Godaire v. Dept. of Social Services

RAYMOND GODAIRE v. DEPARTMENT OF SOCIAL
SERVICES ET AL.
(AC 39068)
Alvord, Sheldon and Norcott, Js.

Syllabus

The plaintiff appealed to this court from the judgment of the trial court
dismissing his administrative appeal from the decision of the defendant
Department of Social Services discontinuing the plaintiff’s medical bene-
fits under a medical assistance program for the aged, blind and disabled
on the ground that he had not met the program’s spenddown require-
ments. Prior to an administrative hearing on the matter, the Department
of Social Services redetermined that the plaintiff, who was eighty-two
years old at the time, was eligible for the program’s benefits under a
spenddown totaling $1929.72 for the period March, 2015, through August,
2015. The plaintiff previously was granted coverage under the program
from August, 2014, to January, 2015, and certain dental work was to
be included in that coverage. Because the dental work would not be
completed until the second week of February, beyond the coverage
date, a department employee extended the plaintiff’s coverage under
the program for one month to include February. At the hearing held on
April 1, 2015, an eligibility specialist for the department told the hearing
officer that the department’s reinstatement of the plaintiff’s benefits for
one month had to be corrected, and following the hearing, a corrected
eligibility document was submitted to the hearing officer indicating that
the plaintiff’s spenddown period would run from February, 2015, to July,
2015, rather than from March, 2015, to August, 2015. The hearing officer
denied the plaintiff’s appeal from the discontinuation of his medical
benefits and concluded that the department correctly determined that
the plaintiff had to meet a spenddown to receive the program’s coverage
beginning February, 2015. The plaintiff thereafter, pursuant to statute
(§ 4-183), filed his administrative appeal from the hearing officer’s deci-
sion in the Superior Court in the judicial district of New London. Subse-
quently, the trial court transferred the appeal to the Tax and
Administrative Appeals Session in the judicial district of New Britain.
The plaintiff, who resided in New London, filed an objection to the
change of venue that was overruled by the trial court, which permitted
the plaintiff to appear at the courthouse in New London and to participate
in the hearing by way of closed-circuit television. The trial court there-
after dismissed the plaintiff’s administrative appeal, and this appeal
followed. The plaintiff claimed that the trial court had no authority to
transfer his appeal from New London to New Britain, and that the court
should have sustained his appeal, pursuant to § 4-183 (j), because the
hearing officer’s decision was made upon unlawful procedure in that it
was made on the basis of records that were changed by the department
to reflect a redetermined spenddown period beginning in February, 2015,
rather than March, 2015, which prevented the plaintiff from receiving
benefits for the dental procedures that he needed in February, 2015. Held:
1. The plaintiff’s claim that he was denied access to the court due to the
change of venue was unavailing; the trial court properly determined
that there was authority for the transfer pursuant to statute (§ 51-347b
[a]), which permits transfers when required for the efficient operation
of the courts and to ensure the prompt and proper administration of
justice, and the plaintiff having been afforded his due process rights by
being allowed to participate in the hearing via closed-circuit television,
he was not denied access to the courts and he could not demonstrate
any prejudice to his rights as a result of the transfer of his administra-
tive appeal.
