust estates created under this [will], even to the point of completely exhausting the same, such amount as he may deem advisable to provide adequately and properly for the support and maintenance of the current income beneficiaries thereof, any expenses incurred by reason of illness and disability. In determining the amount of principal to be so disbursed, the [t]rustee shall take into consideration any other income or property which such income beneficiary may have from any other source, and the [t]rustee’s discretion shall be conclusive as to the advisability of any such disbursement and the same shall not be questioned by anyone. For all sums so distributed, the [t]rustee shall have full acquittance.’’

In March, 2012, the plaintiff entered a long-term care facility. At that time, she applied for financial and medical assistance under Medicaid. At the time she applied for Medicaid benefits, the trust value was approximately $169, 745.91. In May, 2013, the department denied the plaintiff’s application for Medicaid benefits on the ground that her assets, including the trust, exceeded the relevant asset limits.

The plaintiff then requested a hearing to contest the department’s decision. The hearing occurred in October, 2013. Thereafter, on December 20, 2013, the hearing officer issued a decision upholding the department’s denial of the plaintiff’s Medicaid benefits because the trust was an asset that was available to her and, therefore, her assets exceeded the regulatory limits.

The plaintiff subsequently requested reconsideration of the decision pursuant to General Statutes § 4-181a (a) (1) (A). Her motion was denied. Pursuant to General Statutes §§ 17b-61 and 4-183, the plaintiff appealed from the hearing officer’s decision to the Superior Court.

In her complaint, the plaintiff alleged, inter alia, that, under the terms of the department’s policy manual and applicable case law, the trust assets are not available to the plaintiff. Specifically, the plaintiff asserted that, under the terms of the trust, the assets of the trust are not available to her because she is not entitled to receive trust principal and the trustee has sole and absolute discretion regarding trust expenditures and his decisions cannot be challenged by anyone.[3] The trial court rendered judgment dismissing the plaintiff’s appeal, concluding that the hearing officer properly determined that the trust in this case was an available asset and that, therefore, the plaintiff’s assets disqualified her from Medicaid eligibility.

The plaintiff appealed from the trial court’s judgment of dismissal to the Appellate Court. Thereafter, we transferred the appeal to this court pursuant to General Statutes ...


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