Benjamin S. Wright

MDV 45/81748 (02/26/2007)
Refinancing appraisal established FMV, despite arguments re deteriorated condition

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.03 Transfers for FMV, 3.3.12 Homestead property, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Kenneth P. Adler

DHA Case No. MDV 45/81748 (Wis. Div. Hearings and Appeals Feb. 26, 2007) (DHS) ↓ Download PDF A certified appraisal generally considers a home’s condition when estimating its fair market value. In this case, the petitioner sold her home to her son for $80,000. About one year earlier, an appraisal done for refinancing estimated the […] Read more

MDV 23/81821 (04/19/2007)
FMV of farm not reduced by land contract

Tags: 3.3 Divestment, 3.3.03 Transfers for FMV, 3.3.12 Homestead property, 3.3.15 Trusts, 3.3.15.4 Irrevocable trusts—created during or after look back, 3.3.18 Promissory notes – loans – land contracts – mortgages, ALJ Gary M. Wolkstein

DHA Case No. MDV 23/81821 (Wis. Div. Hearings and Appeals Apr. 19, 2007) (DHS) ↓ Download PDF Fair market value is an estimate of the amount an asset will sell for in an arms-length transaction on the open market. In this case, the petitioner established an irrevocable trust and funded it with stocks, life insurance, […] Read more

MDV 13/84361 (05/21/2007)
Purchase of life estate in daughter’s home was for FMV

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.03 Transfers for FMV, 3.3.25 Life estates, 3.3.25.5 Purchase of life estate in another’s home, 4 Program Administration, 4.7 Notices & fair hearings, ALJ Kenneth D. Duren

DHA Case No. MDV 13/84361 (Wis. Div. Hearings and Appeals May 21, 2007) (DHS) ↓ Download PDF The purchase of a life estate in another person’s home is a divestment if the payment exceeds the value of the life estate. In this case, the petitioner was an elderly woman who moved into her daughter’s home. […] Read more

MDV 23/99503 (01/26/2009)
Annuity without interest was divestment

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.17 Irrevocable annuities, 3.3.18 Promissory notes – loans – land contracts – mortgages, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Kenneth D. Duren

DHA Case No. MDV 23/99503 (Wis. Div. Hearings and Appeals Jan. 26, 2009) (DHS) ↓ Download PDF Purchasing an annuity or promissory note with interest at less than the applicable federal rate is a divestment. In this case, the petitioner established a private annuity that met all other requirements but returned no interest. ALJ Kenneth […] Read more

MDV 30/115352 (01/14/2011)
Transfer of adjacent, rented parcel was divestment

Tags: 3 Financial Eligibility, 3.2 Assets, 3.2.8 Business property, 3.3 Divestment, 3.3.04 Transfers of exempt income or assets, 3.3.06 Transfers made for purpose other than to qualify for Medicaid, 3.3.12 Homestead property, 3.3.12.4 Transfer of homestead to caretaker child, 3.3.24 Transfer of right to receive income, ALJ Catherine G. Demski

DHA Case No. MDV 30/115352 (Wis. Div. Hearings and Appeals Jan. 14, 2011) (DHS) ↓ Download PDF While it is generally a divestment to transfer resources for less than fair market value, there are exceptions for transferring homestead property to a caretaker child or transferring exempt business property. In this case, the petitioner owned two […] Read more

MDV 153086 (01/17/2014)
Appraisal established FMV over the county tax assessment

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.03 Transfers for FMV, ALJ Michael D. O’Brien

DHA Case No. MDV 153086 (Wis. Div. Hearings and Appeals Jan. 17, 2014) (DHS) ↓ Download PDF Generally, selling real estate for less than its fair market value is a divestment. In this case the petitioner sold her property (in which she had a life estate) for $55,000 after it was appraised at $74,000. The […] Read more

MDV 37/61571 (04/07/2004)
Real estate FMV determined by appraisal, not county assessment, but no discount for not using realtor

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.03 Transfers for FMV, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Sean P. Maloney

DHA Case No. MDV 37/61571 (Wis. Div. Hearings and Appeals Apr. 7, 2004) (DHS) ↓ Download PDF Fair market value is an estimate of the amount an asset will sell for in an arms-length transaction on the open market. In this case, the petitioner sold three residential properties to his sons for their appraised value, […] Read more

MDV 45/55210 (2003)
Transfer from RLT to family trust at first spouse’s death was a divestment

Tags: 3 Financial Eligibility, 3.3 Divestment, 3.3.13 Transfer of assets to spouse; marital property agreements, 3.3.15 Trusts, 3.3.15.3 Revocable trusts, 3.3.22 Community spouse divestment, 3.3.22.1 Before 5 years, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Nancy J. Gagnon

