Tannler v. Wisconsin Department of Health & Social Services

564 N.W.2d 735, 211 Wis. 2d 179, 1997 Wisc. LEXIS 82
Wisconsin Supreme Court·Decided June 24, 1997·No. 96-0118·Published·Cited by 31 cases

Opinions

DONALD W. STEINMETZ, J.

¶1. The issue in this case is whether an institutionalized person's fail[181] ure to assert a claim against his or her deceased "community spouse's"1 estate constitutes a divestment under the Medical Assistance (MA) program. We conclude that the failure to make a spousal election is an "action" for purposes of determining MA eligibility under Wis. Stat. § 49.4532 as defined by 42 USC § 1396p(e)(l).3 We therefore hold that the failure of an institutionalized spouse to assert a claim against the estate of his or her deceased spouse constitutes a divestment for purposes of determining MA eligibility.4

[182] ¶ 2. The relevant facts are not in dispute. The petitioner, Phyllis Tannler (Tannler), lives in a nursing home.5 She has received MA since early in 1993. Tan-nler's husband, Adolph Tannler, died in 1994 leaving a will that bequeathed all of his assets, both real and personal property, to his grandson and his grandson's wife. Adolph left nothing to his wife. Tannler, represented by a guardian ad litem in the estate of her deceased husband, did not contest the will, nor did she file any elections or select any property passing under her husband's will.6

¶ 3. Tannler continued to receive MA benefits until 1995 when the respondent, Department of Health and Social Services (DHSS), informed Tannler that it was terminating her eligibility. DHSS asserted that Tannler's failure to contest, select, or elect against the will constituted a divestment of assets which rendered her ineligible for MA. A hearing on the matter was held April 12,1995, and the hearing examiner issued a proposed decision that Tannler remain eligible for MA. [183] DHSS rejected this proposal and modified the decision. It concluded as follows:

1. The petitioner's acceptance of her husband's will transferring to a third person assets to which she was entitled under law was a disposal or a transfer of an asset.
2. The petitioner divested herself of an asset.

The Matter of Phyllis A. Tannler, DHSS Decision, August 17, 1995.

¶ 4. Tannler appealed. The Green County Circuit Court, Judge David G. Deininger, ordered that DHSS's action terminating Tannler's MA be set aside. The circuit court found that DHSS erroneously interpreted 42 USC § 1396p(e)(l).

¶ 5. DHSS appealed from the circuit court order. The court of appeals reversed. According due weight to DHSS's interpretation, the court held that the failure to make a spousal election was an "action" constituting divestment that resulted in MA ineligibility. Tannler v. Department of Health and Social Servs., 206 Wis. 2d 385, 557 N.W.2d 434 (Ct. App. 1996).

¶ 6. This case involves the interpretation of Wis. Stat. § 49.453 and 42 USC § 1396p(e)(1). Interpretation of a statute and its application to undisputed facts are questions of law which this court reviews de novo. Local No. 695 v. LIRC, 154 Wis. 2d 75, 82, 452 N.W.2d 368 (1990). This court is not bound by an agency's conclusions of law. See Kelley Co., Inc. v. Marquardt, 172 Wis. 2d 234, 244, 493 N.W.2d 68 (1992). However, this court defers to agency decisions in certain instances. See MCI Telecommunications Corp. v. State, No. 95-0915, op. at 7 (S. Ct. May 13, 1997).

[184] ¶ 7. In reviewing agency interpretations, this court has applied three distinct levels of deference: great weight, due weight, and de novo review. Id., citing Harnischfeger Corp. v. LIRC, 196 Wis. 2d 650, 659-60, 539 N.W.2d 98 (1995). In order to accord great weight deference, a court must conclude that: 1) the agency was charged by the legislature with the duty of administering the statute; 2) the interpretation of the agency is one of long-standing; 3) the agency employed its specialized knowledge or expertise in forming the interpretation; and 4) the agency's interpretation will provide consistency and uniformity in the application of the statute. Id., citing Jicha v. DILHR, 169 Wis. 2d 284, 290, 485 N.W.2d 256 (1992).

