ORDERS:
FINAL ORDER AND DECISION
STATEMENT OF THE CASE
This matter comes before the South Carolina Administrative Law Court (ALC or Court) pursuant to S.C. Code Ann. § 9-21-60 (Supp. 2004) upon Petitioner’s request for a contested case hearing. Petitioner contests the Final Agency Determination issued by Respondent South Carolina Budget and Control Board, South Carolina Retirement Systems (Respondent) which found he was not entitled to receive group life insurance benefits as his wife’s beneficiary because his wife was not “in service” at the time of her death. A hearing was conducted on September 21, 2005, at the offices of the ALC in Columbia, South Carolina.
FINDINGS OF FACT
Having carefully considered the testimony and the arguments of both sides, I make the following Findings of Fact, taking into consideration the burden of proof and the credibility of the witnesses:
1. Notice of the date, time, place, and subject matter of the hearing was provided to all parties in a timely manner.
2. Respondent operates four retirement systems including the South Carolina Retirement System (SCRS), the general retirement system managed by the Respondent. On September 17, 2003, Ann Tyler began working for the Department of Mental Health as a nurse in a temporary, hourly position. When Mrs. Tyler began working for the Department of Mental Health, she enrolled in SCRS and designated her husband, Petitioner Charles Tyler, as her beneficiary for survivor benefits and group life insurance benefits.
3. In August 2004, Mrs. Tyler was diagnosed with Lymphoma. The last day she physically worked and earned compensation from the Department of Mental Health was on August 12, 2004. Mrs. Tyler received her last paycheck on September 1, 2004, and was terminated on September 16, 2004. Mrs. Tyler passed away on January 20, 2005.
4. When processing the death benefits for Mrs. Tyler’s beneficiaries, Respondent informed Petitioner he was not entitled to receive group life insurance benefits because his wife was not "in service" at the time of her death. On March 11, 2005, Petitioner wrote Respondent and requested a waiver of the "in service" requirement. Respondent responded to Petitioner on March 15, 2005, and explained that because Mrs. Tyler was not employed within ninety days prior to her date of death, Respondent had no authority to pay group life insurance benefits to Mrs. Tyler’s beneficiary. Afterwards, Petitioner wrote Director Boykin requesting payment of group life insurance benefits. On April 20, 2005, Director Boykin issued a Final Agency Determination denying payment of group life insurance benefits based on the statutory provisions of S.C. Code Ann. § 9-1-1770 (Supp. 2004).
CONCLUSIONS OF LAW
Based on the foregoing Findings of Fact, I conclude the following as a matter of law:
1. The Court has jurisdiction to decide the issues in this case pursuant to S.C. Code Ann. § 9-21-60 (Supp. 2004).
2. As the trier of fact, the Court must weigh and pass upon the credibility of the evidence presented. See South Carolina Cable Television Ass’n v. Southern Bell Tel. and Tel. Co., 308 S.C. 216, 417 S.E.2d 586 (1992). The standard of proof in these administrative proceedings is a preponderance of the evidence. Anonymous v. State Bd. of Medical Examiners, 329 S.C. 371, 496 S.E.2d 17 (1998). Furthermore, the burden of proof in this case is on Petitioner. Accordingly, he must show that his wife met the statutory requirements of eligibility in order for him to receive the group life insurance benefits.
3. To be eligible to receive group life insurance benefits, a member must meet certain requirements set forth in Section 9-1-1770, which provides, in pertinent part:
Upon receipt of proof, satisfactory to the board, of the death of a contributing member in service who had completed at least one full year of membership in the system or of the death of a contributing member as a result of an injury arising out of and in the course of the performance of his duties regardless of length of membership, as of the effective date of his employer’s participation, there must be paid to the person he nominated for the refund of his accumulated contributions, unless he has nominated a different beneficiary by written designation filed with the board, in the event of his death pursuant to Section 9-1-1650, if the person is living at the time of the member’s death, otherwise to the member’s estate, a death benefit equal to the annual earnable compensation of the member at the time his death occurs. The death benefit is payable apart and separate from the payment of the member’s accumulated contributions on his death pursuant to Sections 9-1-1650 or 9-1-1660. For purposes of this section, a member is considered to be in service at the date of his death if the last day the member was employed in a continuous, regular pay status, while earning regular or unreduced wages and regular or unreduced retirement service credit, whether the member was physically working on that day or taking continuous accrued annual leave or sick leave while receiving a full salary, occurred not more than ninety days before the date of his death and he has not retired.
