Friday, September 11, 2015

Medicaid Applicant Bears Burden of Proof to Rebut Presumption that Joint Account Is Available Resource

Attorneys so often counsel clients not to maintain and hold joint accounts for convenience with persons other than a spouse.  In another object lesson why joint accounts can create legal problems, a Pennsylvania trial court has ruled that a Medicaid applicant has the burden of proving that money in a joint account was not an available resource. Toney v. Dept. of Human Services (Pa. Commw. Ct., No. 2343 C.D. 2014, June 19, 2015).


The applicant, Samuel Toney, had a joint bank account with his son with $41,510.18 in the account. Mr. Toney entered a nursing home and applied for Medicaid.  The state determined that half of the amount in the joint bank account belonged to Mr. Toney, and on that basis,  denied his application due to excess resources.


Mr. Toney appealed the decision, arguing that the amount in the account belonged to his son; the son claimed that the proceeds in the account came from the sale of the son's house ten years prior. The administrative law judge nonetheless denied the appeal, and Mr. Toney appealed to court.


The Pennsylvania Commonwealth Court affirmed the state's decision, holding that the burden of proof is on the applicant to prove to whom the assets in the account belong. According to the court, "no credible evidence was presented to rebut the presumption that Toney’s share is presumed available to him for purposes of determining the availability of resources for his partial or total support."

In one sense, the applicant's loss in this case might be considered a victory.  In support of the court's decision, the court cited the federal Medicaid regulations at 20 CFR Section 416.1208(c), which provides that "[i]f there is only one [applicant] account holder on a jointly held account, we presume that all of the funds in the account belong to that individual.  In other words, the state could have just as easily presumed that "all of the funds" in the joint account were a resource of the Medicaid applicant.  Hopefully, the object lesson learned, seniors will implement plans for their long-term care, asset management, and estate distribution, thereby avoiding the obvious risks associated with joint accounts for convenience.  


For the full text of this decision, click here.

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