2. Under the circumstances of the present case, the hearing officer’s decision
to discontinue the plaintiff’s medical benefits was made upon unlawful
procedure, as the plaintiff did not have a meaningful opportunity to
respond to the ‘‘corrected’’ evidence presented by the department at
the end of the April 1, 2015 hearing, and, therefore, substantial rights
of the plaintiff were prejudiced: the evidence in the administrative record
showed that the department had advised the plaintiff that his new cover-
age period for the program’s benefits would run from March, 2015,
through August, 2015, that the plaintiff’s dental work begun in the prior
coverage period was covered through February, 2015, because he had
satisfied the spenddown requirements for that period, that an employee
of the department had extended the plaintiff’s coverage through Febru-
ary so that he could have his dental work paid for and completed, and
that, on the basis of the documents existing at the time that he appeared
at the April 1, 2015 hearing, the plaintiff was operating under the reason-
able belief that he had satisfied the program’s prior spenddown require-
ments, was covered through February, and did not need to present
any additional bills for his dental work; moreover, the department’s
retroactive change to the eligibility period resulted in the denial of
coverage for the plaintiff’s dental work, the plaintiff having been
informed by the department that his eligibility period had been extended
through February, 2015, he detrimentally relied on such information to
not meet the corrected deadline of January 31 for obtaining and pre-
senting a bill for the dental work that had already begun that would
have entitled him to payment for the completion of such work, and
therefore, his preexisting eligibility through February, 2015, was required
under the doctrine of equitable tolling, as he should not have been
penalized for failing to timely obtain and produce the dental bill when
he could have done so if the department had properly advised him
before January 31 that the prior eligibility period would not in fact
be extended.
Argued April 18—officially released June 21, 2017*

(Appeal from Superior Court, judicial district of New
Britain, Schuman, J.)
Procedural History

Appeal from the decision of the named defendant
discontinuing certain of the plaintiff’s medical benefits,
brought to the Superior Court in the judicial district of
New London, and transferred to the judicial district of
New Britain; thereafter, the matter was tried to the
court, Schuman, J.; judgment dismissing the appeal,
from which the plaintiff appealed to this court.
Reversed; judgment directed.
Raymond Godaire, self-represented, the appellant
(plaintiff).

Tanya Feliciano DeMattia, assistant attorney gen-
eral, with whom, on the brief, was George Jepsen, attor-
ney general, for the appellees (defendants).
Opinion

ALVORD, J. The self-represented plaintiff, Raymond
Godaire, appeals from the trial court’s dismissal of his
appeal from the final decision of the defendant the
Department of Social Services (department).1 The deci-
sion appealed from discontinued the plaintiff’s benefits
under the department’s Medical Assistance to the Aged,
Blind, and Disabled program (program or Husky C) on
the ground that he had not met the program’s spend-
down requirements. On appeal, the plaintiff claims that
the court improperly (1) concluded that the transfer of
his administrative appeal from the judicial district of
New London to the judicial district of New Britain did
not violate his due process rights by denying him rea-
sonable access to the courts, and (2) failed to conclude
that his appeal should be sustained because the hearing
officer’s decision was based on ‘‘faulty records’’ and
‘‘records changed by the department . . . .’’ We reverse
the judgment of the trial court for the reason that sub-
stantial rights of the plaintiff have been prejudiced
because the hearing officer’s decision was made upon
unlawful procedure. See General Statutes § 4-183 (j).2
The following facts, as found by the hearing officer
or as undisputed in the record, and procedural history
are relevant to the resolution of the plaintiff’s claims.
By notice dated January 28, 2015, the department
advised the plaintiff that his medical assistance under
Husky C was to be discontinued on January 31, 2015,
due to his failure to ‘‘complete the review process.’’
The plaintiff, aged eighty-two at that time, requested
an administrative hearing to contest the department’s
action. On February 2, 2015, prior to the scheduled
hearing, the department completed the plaintiff’s ‘‘rede-
termination’’ and concluded that he was eligible for
the program’s benefits ‘‘under a spenddown totaling
$1929.72 for the period March, 2015 through August,
2015.’’3 The plaintiff was sent notice of that redetermi-
nation.
The administrative hearing was held before a hearing
officer on April 1, 2015. At the hearing, the plaintiff
represented that he had been in the process of complet-
ing some dental work when he received the depart-
ment’s notice that he was required to meet a spenddown
requirement before the dental work could continue.
According to the plaintiff, the department had pre-
viously advised his dentist that it would pay for the
making of his false teeth. When the plaintiff reached
the time for his last appointment, which had been sched-
uled for the first or second week of February, 2015,
the dentist was notified by the department that the
plaintiff’s benefits had been discontinued. As a result
of this notification, the plaintiff’s appointment was can-
celed and all work on the false teeth ceased.
