ORDERS:
ORDER OF DISMISSAL
Notice of appeal seeking review of agency action in the above captioned matter was filed with the Administrative Law Court (ALC or Court) on June 15, 2005. Michael R. Johnson (Appellant) seeks benefits from Medicaid under the Aged, Blind or Disabled (ABD) program. Having no success in pressing a claim before the South Carolina Department of Health and Human Services (HHS), Appellant now brings this matter on appeal to the ALC.
In response to the appeal, HHS filed a Motion to Dismiss arguing that the ALC lacks jurisdiction since Appellant presented the same claim to the Social Security Administration (SSA), and that body denied the benefits requested. Given such facts, I conclude jurisdiction is lacking in the ALC and that Appellant's appeal must be dismissed.
HHS is not free to disregard disability determinations made by the SSA. Rather, when SSA has made a determination of no disability, HHS may not make an independent finding on that same issue since the SSA determination is binding on HHS. 42 CFR § 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 re-determine Medicaid eligibility on disability.").
Indeed, these same federal regulations have been judged to show an intent "that the federal agency's determination of non-disability supersedes [even] a previous state agency determination of disability." Disabled Rights Union v. Kizer, 744 F.Supp. 221 (Cal. 1990).
Thus, since Appellant presented the same claim to the Social Security Administration (SSA), and that body denied the benefits requested, the federal regulations deny the state the decision making authority in the instant case.
THEREFORE, this matter must be DISMISSED due to controlling federal regulations. Respondent’s motion to dismiss is HEREBY GRANTED.
AND IT IS SO ORDERED.
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JOHN D. MCLEOD
Administrative Law Judge
September 12, 2005
Columbia, South Carolina |