¶ 8. If an agency conclusion does not meet all of the criteria necessary to accord it great weight deference, this court may give "due weight" deference to the agency conclusions. Jicha, 169 Wis. 2d at 290-91. Due weight deference, the middle level of review, is appropriate "if the agency decision is 'very nearly' one of first impression." Id. at 291. However, if the case is one of first impression for the agency and the agency lacks any special expertise, then the court must review the agency's conclusion de novo. Id.

¶ 9. As the court of appeals noted, the Medical Assistance Handbook produced by DHSS provides guidance on the issue presented by this case. The court stated that "[b]ecause the MA Handbook is designed to assist state and local agencies to implement the federal-state MA program, we conclude that its provisions are persuasive in resolving disputes such as the one before the court." Tannler, 206 Wis. 2d at 391. Tannler claims that this case presents an issue of first impression that should be subject to de novo review by this [185] court. While it appears from the lack of agency precedent that this case is one of first impression, the language found in the handbook indicates that the agency possesses a specialized knowledge on the issue of whether the failure to contest a will constitutes divestment for purposes of determining MA eligibility. Consequently, like the court of appeals, we also conclude that the findings of DHSS should be accorded due weight. Due weight deference means that this court will give some deference to the agency, but if a more reasonable interpretation exists, this court will adopt that interpretation.

Free access — add to your briefcase to read the full text and ask questions with AI

Tannler v. Wisconsin Department of Health & Social Services, 564 N.W.2d 735, 211 Wis. 2d 179, 1997 Wisc. LEXIS 82 (Wis. 1997).

564 N.W.2d 735 (Tannler v. Wisconsin Department of Health & Social Services) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Morgan v. Brown
W.D. Oklahoma, 2022
Christine Tarrant v. DHS
2019 WI App 45 (Court of Appeals of Wisconsin, 2019)
J & E Investments LLC v. Division of Hearings & Appeals
2013 WI App 90 (Court of Appeals of Wisconsin, 2013)
Brown v. State Dep't of Children & Families
2012 WI App 61 (Court of Appeals of Wisconsin, 2012)
Jamerson v. Department of Children & Families
2012 WI App 32 (Court of Appeals of Wisconsin, 2012)
Hedlund v. Wisconsin Department of Health Services
2011 WI App 153 (Court of Appeals of Wisconsin, 2011)
Mervosh v. Labor & Indusrty Review Commission
2010 WI App 36 (Court of Appeals of Wisconsin, 2010)
Mervosh v. LABOR AND INDUSTRY REVIEW COM'N
2010 WI App 36 (Court of Appeals of Wisconsin, 2010)
County of Dane v. Labor & Industry Review Commission
2009 WI 9 (Wisconsin Supreme Court, 2009)
Cholvin v. Wisconsin Department of Health & Family Services
2008 WI App 127 (Court of Appeals of Wisconsin, 2008)
Cholvin v. DEPT. OF HEALTH & FAM. SERVICES
2008 WI App 127 (Court of Appeals of Wisconsin, 2008)
Weston v. WIS. DEPT. OF WORKFORCE DEV.
2007 WI App 167 (Court of Appeals of Wisconsin, 2007)
Weston v. Wisconsin Department of Workforce Development
2007 WI App 167 (Court of Appeals of Wisconsin, 2007)
Meda-Care Vans of Waukesha, Inc. v. Division of Hearings & Appeals
2007 WI App 140 (Court of Appeals of Wisconsin, 2007)
I.G. v. Department of Human Services
900 A.2d 840 (New Jersey Superior Court App Division, 2006)
Ig v. Dmahs
900 A.2d 840 (New Jersey Superior Court App Division, 2006)
Klatt v. Labor & Industry Review Commission
2003 WI App 197 (Court of Appeals of Wisconsin, 2003)
Buettner v. Wisconsin Department of Health & Family Services
2003 WI App 90 (Court of Appeals of Wisconsin, 2003)