South Florida appeals court rules man with rare form of epilepsy is entitled to benefits

By Quinten Plummer | Sep 15, 2016

MIAMI – A South Florida appeals court has ruled in favor of state benefits for an adult suffering from a rare form of epilepsy.

MIAMI – A South Florida appeals court has ruled in favor of state benefits for an adult suffering from a rare form of epilepsy.

After initially deciding against the individual receiving state benefits, the Agency for Persons with Disabilities (APD) says it intends to comply with the 3rd District Court's decision.

The mother of the man applied for benefits through a program administered by the APD. But the man, identified in court documents as "M.T.," was ultimately denied due to not meeting the APD's assessment criteria for individuals living with Lennox-Gastaut syndrome.

The APD denied benefits to M.T. because his mother didn't furnish IQ test scores for him before the age of 18, during his developmental years, the organization argued, citing statutory eligibility criteria.

The plaintiffs argued that an assessment of M.T. at age 10 scored his visual motor integration in the "borderline range," his visual perception at "average" and adaptive functioning in the "extremely low range."

When M.T. was 14, a physician diagnosed M.T. with chronic static encephalopathy that was said to have resulted in mental retardation.

The APD didn't attempt to refute the plaintiff's position that M.T. suffered from multiple cognitive impairments. Instead, the organization stood by its point that a full-scale IQ test wasn't administered on M.T. before he turned 18, which it requires of applicants for assistance.

Ultimately, the court found late last month that the Home and Community Based Services Waiver Program M.T.'s mother had applied for had no requirements for an IQ test. And while the court asserted that it respected APD's interpretation of the laws, it ruled "that deference does not apply when the agency’s interpretation is clearly erroneous."

The APD's Melanie Mowry Etters, communications director, indicated that her organization has accepted the court's decision.

"In following the rules and statutes, APD found that the person was not eligible," Etters told the Florida Record. "However the court has ruled the individual is eligible for APD services, therefore the agency will comply with the court’s decision and declare the person eligible."

While the APD's IQ requirements may seem overly bureaucratic, it's possible the agency's interpretation of state statutes and establishment of the stipulation was a response, at least in part, to how rare Lennox-Gastaut syndrome is.

Further, this rare form of epilepsy is typically diagnosed early on in life, according to Christina SanInocencio, executive director of the LGS Foundation.

"Lennox-Gastaut syndrome is also typically diagnosed in childhood between 1 and 8 years old with a peak diagnoses between 3 and 5," SanInocencio told the Florida Record.

SanInocencio pointed out that this form of epilepsy "usually persists into adulthood."

What makes this form of epilepsy unique is that it's known to trigger multiples types of seizures that SanInocencio said are difficult to control. It causes "cognitive impairment and cognitive impairment, and a slow spike wave EEG pattern."

"According to the diagnostic criteria needed for LGS, an individual is typically not diagnosed with the syndrome if they do not meet these three characteristics: first, is multiple seizure types; second, is cognitive impairment; and third is a slow spike and wave EEG pattern," said SanInocencio.

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