SNT Will Not Protect Assets Until SSA or State Makes Disability Determination

A New Jersey appeals court upholds a denial of Medicaid benefits due to excess resources after finding that a court-approved supplemental needs trust cannot shelter an applicant's assets until the Social Security Administration or the state Disability Review Team determines that the beneficiary meets the federal definition of "disabled." The court also rules that the trust is not irrevocable because it contains a provision that allows the trustee to terminate the trust if it is considered a countable asset in determining the beneficiary's eligibility for benefits. J.C. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., Nos. A-5632-07T25632-07T2, A-6297-07T2, Feb. 8, 2010).

A workers' compensation court awarded J.C. workers' compensation benefits after finding that she was totally and permanently disabled due to a workplace accident. After the resolution of the workers' compensation matter, a first-party supplemental needs trust (SNT) was created for J.C. and the trust was approved by a Law Division judge. Once the trust was created, J.C. applied for Medicaid, General Assistance and food stamps. The Ocean County Board of Social Services denied J.C.'s original Medicaid application after the agency determined that the SNT was not sufficient to shelter J.C.'s workers' compensation payments from being counted as available resources. The Division of Medical Assistance and Health Services (DMAHS) upheld the denial and J.C. appealed.

On appeal, J.C. argued that the resources in the SNT were unavailable because the trust met the requirements for an exempt trust under 42 USC § 1396(p)(d)(4)(A). The DMAHS reasoned that the trust did not meet the federal requirements because a (d)(4)(A) trust can only be established for a person who falls under the federal definition of "disabled." The state asserted that only the Social Security Administration or the state Disability Review Team could make the disability determination, and since the determination had not been made at the time that the trust was created, the trust did not meet the requirements of 42 USC § 1396(p)(d)(4)(A). Finally, the state also claimed that the trust was not an irrevocable trust as required by law because the trust would terminate if it was deemed an available resource for purposes of obtaining state or federal benefits.

The Superior Court of New Jersey, Appellate Division, upholds the DMAHS' denial of Medicaid benefits. The court explains that "the workers' compensation court judgment as to [J.C.'s] disability, issued by a judge in the workers' compensation context, is not dispositive of whether she is 'disabled' pursuant to the federal definition. . . [U]ntil petitioner is found to be disabled by the Social Security Administration or the state disability review team, she is not entitled to protect her assets through the use of a special needs trust." The court also determines that the language causing the trust to terminate "makes the special needs trust neither irrevocable nor in the absolute control of the trustee."

For the full text of this decision, go to: https://lawlibrary.rutgers.edu/courts/appellate/a6297-07.opn.html