(Emphasis added). Based on Section 9-1-1770, a group life insurance beneficiary of a member is entitled to an amount equal to the member’s annual earnable compensation if the member is: (1) a contributing member in service with at least one full year of membership in the system at the date of death; or (2) a contributing member who dies as a result of an injury arising out of and in the course of the performance of his duties regardless of length of membership in the system.
The cardinal rule of statutory construction is to ascertain and effectuate the intent of the legislature. Cox v. BellSouth Tele., 356 S.C. 468, 589 S.E.2d 766 (Ct. App. 2003). Statutory construction first requires the court to read the words of the statute according to “their plain and ordinary meaning without resorting to subtle or forced construction to limit or expand the statute’s operation.” Id. at 768; see also Mosteller v. County of Lexington, 336 S.C. 360, 520 S.E.2d 620 (1999). Furthermore, the court must read the language of the statute in such a way to harmonize it with its subject matter and in accordance with its general purpose. Cox at 768.
Here, the legislature clearly defined “in service.” As defined in the statute, a member is considered to be “in service” at the time of his or her death “if the last day the member was employed in a continuous, regular pay status . . . occurred not more than ninety days before the date of his death and he has not retired.” Accordingly, a member must be earning regular wages by physically working or taking accrued annual leave or sick leave within ninety days of death in order for the member’s beneficiary to be eligible to receive the group life insurance benefit. However, Mrs. Tyler died on January 20, 2005. Mrs. Tyler, therefore, was not earning regular wages on or after October 22, 2004, which was ninety days prior to her date of death. Consequently, Petitioner was not eligible to receive group life insurance benefits as his wife’s beneficiary.
4. Petitioner alleges Respondent used a narrow interpretation of the statute in denying his claim for group life insurance benefits. He argues that the statute should be broadly interpreted in this case since treatment prolonged his wife’s life and she most likely would have died within ninety days after she stopped earning wages had she not sought treatment. Though granting Petitioner's request appears to be a fair resolution of this matter, I find no authority to waive the ninety day requirement and award benefits that are precluded by state law. See Section 9-1-1770.
Petitioner also argues Respondent failed to consider the Family and Medical Leave Act of 1993 (FMLA). See 29 C.F.R. § 825.112. Petitioner argues FMLA allows for ninety days in addition to the ninety days provided by Section 9-1-1770. Indeed, the purpose of FMLA is to allow an employee to take “reasonable unpaid leave for medical reasons, for the birth or adoption of a child, and for the care of a child, spouse, or parent who has a serious health condition.” 29 C.F.R. § 825.101(a). Under FMLA, employers are required to grant leave to employees for, among other things, serious health conditions. 29 C.F.R. § 825.112. An employee would be entitled to take a total of twelve workweeks of leave during any twelve-month period for such health conditions. 29 C.F.R. § 825.200.
However, FMLA has no bearing on determining whether a member was “in service” as required by the statute applicable in this case. As a temporary, hourly employee, Mrs. Tyler did not accrue sick leave or annual leave. As a result, even if Mrs. Tyler was taking FMLA leave, she was not employed in a continuous, regular pay status earning regular or unreduced wages on or after October 22, 2004, as required by Section 9-1-1770.
5. I therefore find that Petitioner Charles Tyler is not eligible to receive group life insurance benefits as the beneficiary of Ann Tyler because her death did not occur while she was “in service” as required by statute.
ORDER
Based upon the foregoing Findings of Fact and Conclusions of Law:
IT IS HEREBY ORDERED that Petitioner’s request to receive group life insurance benefits as his wife’s beneficiary is denied.
AND IT IS SO ORDERED.
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Ralph King Anderson, III
Administrative Law Judge
October 19, 2005
Columbia, South Carolina |