The department’s Eligibility Services Specialist, Gary
Sardo, read the Medicaid hearing summary into the
record at the April 1, 2015 hearing. The summary sets
forth the issue as follows: ‘‘[The plaintiff] receives $1182
monthly in [Social Security Administration] benefits.
His income is in excess of the monthly gross limit for
S99 Medicaid eligibility. [The plaintiff’s] period of eligi-
bility runs from March 1, 2015, to August 31, 2015. His
current spenddown amount is $1929.72. [The plaintiff]
does not agree with the fact that he is on a spenddown.’’
(Emphasis added.) Also part of the administrative
record was a notice for spenddown, dated March 30,
2015, which advised the plaintiff: ‘‘Your income is too
high for you to receive medical assistance now. How-
ever, you may still receive medical assistance from
March, 2015, to August, 2015. To be eligible, you must
show us that you have medical bills that you owe or
have recently paid. When your bills total $1929.72, your
eligibility for medical assistance will begin.’’ (Empha-
sis added.)
The plaintiff told the hearing officer that he had sub-
mitted the requisite medical bills for the period from
August, 2014, through January 31, 2015. As acknowl-
edged by Sardo at the hearing, the department employee
who assisted the plaintiff had ‘‘reinstated [the benefits]
for one month, February [2015] . . . .’’ A letter from
the department to the plaintiff dated February 18, 2015,
titled ‘‘Appeal Resolution Notice,’’ appears to confirm
this statement. Referring to the discontinuance of the
program’s benefits, the letter advised: ‘‘Our records
show that since the time you requested this hearing,
the agency has taken the following action to address
the above mentioned matter that you have appealed:
Benefits reinstated.’’ Despite these documents indicat-
ing that the plaintiff’s benefits had been reinstated for
the month of February, 2015, and that the new redeter-
mination period would run from March, 2015, through
August, 2015, Sardo told the hearing officer that the
department’s reinstatement of the plaintiff’s benefits for
one month ‘‘would need to be corrected.’’ The hearing
officer inquired: ‘‘Then let me ask, if the department
should have begun the spenddown February 1, why
wasn’t any action taken to correct that prior to today’s
hearing?’’ Sardo responded: ‘‘I just noticed it.’’
Later during the hearing, the hearing officer asked
Sardo if he would ‘‘be able to pull off the Connect
system [the plaintiff’s] actual redetermination and any
supporting documents that he submitted with that.’’
Sardo responded that he would. At the very end of the
hearing, the hearing officer stated: ‘‘And then also make
sure, Mr. Sardo, since you’ll be submitting that redeter-
mination and supporting documents along with the shel-
ter screen and the . . . fee screen, that you make
copies to send to Mr. Sardo [sic] as well, so that he
knows what I’m looking at as well.’’ Sardo responded
that he would get the requested documents to the hear-
ing officer by the end of the day. Following the hearing,
a ‘‘corrected’’ financial eligibility screen print was sub-
mitted to the hearing officer that indicated that the
plaintiff’s redetermination period ‘‘begin date’’ was Feb-
ruary, 2015, and ‘‘end date’’ was July, 2015. In the hear-
ing officer’s notice of decision dated April 28, 2015, she
made the following finding of fact: ‘‘On April 1, 2015,
the department corrected the spenddown period from
March, 2015, through August, 2015, to February, 2015,
through July, 2015. No change made to spenddown
amount.’’ The hearing officer denied the plaintiff’s
appeal, concluding that ‘‘the department correctly
determined [that the plaintiff] must meet a spenddown
to receive [the program’s] coverage beginning Febru-
ary, 2015.’’
On June 11, 2015, the plaintiff, who resides in New
London, filed this administrative appeal from the hear-
ing officer’s decision in the Superior Court for the judi-
cial district of New London, pursuant to General
Statutes § 4-183. The court transferred the appeal to the
Tax and Administrative Appeals Session in the judicial
district of New Britain. The plaintiff filed an objection
to the change of venue on June 25, 2015, which was
overruled by the court on June 26, 2015. Oral argument
on the merits of the appeal was scheduled for March
11, 2016. The court permitted the plaintiff to appear at
the courthouse in New London and to participate in
the hearing by way of closed-circuit television.
