Not eligible for medicaid where over 6k in joint account
F.J.,
Petitioner-Appellant,
v.
DIVISION OF MEDICAL ASSISTANCE
AND HEALTH SERVICES and CAMDEN
COUNTY BOARD OF SOCIAL SERVICES,
Respondents-Respondents.
________________________________
Argued November 13, 2017 – Decided January 9, 2018
Before Judges Accurso and Vernoia.
On appeal from the Department of Human
Services, Division of Medical Assistance
and Health Services, Docket No. 0410053111.
Joseph T. Threston argued the cause for
appellant.
Melissa Bayly, Deputy Attorney General,
argued the cause for respondent Division of
Medical Assistance and Health Services
(Christopher S. Porrino, Attorney General,
attorney; Melissa H. Raksa, Assistant
Attorney General, of counsel; Melissa Bayly,
on the brief). NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION
This opinion shall not "constitute precedent or be binding upon any court."
Although it is posted on the internet, this opinion is binding only on the
parties in the case and its use in other cases is limited. R. 1:36-3.
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-5216-15T2
PER CURIAM
F.J. appeals from a final decision of the Director of the
Division of Medical Assistance and Health Services (DMAHS)
finding her ineligible for Medicaid benefits because her
available resources exceeded the $2000 resource limit. We
affirm.
The Camden County Board of Social Services denied F.J.'s
request for Nursing Home Medicaid, finding she had resources of
$6725.77; $1066.89 in two Wells Fargo accounts and $5658.88 in
an account maintained at Morgan Stanley. F.J. sought a fair
hearing, and the matter was transferred to the Office of
Administrative Law. In the OAL, the parties stipulated to the
amounts in the accounts, and that the Wells Fargo accounts were
unrestricted, permitting F.J. access to the funds. The only
issue was the ownership of the restricted Morgan Stanley
account.
C.J., F.J.'s daughter and guardian, testified she opened
the account in 1985 with her own money, only adding F.J.'s name
to the account as a convenience. C.J. claimed she made no
further deposits into the account and that neither she nor her
mother ever made withdrawals. In a certification, C.J. averred
the Morgan Stanley account was a joint account with her mother,
and, like a joint account the two maintained with Ameritrade,
both had to "sign off on the account" to make withdrawals.
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Based on the testimony, the administrative law judge rendered an
initial decision, finding the account belonged to the daughter
and should not be counted in determining F.J.'s eligibility for
Medicaid.
The Director reversed, finding no competent evidence to
support C.J.'s testimony about the ownership of the account or
the source of the funds, see N.J.A.C. 1:1-15.5(b) (the "residuum
rule"), and remanded for further fact-finding.
On remand, F.J. submitted a 2014 Morgan Stanley account
statement bearing the names of both C.J. and F.J. as joint
tenants, and a letter from Ameritrade explaining that in an
account held by joint tenants with right of survivorship, each
owner has an undivided interest in the entire account and can
act independently with regard to transactions. The ALJ accepted
the letter as proof that F.J. had unrestricted access to all of
the funds in the joint Ameritrade account she held with her
daughter. He further found, based on C.J.'s certification that
the Morgan Stanley account operated in the same fashion as the
Ameritrade account and the absence of any documentation showing
F.J.'s access to the Morgan Stanley account was restricted, that
"there is not sufficient evidence to overcome the presumption
that, like the . . . Ameritrade account, F.J. has access to all
of the funds in the Morgan Stanley account." The ALJ
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accordingly concluded that all of the funds in the Morgan
Stanley account should be considered available resources to
F.J., making her ineligible for Medicaid. The Director adopted
the ALJ's decision on remand.
On appeal, F.J. argues the parties stipulated the account
at Morgan Stanley was a restricted "and" account, the unrebutted
testimony was that the funds belonged to C.J., and that they
were not accessible to F.J. in any event because of her
incapacity, making them not countable toward her resource
maximum under N.J.A.C. 10:71-4.1(d)(2). We reject those
arguments.
