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Quick Note: Bryant v. Perales

Bryant v. Perales, 161 A.D.2d 1186 (N.Y. App. Div. 1990), is certainly not the longest decision ever written by the New York Supreme Court Appellate Division (coming in at just under six hundred words), but it is an interesting case worth discussing.  In Perales, the petitioner had requested a fair hearing after the state discontinued her medical assistance, public assistance, and food stamp benefits. The Commissioner did not review the petitioner’s request relating to her Medicaid and public assistance benefits because her request for a fair hearing was not made within sixty days of the discontinuation notice.

 

The Appellate Division determined on appeal that the sixty-day time limit to file a request for a fair hearing begins to run upon the date the affected party receives notice of the agency’s determination. The petitioner had argued that the time-limit should begin to run on the date the agency’s action took effect. However, in this particular case, the state agency was not able to avoid a fair hearing on the Medicaid and public assistance benefits because the Appellate Division determined that the notice had been defective.

 

In citing a long string of New York state cases and the Code of Federal Regulations, the Appellate Division held that the state’s discontinuation notice “failed to cite the regulation upon which the agency determination was based.” Further, the Court ruled that the defective notice “effectively tolls the applicable Statute of Limitations.” Instead of remanding the issue to the agency for determination, the Court reversed the discontinuance of the petitioner’s benefits and her benefits were restored.

 

Though not a sweeping decision with broad impact, Perales exemplifies a common failing of state agencies: providing insufficient detail or authority justifying the reason for denying the applicant benefits. As discussed in previous posts, an application for public benefits implicates due process protections. This includes not only the right to a hearing, but the right to be made aware of the specific reason benefits have been denied or terminated.

 

In working with a vast network of attorneys, our office from time-to-time encounters denials from state agencies. In many cases, the denial notices are bare or include citations to the entirety of a state Medicaid manual without reference to the specific section relied upon in issuing the denial. In other cases, the state agency will deny an application based on an income, penalty period, or resource determination without illustrating the calculation that led to their conclusion. In some cases, both deficiencies are present. In all of these cases, it is essential that the Elder Law Attorney advocate for their client’s rights.

 

In the event of a denial, remember that Krause Financial Services offers litigation support. In appropriate cases, our office will even provide expert testimony on the case-specific issues. In all cases, you can expect to work with an experienced, attorney-led company dedicated to helping you and your client obtain a positive outcome.