In his administrative appeal, the plaintiff alleged, inter
alia, that (1) ‘‘on February 2, 2015, [the] Husky C spend-
down extended through [the] last day of February,
2015,’’ (2) ‘‘on April 1, 2015, [the] ‘Hearing Summary’
[provided that] . . . Husky C extended through [the]
last day of February, 2015,’’ (3) ‘‘the hearing officer and
[Sardo] . . . opened the hearing after [the] plaintiff
was gone on April 1, 2015, to change [the] plaintiff’s
Husky C eligibility date . . . to make the decision to
discontinue [the] plaintiff’s Husky C medical [benefits]
within the right time frame, thus denying [the] plaintiff
coverage for his false teeth,’’ (4) ‘‘[General Statutes]
§ 4-183 . . . permits modification or reversal of an
agency’s decision if substantial rights of the appellant
have been prejudiced because the administrative find-
ings . . . conclusions, or decisions are . . . made
upon unlawful procedure,’’ (5) the department ‘‘can-
celed payment for [the] plaintiff’s false teeth on [Janu-
ary 31, 2015], and this date would not hold up if [the]
plaintiff had coverage [until] the end of February, 2015,’’
(6) ‘‘the office manager [at New London Dental Care]
called [the department] and was told [that the depart-
ment] would pay for the false teeth. Work was begun
to make [the] plaintiff’s false teeth. [The plaintiff’s] last
appointment before [he] received [his] false teeth fell
on [February 9, 2015]. [The plaintiff] called [the depart-
ment] and told [it that] the appointment fell on a date
beyond [his] coverage date. [The department] said the
date would be changed so [the plaintiff] could get [his]
false teeth, from [August, 2014], to [January 31, 2015],
changed to [August, 2014], to [February, 2015],’’ and (7)
‘‘the hearing officer’s decision was made under unlawful
procedures . . . .’’ (Citations omitted; internal quota-
tion marks omitted.)
Prior to the March 11, 2016 hearing before the court,
the plaintiff filed a prehearing brief in which he set
forth his claims and arguments. In the section titled
‘‘Statement of the Case,’’ the plaintiff made the follow-
ing representations: ‘‘[The] plaintiff was granted Husky
C . . . coverage from August, 2014, to January, 2015.
[The] plaintiff was allowed to have his upper teeth
pulled with the understanding that New London Dental
[Care] would make up an upper plate to replace the
teeth which were removed. [The department] notified
New London Dental [Care] that [the department] would
pay for the replacement plate. The making of the false
teeth went beyond the January coverage [the] plaintiff
had with his Husky C . . . August, 2014, to January,
2015. The teeth were to be completed the second week
of February, 2015. [The department’s] worker extended
[the] plaintiff’s Husky C . . . for one month so [the]
plaintiff would receive his teeth. Coverage included
February, 2015. [The department] now states no exten-
sion was granted, and if one was, it was a mistake.’’ In
support of his argument that he was covered through
February, 2015, the plaintiff referred to the depart-
ment’s letter to him dated February 2, 2015, which
stated that new coverage would start in March, 2015,
and run through August, 2015, if the plaintiff met certain
spenddown requirements. Additionally, the plaintiff
referred to the hearing summary, which had been sent
to him by Sardo and had been cosigned by Sardo’s
supervisor, which stated that the plaintiff’s new cover-
age period would be from March 1, 2015, to August 31,
2015. That hearing summary was read into the adminis-
trative record at the April 1, 2015 hearing. The plaintiff
argued that both of those documents demonstrated that
February, 2015, was covered in the prior spenddown
period and that he had satisfied those requirements.
In his prehearing brief, the plaintiff also referred to
the hearing officer’s action in allowing the department
to change the dates of the redetermination period.
