ORDERS:
ORDER OF DISMISSAL
This
appeal is before the Administrative Law Court (Court) pursuant to the Notice of
Appeal filed by Appellant on March 24, 2005. Appellant appeals the March 17,
2005 decision of a hearing officer for the South Carolina Department of Health
and Human Services (HHS) which dismissed her case for Medicaid benefits under
the “Aged, Blind or Disabled” program due to a non-disability determination
made by the Social Security Administration (SSA) on the same issues in the
previous twelve (12) months. The hearing officer concluded that the case must
be dismissed because the SSA determination was binding on HHS pursuant to 42
C.F.R. § 435.541.
On
April 6, 2005, HHS filed a Motion to Dismiss arguing that the Court is without
jurisdiction to hear this appeal because Appellant presented the same claim to
the SSA which made a non-disability determination and denied the benefits
requested. As
of the date of this Order, Appellant has not filed a response to the Motion,
nor has any other correspondence been received from Appellant.
HHS
is not free to disregard non-disability determinations made by the SSA. Rather,
when the SSA has made a determination of non-disability, HHS may not make an
independent finding on the same issue because the SSA determination is binding
on Respondent. Furthermore, that decision remains binding until the
determination is changed by the SSA. 42 C.F.R. §435.541(b)(1)(i). See Sebastian
v. Commissioner of Human Services, 1993 WL 642701 (M.D.Tenn. 1993)
(“Specifically, if the Social Security Administration (SSA) has made a
determination of non-disability for SSI benefits purposes, then the state
agency must defer to this decision and cannot redetermine Medicaid eligibility
on disability grounds….”) These same federal regulations have been adjudicated
to show an intent “that the federal agency’s determination of nondisability supersedes
[even] a previous state agency determination of disability.” Disabled
Rights Union v. Kizer, 744 F.Supp. 221, 224 (Cal. 1990).
In
light of the binding nature of the SSA’s determination of non-disability, the
hearing officer was without jurisdiction to issue a ruling inconsistent with
the SSA’s ruling. Accordingly, this tribunal is likewise without jurisdiction
to issue a ruling inconsistent with the SSA’s determination. Therefore,
IT
IS HEREBY ORDERED that this matter is dismissed.
AND
IT IS SO ORDERED.
__________________________________
MARVIN F.
KITTRELL
Chief
Administrative Law Judge
May 31, 2005
Columbia, South Carolina |
