DocketNumber: No. CV900438151
Citation Numbers: 1991 Conn. Super. Ct. 10367, 7 Conn. Super. Ct. 130
Judges: HOLZBERG, J. CT Page 10368
Filed Date: 12/11/1991
Status: Non-Precedential
Modified Date: 4/18/2021
The facts are not disputed by the parties. On April 26, 1989, Helen C. Danielson and her husband Raymond, who are residents of the Lutheran Home of Middletown, were awarded Old Age Benefits by the Department of Income Maintenance (hereinafter "DIM"). In October, 1989, Mrs. Danielson, who was then 84 years old, was transferred to the long term medical and nursing section of the Home. Since Old Age Assistance does not, under the defendant's regulations, cover the expenses of long term care, Mrs. Danielson applied for Title XIX, the joint federal-state program that pays for the costs related to the medical care and treatment of elderly persons. Under applicable federal and state rules a married person such as the applicant is not eligible for Title XIX if she has resources in excess of $2400. The defendant denied Mrs. Danielson's application for Title XIX benefits based on the existence of an irrevocable spendthrift trust created by Mr. Danielson for the benefit of his wife and other family members. At the time of its creation the value of the trust was $397,000.
After her application was denied the plaintiff applied for and was granted a fair hearing pursuant to Conn. Gen. Stats. 17-2a and 2b. The hearing officer sustained the agency decision, ruling that as a beneficiary of the trust created by her husband, Mrs. Danielson in fact had assets available to her which rendered her ineligible for Title XIX. In particular the hearing officer concluded that under applicable federal and state law, even though the trust vested the trustees with complete discretion as to whether or not they may disburse funds to the plaintiff, the value of the trust is to be considered an asset available to the plaintiff.
Plaintiff appeals from the decision of the hearing officer1, contending that while federal and state law may deem the proceeds of the trust available to Mrs. Danielson, in fact those proceeds are not actually available because the trustees CT Page 10369 have exercised their discretion not to make any monies available to her.
In 1965, Congress enacted Title XIX of the Social Security Act (
The Medicaid program has traditionally provided medical assistance for two categories of recipients, the "categorically needy" and the "medically needy." Winter v. Miller,
Plaintiff applied for Title XIX as a medically needy person. Her application was denied on the basis that she was the beneficiary of what is described under federal law as a Medicaid Qualifying Trust, the value of which must be considered when determining the eligibility of a Title XIX applicant.
(2) For purposes of this subsection, a "Medicaid Qualifying Trust" is a trust, or similar legal device, established (other than by will) by an individual (or an individual's spouse) under which the individual may be the beneficiary of all or part of the payments from the trust and the distribution of such payments is determined by one or more trustees who are permitted to exercise any discretion with respect to the distribution to the individual.
(3) This subsection shall apply without regard to (A) Whether or not the Medicaid Qualifying Trust is irrevocable or is established for purposes other than to enable a grantor to qualify for medical assistance under this title [
42 USCS 1396 et seq.]; or (B) whether or not the discretion described in paragraph (2) is actually exercised.
Likewise, defendant's regulations also describe the circumstances under which funds in a trust are available to an applicant:
CT Page 10371The funds in a trust are considered available to an individual if:
1. the trust was established by the individual or individual's spouse other than by means of a will; and
2. the individual is the beneficiary of the trust; and
3. the trustee is able to distribute the funds to the individual at the trustee's discretion. This is true even if:
a. the trust is irrevocable; and
b. the trustee does not exercise his or her discretion.
Connecticut DIM Uniform Policy Manual 4030.80.
A comparison of the terms of the trust with the definition of a Medicaid Qualifying Trust discloses that plaintiff's trust falls squarely within the meaning of a Medicaid Qualifying Trust. First, the trust was established by Mr. Danielson by means other than a will. Second, both Mr. Danielson and his wife are named beneficiaries of the trust. Third, the trustees are vested with complete discretion with respect to distributions to the plaintiff. Based on the foregoing the fair hearing officer properly concluded that the Danielson Trust is a Medicaid Qualifying Trust within the meaning of
While plaintiff acknowledges that the Danielson trust appears to be a Medicaid Qualifying Trust, she claims that because the trustee has exercised his discretion in favor of not disbursing funds to her the corpus of the trust is not actually available to her and therefore should not be considered in determining her eligibility for Title XIX. In support of her claim plaintiff relies on Zeoli v. Commissioner of Social Services,
While the Zeoli case bears a striking resemblance to the instant case it is no longer controlling because of the subsequent enactment by Congress of
For the foregoing reasons, plaintiff's appeal is denied.
HOLZBERG, J.
Caroline Winter v. Jeffrey C. Miller, Director, Illinois ... , 676 F.2d 276 ( 1982 )
DiBenedetto v. Commissioner of Motor Vehicles , 168 Conn. 587 ( 1975 )
Lawrence v. Kozlowski , 171 Conn. 705 ( 1976 )
C & H ENTERPRISES, INC. v. Commissioner of Motor Vehicles , 176 Conn. 11 ( 1978 )
Connecticut Television, Inc. v. Public Utilities Commission , 159 Conn. 317 ( 1970 )