According to the plaintiff: ‘‘[The] plaintiff was pre-
viously covered by Husky C . . . from August, 2014,
through February, 2015. . . . [The action] change[d]
that coverage back to August, 2014, to January, 2015,
denying [the] plaintiff coverage for the completion of
his false teeth and conform[ing] to the decision of the
hearing officer.’’ The documents in the administrative
record support these representations regarding the
change in coverage periods.
The department, in its prehearing brief filed on Janu-
ary 29, 2016, acknowledged that ‘‘the administrative
record . . . shows that on February 2, 2015, [the
department] completed the plaintiff’s recertification for
[the program] and determined that he was eligible for
[the program’s benefits], subject to a spenddown total-
ing $1929.72, for the time period of March, 2015,
through August, 2015. . . . [The department] notified
the plaintiff that he would need to submit medical bills
totaling $1929.72 to meet the spenddown requirements
in order to become eligible for [the program’s] coverage
for the March, 2015, [to] August, 2015 period.’’ (Cita-
tions omitted; emphasis added.) The department further
acknowledged that the period was changed at the April
1, 2015 hearing: ‘‘At the administrative hearing, [the
department] determined that its determination of a
spenddown period of March [to] August, 2015, as noted
in the [notice from the department to the plaintiff dated
January 28, 2015] was incorrect because the prior
spenddown period had been from August, 2014, [to]
January, 2015. . . . The spenddown period was cor-
rected to February, 2015, [to] July, 2015, although
there was no change to the $1929.72 spenddown
amount.’’ (Citations omitted; emphasis added.) In a
footnote in its prehearing brief, the department stated:
‘‘It appears that the plaintiff considers [the] correction
of this error (correcting the beginning of the spenddown
period from March, 2015, to February, 2015) to be the
revocation of an ‘extension’ of his prior six month eligi-
bility period.’’
The teleconference hearing before the court was held
on March 11, 2016. At that time, the plaintiff read
excerpts from the transcript of the April 1, 2015 hearing
before the hearing officer. He referred to the hearing
officer’s question: ‘‘Okay. So is [the plaintiff] under a
spenddown for the month of February as well?’’ Sardo
responded: ‘‘He’s on a one month spenddown and that’s
incorrect.’’4 The plaintiff argued to the court: ‘‘[The
department] also stated that [it] didn’t know the spend-
down for February was incorrect until the hearing of
April 1. So how could [the department] possibly deny
Husky [C] coverage in February when [the department]
didn’t know it was an error?’’ The plaintiff also told the
court that the documents in the administrative record
showed that his income was too high, but that he still
might receive benefits from March, 2015 through
August, 2015: ‘‘The [month of] February was covered by
the previous spenddown. Other than that, [the plaintiff]
would have had February, 2015, to July, 2015.’’
Additionally, the plaintiff argued to the court: ‘‘I’m
not a mind reader. I was covered in February by [the
department’s] own documents and [it] told me I was
covered. [The department] told me [and] the dentist
[that it] would pay [the bill]. Now, [the department]
declares a ruling [that it is] no longer going to pay for
it.’’ The attorney for the department responded to the
plaintiff’s claim pertaining to the change in the coverage
period as follows: ‘‘[The court is] correct in noting that
the—I believe it was a typo, was noticed at the hearing.
. . . [T]he record was held open for additional docu-
ments while this correction was made, so [the plaintiff]
was aware at the time. I don’t believe he presented any
evidence at the hearing about these specific dental
bills.’’
The court issued its memorandum of decision on
March 14, 2016. The court first addressed the plaintiff’s
claim that the court had no authority to transfer his
administrative appeal from New London to New Britain
and concluded that General Statutes § 51-347b (a)5
authorized such a transfer. The court referred to two
standing orders that permit the transfer of Uniform
Administrative Procedure Act appeals from the court
where initially filed to the Tax and Administrative
Appeals Session at the judicial district of New Britain.
Furthermore, the court concluded that the plaintiff
could not demonstrate that substantial rights of his had
been prejudiced by the transfer because the plaintiff
was permitted to appear in the courthouse in New Lon-
don and to participate in the hearing by way of a closed-
circuit television.
