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Loboy v. Ohio Department of Job and Family Services

Court of Appeals of Ohio, Seventh District, Mahoning

June 2, 2017

GLORIA LOBOY, PLAINTIFF-APPELLANT
v.
OHIO DEPARTMENT OF JOB AND FAMILY SERVICES, DEFENDANT-APPELLEE

         Civil Appeal from the Court of Common Pleas of Mahoning County, Ohio Case No. 14 CV 2686.

          For Plaintiff-Appellant Attorney Mary Pisciotta

          For Defendant-Appellee Attorney Mike DeWine Ohio Attorney General Attorney Rebecca Thomas Assistant Attorney General

          JUDGES: Hon. Mary DeGenaro Hon. Gene Donofrio Hon. Carol Ann Robb

          OPINION

          DeGENARO, J.

         {¶1} Plaintiff-Appellant, Gloria Loboy, appeals the trial court's judgment affirming the administrative appeal decision of Defendant-Appellee, Ohio Department of Job and Family Services (Agency), denying her application for benefits. Because Loboy's arguments are meritless the judgment of the trial court is affirmed.

         {¶2} Loboy entered a nursing home in July 2013 and, through her daughter as her authorized representative, applied for Nursing Home Vendor Payment Medicaid on October 24, 2013. The Agency sent a checklist requesting verification of resources but did not inform the applicant or her daughter of the $1, 500 Medicaid resource limit. It is undisputed that Loboy had between $5, 000 and $7, 700 in her bank accounts at the time of her application.

         {¶3} Loboy's application was denied by the Mahoning County Department of Job and Family Services because her resources exceeded Medicaid eligibility limits. Loboy challenged the denial to the ODJFS Bureau of State Hearings. Although the hearing officer recognized in his state hearing decision that the Agency had not informed Loboy's daughter of the resource limit and how to reduce her resources to qualify, he nonetheless overruled Loboy's appeal, holding that there is no provision waiving the resource requirement due to agency error.

         {¶4} Loboy then appealed the state hearing decision to the ODJFS Administrative Appeal Section. The administrative appeal decision recognized that there was no dispute that Loboy had resources exceeding the $1, 500 limit in various bank accounts and found the county's actions to be correct because Loboy was not eligible for Medicaid benefits when her application was denied. Loboy appealed this decision to the trial court which affirmed the denial of Medicare benefits.

         {¶5} Loboy's sole assignment of error asserts:

The Mahoning Court of Common Pleas erred by denying the instant appeal and ruling the administrative decisions appealed from were in accordance with law.
In determining an applicant or recipient's eligibility for Medicaid, the reviewing agency must conduct a resource assessment to determine whether the applicant or recipient's aggregate resources exceed the "resource limit, " which is defined as the "maximum combined value of all resources an individual can have an ownership interest in and still qualify for Medicaid." See Ohio Adm.Code 5101:1-39-05(B)(11). For an individual, the resource limit is $1, 500. See Ohio Adm.Code 5101:1-39-05(B)(11)(a)[1].

Cook v. Ohio Dept. of Job & Family Servs., 10th Dist. No. 14AP-852, 14AP-853, 2015-Ohio-4966, ¶ 11.

         {¶6} When reviewing an administrative agency order, a common pleas court must affirm the order if, upon consideration of the entire record, it is in accordance with law and is supported by reliable, probative, and substantial evidence. Our Place, Inc. v. Ohio Liquor Control Comm., 63 Ohio St.3d 570, 571, 589 N.E.2d 1303 (1992); R.C. 119.12. An appellate court is limited to determining whether the trial court abused its discretion when reviewing the factual determinations made by the trial court. Bryant Health Care Ctr, Inc. v. Ohio Dept. of Job & Family Servs., 10th Dist. No. 13AP-263, 2014-Ohio-92, ΒΆ 23. With respect to issues of law, such as statutory construction, an appellate court ...


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