Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Godaire v. Department of Social Services

Court of Appeals of Connecticut

June 21, 2017

RAYMOND GODAIRE
v.
DEPARTMENT OF SOCIAL SERVICES ET AL.

          Argued April 18, 2017

         Appeal from Superior Court, judicial district of New Britain, Schuman, J.

         Procedural History

         Appeal from the decision of the named defendant discontinuing certain of the plaintiff's medical benefits, brought to the Superior Court in the judicial district of New London, and transferred to the judicial district of New Britain; thereafter, the matter was tried to the court, Schuman, J.; judgment dismissing the appeal, from which the plaintiff appealed to this court. Reversed; judgment directed.

          Raymond Godaire, self-represented, the appellant (plaintiff).

          Tanya Feliciano DeMattia, assistant attorney general, with whom, on the brief, was George Jepsen, attorney general, for the appellees (defendants).

          Alvord, Sheldon and Norcott, Js.

         Syllabus

         The plaintiff appealed to this court from the judgment of the trial court dismissing his administrative appeal from the decision of the defendant Department of Social Services discontinuing the plaintiff's medical benefits under a medical assistance program for the aged, blind and disabled on the ground that he had not met the program's spenddown requirements. Prior to an administrative hearing on the matter, the Department of Social Services redetermined that the plaintiff, who was eighty-two years old at the time, was eligible for the program's benefits under a spenddown totaling $1929.72 for the period March, 2015, through August, 2015. The plaintiff previously was granted coverage under the program from August, 2014, to January, 2015, and certain dental work was to be included in that coverage. Because the dental work would not be completed until the second week of February, beyond the coverage date, a department employee extended the plaintiff's coverage under the program for one month to include February. At the hearing held on April 1, 2015, an eligibility specialist for the department told the hearing officer that the department's reinstatement of the plaintiff's benefits for one month had to be corrected, and following the hearing, a corrected eligibility document was submitted to the hearing officer indicating that the plaintiff's spenddown period would run from February, 2015, to July, 2015, rather than from March, 2015, to August, 2015. The hearing officer denied the plaintiff's appeal from the discontinuation of his medical benefits and concluded that the department correctly determined that the plaintiff had to meet a spenddown to receive the program's coverage beginning February, 2015. The plaintiff thereafter, pursuant to statute (§ 4-183), filed his administrative appeal from the hearing officer's decision in the Superior Court in the judicial district of New London. Subsequently, the trial court transferred the appeal to the Tax and Administrative Appeals Session in the judicial district of New Britain. The plaintiff, who resided in New London, filed an objection to the change of venue that was overruled by the trial court, which permitted the plaintiff to appear at the courthouse in New London and to participate in the hearing by way of closed-circuit television. The trial court thereafter dismissed the plaintiff's administrative appeal, and this appeal followed. The plaintiff claimed that the trial court had no authority to transfer his appeal from New London to New Britain, and that the court should have sustained his appeal, pursuant to § 4-183 (j), because the hearing officer's decision was made upon unlawful procedure in that it was made on the basis of records that were changed by the department to reflect are determined spenddown period beginning in February, 2015, rather than March, 2015, which prevented the plaintiff from receiving benefits for the dental procedures that he needed in February, 2015.Held:

         1. The plaintiff's claim that he was denied access to the court due to the change of venue was unavailing; the trial court properly determined that there was authority for the transfer pursuant to statute (§ 51-347b [a]), which permits transfers when required for the efficient operation of the courts and to ensure the prompt and proper administration of justice, and the plaintiff having been afforded his due process rights by being allowed to participate in the hearing via closed-circuit television, he was not denied access to the courts and he could not demonstrate any prejudice to his rights as a result of the transfer of his administrative appeal.

         2. Under the circumstances of the present case, the hearing officer's decision to discontinue the plaintiff's medical benefits was made upon unlawful procedure, as the plaintiff did not have a meaningful opportunity to respond to the ‘‘corrected'' evidence presented by the department at the end of the April 1, 2015 hearing, and, therefore, substantial rights of the plaintiff were prejudiced: the evidence in the administrative record showed that the department had advised the plaintiff that his new coverage period for the program's benefits would run from March, 2015, through August, 2015, that the plaintiff's dental work begun in the prior coverage period was covered through February, 2015, because he had satisfied the spenddown requirements for that period, that an employee of the department had extended the plaintiff's coverage through February so that he could have his dental work paid for and completed, and that, on the basis of the documents existing at the time that he appeared at the April 1, 2015 hearing, the plaintiff was operating under the reasonable belief that he had satisfied the program's prior spenddown requirements, was covered through February, and did not need to present any additional bills for his dental work; moreover, the department's retroactive change to the eligibility period resulted in the denial of coverage for the plaintiff's dental work, the plaintiff having been informed by the department that his eligibility period had been extended through February, 2015, he detrimentally relied on such information to not meet the corrected deadline of January 31 for obtaining and presenting a bill for the dental work that had already begun that would have entitled him to payment for the completion of such work, and therefore, his preexisting eligibility through February, 2015, was required under the doctrine of equitable tolling, as he should not have been penalized for failing to timely obtain and produce the dental bill when he could have done so if the department had properly advised him before January 31 that the prior eligibility period would not in fact be extended.

          OPINION

          ALVORD, J.

         The self-represented plaintiff, Raymond Godaire, appeals from the trial court's dismissal of his appeal from the final decision of the defendant the Department of Social Services (department).[1] The decision appealed from discontinued the plaintiff's benefits under the department's Medical Assistance to the Aged, Blind, and Disabled program (program or Husky C) on the ground that he had not met the program's spend-down requirements. On appeal, the plaintiff claims that the court improperly (1) concluded that the transfer of his administrative appeal from the judicial district of New London to the judicial district of New Britain did not violate his due process rights by denying him reasonable access to the courts, and (2) failed to conclude that his appeal should be sustained because the hearing officer's decision was based on ‘‘faulty records'' and ‘‘records changed by the department . . . .'' We reverse the judgment of the trial court for the reason that substantial rights of the plaintiff have been prejudiced because the hearing officer's decision was made upon unlawful procedure. See General Statutes § 4-183 (j).[2]

         The following facts, as found by the hearing officer or as undisputed in the record, and procedural history are relevant to the resolution of the plaintiff's claims. By notice dated January 28, 2015, the department advised the plaintiff that his medical assistance under Husky C was to be discontinued on January 31, 2015, due to his failure to ‘‘complete the review process.'' The plaintiff, aged eighty-two at that time, requested an administrative hearing to contest the department's action. On February 2, 2015, prior to the scheduled hearing, the department completed the plaintiff's ‘‘redetermination'' and concluded that he was eligible for the ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.