The court next addressed the plaintiff’s claim that
the department ‘‘changed the administrative record
from one reflecting a spenddown period beginning in
March, 2015, to one beginning in February, 2015,’’ which
‘‘prevented him from receiving benefits for dental pro-
cedures that he needed in February, 2015.’’ The court
rejected the plaintiff’s claim: ‘‘At the end of the hearing,
the hearing officer reiterated that the department would
submit ‘that redetermination’ and the department stated
that it could do so ‘by the end of today.’ ’’ The court
noted that exhibit 7 in the administrative record was
the corrected redetermination document and that the
document had been submitted by the department ‘‘on
April 1 [2015], after the hearing, just as it promised to
do at the hearing itself.’’ The court determined that
‘‘[t]he exhibit merely confirmed the department’s repre-
sentations at the hearing that it had corrected the plain-
tiff’s records so that the spenddown period would begin
in February rather than March, 2015. . . . The plaintiff
was present at the hearing and never voiced any objec-
tion as the hearing officer and the department discussed
submitting the supplemental exhibit.’’ Accordingly, the
court concluded that ‘‘there is no merit to the plaintiff’s
complaint.’’ The court affirmed the department’s deci-
sion and dismissed the plaintiff’s administrative appeal.
This appeal followed.
Even though we are reversing the judgment on
another ground, we address the plaintiff’s first claim
that he was denied access to the courts, because his
appeal was transferred from New London to New Brit-
ain, for the reason that it is likely to arise in any subse-
quent proceedings. See State v. A. M., 156 Conn. App.
138, 156–57, 111 A.3d 974 (2015), aff’d, 324 Conn. 190,
152 A.3d 49 (2016). The plaintiff’s argument merits little
discussion. We agree with the trial court that there is
statutory authority for the transfer; General Statutes
§ 51-347b (a); and that the plaintiff was afforded his
due process rights by being allowed to participate in
the hearing via closed-circuit television. The plaintiff
was not denied access to the courts, and he cannot
demonstrate any prejudice to his rights as a result of
the transfer of his administrative appeal.
The plaintiff’s next claim is that the trial court should
have sustained his appeal because the hearing officer’s
decision was based on ‘‘faulty records’’ and ‘‘records
changed by the department . . . .’’ The plaintiff argues
that the decision violated his rights because, inter alia,
it was ‘‘made upon unlawful procedure . . . .’’ He
argues: ‘‘The department and its attorney altered docu-
ments to fit the hearing officer’s decision. The hearing
officer was a party to the altering of [the] plaintiff’s
Husky C . . . coverage, changing it from coverage for
the month of February, 2015, to no coverage, by their
change to January, 2015.’’ We agree that substantial
rights of the plaintiff have been prejudiced because
the hearing officer’s decision was made upon unlawful
procedure. See General Statutes § 4-183 (j).
We begin with the applicable standard of review.
‘‘[J]udicial review of an administrative agency’s action
is governed by the Uniform Administrative Procedure
Act (UAPA), General Statutes § 4-166 et seq., and the
scope of that review is limited. . . . When reviewing
the trial court’s decision, we seek to determine whether
it comports with the [UAPA].’’ (Internal quotation
marks omitted.) Dickman v. Office of State Ethics, Citi-
zen’s Ethics Advisory Board, 140 Conn. App. 754, 766,
60 A.3d 297, cert. denied, 308 Conn. 934, 66 A.3d 497
(2013). ‘‘Conclusions of law reached by the administra-
tive agency must stand if . . . they resulted from a
correct application of the law to the facts found and
could reasonably and logically follow from such facts.
. . . The court’s ultimate duty is only to decide
whether, in light of the evidence, the [agency] has acted
unreasonably, arbitrarily, illegally, or in abuse of [its]
discretion.’’ (Internal quotation marks omitted.) Id., 767.