DHA Case No. MDV 45/55210 (Wis. Div. Hearings and Appeals, 2003) (DHS) ↓ Download PDF It is generally a divestment for a community spouse to transfer assets for less than fair market value to anyone other than the institutionalized spouse. In this case, the community spouse’s interest in marital property was transferred by his revocable […] Read more

MDV 13/106538 (01/04/2010)
No cure when son used distribution from IRR to pay for parent’s care

Tags: 3 Financial Eligibility, 3.2 Assets, 3.2.1 Availability, 3.3 Divestment, 3.3.01 Penalty period, 3.3.05 Ownership returned; cure, 3.3.15 Trusts, 3.3.15.4 Irrevocable trusts—created during or after look back, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Brian C. Schneider

DHA Case No. MDV 13/106538 (Wis. Div. Hearings and Appeals Jan. 4, 2010) (DHS) ↓ Download PDF A transfer to an irrevocable trust is generally a divestment if the trust cannot make payments back to (or for the benefit of) the grantor under any circumstances, but a divestment can be cured if the full value […] Read more

CWA 208558 (02/26/2024)
Time spent by service provider not an allowable cost under WEAJA

Tags: 4 Program Administration, 4.7 Notices & fair hearings, ALJ Kelly Cochrane

DHA Case No. CWA 208558 (Wis. Div. Hearings and Appeals Feb. 26, 2024) (DHS) (proposed decision on cost motion) ↓ Download PDF Under the Wisconsin Equal Access to Justice Act (WEAJA), petitioners who prevail in a fair hearing are entitled to an award of costs unless the agency’s action was “substantially justified.” In this case, […] Read more

CWA 208558 RHG (09/05/2023)
Agency took 7 months to decide BA request

Tags: 4 Program Administration, 4.2 Benefits, 5 Subprograms, 5.05 Home and Community-Based Waivers Long-Term Care, 5.05.4 IRIS, ALJ Kelly Cochrane

DHA Case No. CWA 208558 RHG (Wis. Div. Hearings and Appeals Sep. 5, 2023) (DHS) (decision on rehearing) ↓ Download PDF Participants in IRIS may submit a budget amendment (BA) request to increase their budget to pay for an ongoing need not met within the current budget. In this case, the petitioner submitted a BA […] Read more

CWA 208558 (07/26/2023)
Appeal erroneously dismissed (corrected on rehearing)

Tags: 4 Program Administration, 4.2 Benefits, 4.7 Notices & fair hearings, 5 Subprograms, 5.05 Home and Community-Based Waivers Long-Term Care, 5.05.4 IRIS, ALJ Kelly Cochrane

DHA Case No. CWA 208558 (Wis. Div. Hearings and Appeals Jul. 26, 2023) (DHS) ↓ Download PDF Participants in the IRIS program have certain rights to appeal that do not extend to providers. In this case, the petitioner appealed the denial of his budget amendment request to increase the rate paid to his supportive home […] Read more

MGE 175523 (03/29/2017)
Successful cost motion after over-verification appeal

Tags: 4 Program Administration, 4.1 Verification, 4.7 Notices & fair hearings, ALJ Michael D. O’Brien

DHA Case No. MGE 175523 (Wis. Div. Hearings and Appeals Mar. 29, 2017) (DHS) (proposed decision on cost motion) ↓ Download PDF A petitioner who wins a contested fair hearing is entitled to costs (including attorney fees) unless the agency was “substantially justified” or special circumstances would make the award unjust. In this case, the […] Read more

MGE 175523 (09/27/2016)
Over-verification of annuity after appeal, and divestment hunting

Tags: 4 Program Administration, 4.1 Verification, 4.7 Notices & fair hearings, ALJ Michael D. O’Brien

DHA Case No. MGE 175523 (Wis. Div. of Hearings and Appeals September 27, 2016) (DHS) ↓ Download PDF Although medical assistance applicants must verify relevant information, an agency cannot deny benefits if the applicant is incapable of obtaining the verification or needs help getting it. In this case, a prior fair hearing had determined that […] Read more

MGE 157892 (07/30/2014)
Over-verification of Wispact trust

Tags: 3 Financial Eligibility, 3.2 Assets, 3.2.5 Trusts, 3.2.5.5 Pooled trusts, 4 Program Administration, 4.1 Verification, 5 Subprograms, 5.04 Institutional Long-Term Care, ALJ Michael D. O’Brien

DHA Case No. MGE 157892 (Wis. Div. of Hearings and Appeals July 30, 2014) (DHS) ↓ Download PDF County agencies may not over-verify; they may only require the verification needed to determine eligibility. In this case, the agency requested verification of an old family trust that had been depleted and the value of a Wispact […] Read more