Argued
March 19, 2018
Procedural
History
Appeal
from the decision of the defendant Commissioner of Social
Services denying in part an application for Medicaid
benefits, brought to the Superior Court in the judicial
district of New Britain and tried to the court, Cole-Chu,
J.; judgment dismissing the appeal, from which the
plaintiff appealed. Reversed; judgment directed.
Andrew
S. Knott, with whom, on the brief, was Robert J. Santoro, for
the appellant (plaintiff).
Patrick Kwanashie, assistant attorney general, with whom, on
the brief, was George Jepsen, attorney general, for the
appellee (defendant).
DiPentima, C. J., and Sheldon and Harper, Js.
OPINION
SHELDON, J.
The
plaintiff, Heather Handel, conservatrix for her father,
Robert Wojciechowski (applicant), appeals from the judgment
of the trial court affirming the denial of certain Medicaid
benefits by the defendant, the Commissioner of Social
Services, and dismissing her administrative appeal from that
denial. On appeal to this court, the plaintiff claims that
she is entitled to the relief requested-Medicaid coverage for
a specified period of months-because the decision denying
that relief was not issued by the Department of Social
Services (department)[1] within the time period mandated by
law.[2] We agree and, accordingly, reverse the
judgment of the trial court.
The
trial court set forth the following relevant factual and
procedural history. ‘‘On August 2, 2013, the
applicant, suffering from a primary diagnosis of dementia,
was admitted to Sheriden Woods Health Care Center, a
long-term care facility in Bristol, Connecticut. Two days
later, with the plaintiff's help he applied for Medic-aid
for his residential care costs not covered by his Social
Security benefits. On August 7, 2013, the plaintiff was
appointed to the fiduciary capacity in which she brings this
appeal: conservat[rix] of the applicant. Her initial
fiduciary certificate did not give her authority to liquidate
insurance policies or retirement accounts. On September 16,
2013, the department sent the plaintiff the first of what
would eventually be twelve asset verification requests. Each
such request informed the plaintiff of the $1600 asset limit
for eligibility for the Medicaid benefit applied for. There
were only two assets which were not liquidated and spent
until June of 2014: a Lincoln Life Insurance account with a
cash value of $9315.01 as of June 4, 2014 [insurance policy],
and a Fidelity IRA account with a balance of $2187.88 as of
June 2, 2014 [IRA].
‘‘In
December of 2013, the plaintiff began trying to cash in the
insurance policy. On March 14, 2014, after she discovered
that Lincoln Life Insurance required specific Probate Court
authority to liquidate the insurance policy, the plaintiff
asked the Probate Court for authority to liquidate the
insurance policy and the IRA. On May 1, 2014, the Probate
Court granted the plaintiff that authority. On June 2, 2014,
the plaintiff closed the IRA account. On June 4, 2014, the
plaintiff liquidated the insurance policy. She promptly
applied the proceeds of the IRA and insurance policy to the
applicant's debts, thus bringing the applicant's
assets under $1600.
‘‘On
July 23, 2014, the department granted [the applicant's]
application for Medicaid benefits, starting June 1, 2014, and
denied benefits for March, April and May, 2014.
‘‘On
September 17, 2014, the plaintiff requested that the
department hold an administrative hearing on her challenge to
the July 23, 2014 denial of benefits for March, April and
May, 2014. On September 30, 2014, the department sent the
plaintiff a notice that the requested hearing would take
place on October 23, 2014. On October 16, 2014, the
plaintiff, by her attorney, asked the department for a
postponement of the hearing due to a conflict with a court
event. On October 21, 2014, the department sent the plaintiff
a notice of rescheduled hearing on November 10, 2014.
‘‘On
November 10, 2014, the requested hearing was conducted by the
department's hearing officer. At the end of the hearing,
the hearing officer left the record open, by agreement, for
additional information. The hearing record was announced as
closing, and did close, on December 1, 2014. The hearing
officer's decision was issued on February 20, 2015, the
81st day after December 1, 2014, and the 127th day after
October 16, 2014.'' (Footnotes omitted.)
The
plaintiff filed an administrative appeal, pursuant to General
Statutes § 4-183, to the Superior Court from the
department's denial of benefits for March, April and May,
2014, on the ground that the department erroneously
determined that the life insurance policy and the IRA were
assets that were available to the applicant during those
months, and thus that he had more than the minimum $1600
worth of assets available to him and was ineligible for
Medicaid until those assets were spent down. The plaintiff
also argued that her claim for benefits during March, April
and ...