‘‘General Statutes § 4-183 (a) provides an avenue for
any person, aggrieved by a final administrative decision,
to appeal to the Superior Court.’’ Searles v. Dept. of
Social Services, 96 Conn. App. 511, 513, 900 A.2d 598
(2006). Section 4-183 (j) provides, in relevant part, that
‘‘[t]he court shall affirm the decision of the agency
unless the court finds that substantial rights of the per-
son appealing have been prejudiced because the admin-
istrative findings, inferences, conclusions, or decisions
are . . . made upon unlawful procedure . . . .’’
We note that there is a paucity of case law that dis-
cusses the issue of whether the decision of an adminis-
trative agency is improper because it was made upon
unlawful procedure. Nevertheless, we find the case of
Henderson v. Dept. of Motor Vehicles, 202 Conn. 453,
521 A.2d 1040 (1987), to be instructive. In Henderson,
the plaintiff appealed from a decision of the adjudica-
tion unit of the Department of Motor Vehicles that sus-
pended his license because of his involvement in a fatal
accident. Relying on General Statutes (Rev. to 1987)
§ 4-183 (g) of the UAPA, subsequently amended and
renumbered as § 4-183 (j), the plaintiff argued that the
agency’s decision had been made upon unlawful proce-
dure because it had received an ex parte communica-
tion. Id., 454–58. Although the issue certified for appeal
was whether the plaintiff had the burden of proving
prejudice to substantial rights under those circum-
stances, our Supreme Court nevertheless recognized
that ‘‘an ex parte communication by an adjudicator
concerning a case before him would indicate that the
decision had been ‘made upon unlawful procedure,’ a
ground for reversal or modification specifically men-
tioned in § 4-183 (g) (3).’’ Id., 458. We conclude that
the circumstances of this case are similar to those in
Henderson, in that the plaintiff did not have a meaning-
ful opportunity to respond to the ‘‘corrected’’ evidence
presented by the department at the end of the April 1,
2015 hearing.
The evidence in the administrative record supports
the plaintiff’s claim that the department had advised
him that his new coverage period for the program’s
benefits would run from March, 2015, through August,
2015, and that his dental work begun in the prior period
was covered through February, 2015, because he had
satisfied the spenddown requirements for that period.
The evidence further supports the plaintiff’s claim that
he proceeded at the April 1, 2015 hearing under those
reasonable assumptions as to his satisfaction of the
program’s prior spenddown requirements.
The plaintiff consistently and persistently has
claimed that an employee of the department extended
his coverage through February, 2015, so that he could
have his dental work paid for and completed. There is
evidence in the administrative record to support that
claim and, in fact, the department acknowledged that
it appears that an extension had been given, but that
it was ‘‘incorrect’’ and needed to be ‘‘corrected.’’ The
plaintiff, however, on the basis of the documents
existing at the time that he appeared at the April 1,
2015 hearing, was operating under the reasonable belief
that he was covered through February and, therefore,
did not need to present any additional bills for his dental
work. There was no reason for him to have presented
the bill from New London Dental Care for the comple-
tion of his false teeth because (1) he had been advised
when the extension had been granted that the work to
be completed in February would be covered by the
program, (2) his documents from the department pro-
vided that he was covered through February, 2015, and
(3) his dental work was to be completed in the second
week in February, and he had met the requirements for
coverage for the previous period. He already had had
his upper teeth removed in preparation for the upper
dental plate, and was about to attend his last dental
appointment when he was told that the work was no
longer covered. At the April 1, 2015 hearing, he was
told that the department’s documents were incorrect
and that the documents needed to be changed to reflect
that he was not covered for work completed in Febru-
ary, 2015. The hearing officer allowed the submission
of the ‘‘corrected document,’’ which had the effect of
excluding him from coverage, after the hearing.6
Under the circumstances of this case, we conclude
that the decision was made upon unlawful procedure.
