Justia Public Benefits Opinion Summaries

The Supreme Court affirmed in part and reversed in part the judgment of the trial court concluding that the Town of Fairfield may require James Gallagher and his wife to enroll in medicare but may also reimburse the costs of their Medicare Part B premiums, holding that the Town was not required to reimburse the Gallaghers for their Medicare premium costs.In 1985, when federal law did not permit municipal employees to participate in the Medicare system, the Town and its police union entered into a collective bargaining agreement providing that upon members who retired early, such as James, due to disability and their eligible dependents would be entitled to Town-paid private health insurance. An intervening change in federal law permitted retirees, such as James, to enroll in Medicare upon reaching the age of sixty-five. At issue was whether the Town was permitted to terminate James's private health insurance, provide him with comparable Town-paid Medicare supplemental insurance, and require that he bear the costs of his Medicare premium. The Supreme Court held that the trial court (1) properly concluded that the Town may require the Gallaghers to enroll in Medicare; but (2) erred in concluding that the Town must also reimburse the costs of the Gallaghers' Medicare premium costs. View "Gallagher v. Fairfield" on Justia Law

At issue was the relationship between Conn. Gen. Stat. 45a-655(b) and (d) in determining whether a spousal support order previously rendered by the probate court was binding on the Commission of Social Services when calculating the allowance that may be diverted to the support of the community spouse of a Medicaid eligible institutionalized person pursuant to 42 U.S.C. 1396r-5. The Commissioner decided to set a community spouse allowance for Paul Valliere in the amount of $0 with respect to the Medicaid benefit that paid for the long-term residential care of his wife, Majorie Valliere. The trial court sustained the administrative appeal brought by Plaintiffs, Paul and Ellen Shea, conservatrix and executrix of Majorie’s estate. The Supreme Court affirmed, holding that the probate court did not exceed its authority under section 45a-655 by ordering community spouse support in an amount that exceeded that which the Department of Social Services could order pursuant to 42 U.S.C. 1396r-5. View "Valliere v. Commissioner of Social Services" on Justia Law

At issue was the relationship between Conn. Gen. Stat. 45a-655(b) and (d) in determining whether a spousal support order previously rendered by the probate court was binding on the Commission of Social Services when calculating the allowance that may be diverted to the support of the community spouse of a Medicaid eligible institutionalized person pursuant to 42 U.S.C. 1396r-5. The Commissioner decided to set a community spouse allowance for Paul Valliere in the amount of $0 with respect to the Medicaid benefit that paid for the long-term residential care of his wife, Majorie Valliere. The trial court sustained the administrative appeal brought by Plaintiffs, Paul and Ellen Shea, conservatrix and executrix of Majorie’s estate. The Supreme Court affirmed, holding that the probate court did not exceed its authority under section 45a-655 by ordering community spouse support in an amount that exceeded that which the Department of Social Services could order pursuant to 42 U.S.C. 1396r-5. View "Valliere v. Commissioner of Social Services" on Justia Law

Plaintiff was a registered sex offender when he was admitted to the state rental assistance program. Thereafter, the legislature promulgated section 17b-812-13(9) of the Regulations of Connecticut States Agencies, which makes sex offender registration a ground for termination or denial of rental program assistance. The Commissioner of Housing (Commissioner) subsequently terminated Plaintiff’s rental program benefits. Plaintiff took an administrative appeal of the Commissioner’s decision to the trial court, which concluded that the Commissioner’s application of section 17b-812-13(9) was not retroactive and therefore did not exceed the authority granted to the Commissioner by the legislature. The Supreme Court reversed, holding (1) the Commissioner applied section 17b-812-13(9) of the regulations retroactively in this case by imposing a new obligation on Plaintiff’s sex offender status that terminated his rental program assistance; and (2) such retroactive application of the regulation was not statutorily authorized, and therefore, the trial court erred in dismissing Plaintiff’s administrative appeal. View "Shannon v. Comm’r of Housing" on Justia Law

Plaintiff, the beneficiary of a testamentary trust, entered a long-term care facility in 2012, at which time she applied for financial and medical assistance under Medicaid. The Department of Social Services denied the application for Medical benefits, finding that Plaintiff’s assets, including the trust, exceeded the relevant asset limits. A hearing officer upheld the department’s denial. Plaintiff appealed, arguing that the trust was not an asset available to her as defined by relevant Medicaid regulations. The trial court dismissed Plaintiff’s appeal. The Supreme Court reversed, holding that the testator intended to create a discretionary, supplemental needs trust and, therefore, the trust corpus and income may not be considered to be available to Plaintiff for the purpose of determining eligibility for Medicaid benefits. View "Pikula v. Dep’t of Social Servs." on Justia Law