Our role in reviewing the decision of an administrative
agency is limited. In re Stallworth,
208 N.J. 182, 194 (2011).
We accord a strong presumption of reasonableness to an agency's
exercise of its statutorily delegated responsibility, City of
Newark v. Nat. Res. Council,
82 N.J. 530, 539, cert. denied,
449 U.S. 983 (1980), and defer to its fact finding, Utley v. Bd. of
Review,
194 N.J. 534, 551 (2008). We will not upset the
determination of an administrative agency absent a showing that
it was arbitrary, capricious, or unreasonable; that it lacked
fair support in the evidence; or that it violated legislative
policies. Lavezzi v. State,
219 N.J. 163, 171 (2014); Campbell
v. Dep't of Civil Serv.,
39 N.J. 556, 562 (1963).
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Applying those standards here, we are satisfied the
Director was correct in adopting the ALJ's decision on remand.
N.J.A.C. 10:71-4.1(d)(2) provides:
When a savings or checking account is held
by the eligible individual with other
parties, all funds in the account are
resources to the individual, so long as he
or she has unrestricted access to the funds
(that is, an "or" account) regardless of
their source. When the individual's access
to the account is restricted (that is, an
"and" account), the [county welfare agency]
shall consider a pro rata share of the
account toward the appropriate resource
maximum, unless the client and the other
owner demonstrate that actual ownership of
the funds is in a different proportion. If
it can be demonstrated that the funds are
totally inaccessible to the client, such
funds shall not be counted toward the
resource maximum. Any question concerning
access to funds should be verified through
the financial institution holding the
account.
Although the parties initially stipulated the Morgan Stanley
account was a restricted one (an "and" account), C.J. certified
the account operated in the same way as her and her mother's
Ameritrade account. She subsequently produced a Morgan Stanley
statement, which listed her and her mother as joint tenants, and
a letter from Ameritrade explaining that joint tenants each have
an undivided interest in the entire account and can act
independently with regard to transactions.
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Those facts provide ample support for the Director's
reasonable conclusion that F.J. had unrestricted access to the
funds in the Morgan Stanley account held with her daughter.
Although F.J. argues the Board of Social Services should be held
to its stipulation that the Morgan Stanley account was
restricted, the Director rejected that stipulation as without
adequate support in the record under the residuum rule when she
reversed the ALJ's first decision in the case. Relying on the
law governing joint bank accounts,
N.J.S.A. 17:161-4, the
Director found that under New Jersey law "and absent any
evidence from the financial institution[], [F.J.] would have had
unrestricted access to the funds and the account is considered
her asset." The Director remanded the matter to the ALJ to
permit F.J. to adduce evidence from Morgan Stanley that her
access to the account was restricted. See Negrotti v. Negrotti,
98 N.J. 428, 433 (1985) (holding a party losing the benefit of a
stipulation must be provided "the same opportunity to present
his proofs as he would have received had the stipulation not
been entered on the record").
F.J. produced no such evidence on remand. Indeed, the
evidence she did produce, the Ameritrade letter and Morgan
Stanley statement, coupled with C.J.'s prior certification,
leads ineluctably to the conclusion that F.J. had access to all
6 A-5216-15T2
the funds in the Morgan Stanley account. That F.J. would have
been unable to withdraw the funds herself due to her incapacity
is of no moment as she could have done so through her court
appointed guardian, C.J. Cf. Chalmers v. Shalala,
23 F.3d 752,
755 (3d Cir. 1994) (holding disabled individual's physical and
mental inability to manage her resources did not preclude her
from exercising her legal right to such resources). F.J.'s
argument that the Board should be equitably estopped from
repudiating a factual stipulation, the accuracy of which she has
been unable to demonstrate, is without sufficient merit to
warrant discussion in a written opinion. R. 2:11-3(e)(1)(E).
Affirmed.
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