Although the plaintiff has not used the term ‘‘equitable
tolling’’ in his administrative appeal, in his briefs or
in his arguments to the trial court or this court, the
substance of his claim falls within the parameters of
that doctrine. He has argued, with support from the
record, that the department retroactively changed the
eligibility period, thereby resulting in the denial of cov-
erage for the remainder of his dental work. Having been
informed by the department that his eligibility period
had been extended through February, 2015, the plaintiff
detrimentally relied on such information to not meet
the corrected deadline of January 31, 2015, for obtaining
and presenting a bill from New London Dental Care for
work that had already begun that would have entitled
him to payment for the completion of such work. ‘‘We
treat ‘equitable tolling’ as a doctrine inclusive of waiver,
consent, or estoppel, that is, as an equitable principle
to excuse untimeliness.’’ Williams v. Commission on
Human Rights & Opportunities, 67 Conn. App. 316,
320 n.9, 786 A.2d 1283 (2001). The plaintiff should not
be penalized for failing to timely obtain and produce
the dental bill when he could have done so if the depart-
ment had properly advised him before January 31, 2015,
that the prior eligibility period would not in fact be
extended. The plaintiff’s preexisting eligibility through
February, 2015, is required under the equitable tolling
doctrine, and the department is ordered to proceed in
accordance with this opinion.
The judgment is reversed and the case is remanded
with direction to render judgment sustaining the plain-
tiff’s appeal.
In this opinion the other judges concurred.
* June 21, 2017, the date that this decision was released as a slip opinion,
is the operative date for all substantive and procedural purposes.
1
Gary Sardo, an eligibility service specialist for the department, was also
named as a defendant in this appeal, and we refer to him by name.
2
General Statutes § 4-183 (j) provides: ‘‘The court shall not substitute its
judgment for that of the agency as to the weight of the evidence on questions
of fact. The court shall affirm the decision of the agency unless the court
finds that substantial rights of the person appealing have been prejudiced
because the administrative findings, inferences, conclusions, or decisions
are: (1) In violation of constitutional or statutory provisions; (2) in excess
of the statutory authority of the agency; (3) made upon unlawful procedure;
(4) affected by other error of law; (5) clearly erroneous in view of the
reliable, probative, and substantial evidence on the whole record; or (6)
arbitrary or capricious or characterized by abuse of discretion or clearly
unwarranted exercise of discretion. If the court finds such prejudice, it
shall sustain the appeal and, if appropriate, may render a judgment under
subsection (k) of this section or remand the case for further proceedings. For
purposes of this section, a remand is a final judgment.’’ (Emphasis added.)
3
Eligibility for the program’s benefits is redetermined by the department
every six months.
4
Sardo went on to explain: ‘‘It should be a six month spenddown but the
worker who worked on it did a reinstatement instead of a regranting [of]
the case.’’
5
General Statutes § 51-347b (a) provides in relevant part: ‘‘Any action or
the trial of any issue or issues therein may be transferred, by order of the
court on its own motion or on the granting of a motion of any of the parties,
or by agreement of the parties, from the superior court for one judicial
district to the superior court in another court location within the same
district or to a superior court location for any other judicial district, upon
notice by the clerk to the parties after the order of the court . . . . The
Chief Court Administrator or any judge designated by the Chief Court Admin-
istrator to act on behalf of the Chief Court Administrator under this section
may, on motion of the Chief Court Administrator or any such judge, when
required for the efficient operation of the courts and to insure the prompt
and proper administration of justice, order like transfers.’’
6
We do not believe that the plaintiff’s failure to object at the hearing
warrants a different conclusion. After reading the transcript, it is not at all
clear exactly what was going to be submitted later that day to the hearing
officer by the department. The plaintiff had also challenged the department’s
determination with respect to his receipt of food stamps, which is not at
issue in this appeal, and the plaintiff reasonably could have been confused.
We accord the plaintiff ‘‘the leniency traditionally afforded to inexperienced
pro se parties . . . .’’ (Internal quotation marks omitted.) Bridgeport Dental,
LLC v. Commissioner of Social Services, 165 Conn. App. 642, 657, 140 A.3d
263, cert. denied, 322 Conn. 908, 140 A.3d 221 (2016).