South Carolina              
Administrative Law Court
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SC Administrative Law Court Decisions

CAPTION:
Jimmy Lewis vs. SCDHHS

AGENCY:
South Carolina Department of Health and Human Services

PARTIES:
Appellant:
Jimmy Lewis

Respondent:
South Carolina Department of Health and Human Services
 
DOCKET NUMBER:
06-ALJ-08-0192-AP

APPEARANCES:
n/a
 

ORDERS:

ORDER

In the above-captioned matter, Appellant Jimmy Lewis appeals the decision of Respondent South Carolina Department of Health and Human Services (Department) to dismiss his application for Medicaid benefits under the Aged, Blind or Disabled (ABD) Program after he failed to appear at a hearing on his application before a Department hearing officer. For the reasons set forth below, I find that this matter should be remanded to the Department for it to conduct a new hearing on Appellant’s application for Medicaid disability benefits.

BACKGROUND

On December 9, 2005, Appellant submitted an application to the Department for disability benefits under the ABD Medicaid Program. By a letter dated February 6, 2006, the Department informed Appellant of its initial determination that he did not meet the disability criteria so as to be eligible for Medicaid benefits under the ABD Program. On February 9, 2006, Appellant requested a hearing with the Department on the denial of his application for disability benefits. By a Notice of Hearing sent to Appellant by certified mail on March 3, 2006, and received by Appellant on March 8, 2006, the Department notified Appellant of the time, date, and location of the hearing scheduled on his application. According to the notice, the hearing was scheduled for Wednesday, April 5, 2006, at 9:30 a.m., in the conference room of the Community Long Term Care Office at 201 Dozier Boulevard in Florence, South Carolina. A cover letter to an exchange of evidence sent from the Department to Appellant by certified mail on March 23, 2006, and received by Appellant on March 25, 2006, further reiterated the time, date, and location of the hearing on his application for disability benefits.

Despite these notices, Appellant failed to appear at the hearing on his application as scheduled by the Department for April 5, 2006. Rather, on the day of the hearing, Appellant mistakenly reported to the federal building on West Evans Street in Florence, South Carolina, at 9:30 a.m., instead of the Community Long Term Care Office at 201 Dozier Boulevard, where his hearing was scheduled to be held. Appellant did not realize his mistake until 11:00 a.m., when he inquired about his hearing with staff at the federal building. Subsequently, at 12:30 p.m., Appellant telephoned the Department’s hearing officer to explain his failure to appear at his hearing and to seek a new hearing.

Based upon Appellant’s failure to appear at the hearing, the Department hearing officer presiding over the hearing dismissed Appellant’s case. The case was initially dismissed on the record at the hearing at 10:00 a.m., a half hour after the hearing was scheduled to begin, and the dismissal was recorded in a written order issued by the hearing officer on April 6, 2006. In his written order, the hearing officer found that Appellant had not presented good cause for his failure to appear at the hearing, despite his mistaken appearance at the federal building. On appeal, Appellant accepts responsibility and apologizes for his failure to appear at the hearing, and seeks relief from the dismissal of his case by the Department based upon his mistake.

DISCUSSION

In the instant matter, Appellant essentially appeals the Department’s refusal to grant him relief from the dismissal of his application for disability benefits. While there is no specific statute, regulation, or rule governing reconsideration of dismissals issued by the Department, the Department has inherent authority to reconsider or rehear its decisions in contested matters. See Bennett v. City of Clemson, 293 S.C. 64, 66-67, 358 S.E.2d 707, 708-09 (1987) (holding that, unless specifically curtailed by statute or regulation, an administrative agency has the inherent power to reconsider or rehear its decisions “where there is justification and good cause”). In considering a motion for such reconsideration or rehearing, it is appropriate for the Department to refer to the grounds for relieving a party from a final judgment or order set forth in Rule 60(b), SCRCP. See Br. of Resp’t at 2 (considering, by analogy, Appellant’s appeal under the grounds for relief set forth in Rule 60(b), SCRCP); cf. ALC Rule 29(D) (providing that motions for reconsideration of decisions issued by the ALC in contested cases are governed by the grounds for relief from a final order set out in Rule 60(b), SCRCP). Under Rule 60(b), a party may be relieved from a final judgment or order based upon the party’s “mistake, inadvertence, surprise, and excusable neglect.” Rule 60(b)(1), SCRCP. This relief is not limited solely to instances of excusable neglect, but includes, among other grounds, simple mistakes of fact, such that “where there is a good faith mistake of fact, and no attempt to thwart the judicial system, there is basis for relief.” Columbia Pools, Inc. v. Galvin, 288 S.C. 59, 61, 339 S.E.2d 524, 525 (Ct. App. 1986) (addressing a statutory predecessor to Rule 60(b) that contained identical language). However, in determining whether to grant a motion for reconsideration under Rule 60(b), the court should consider (1) the promptness with which relief is sought, (2) the reasons for the failure to act promptly, (3) the existence of a meritorious defense, and (4) the prejudice to the other party. See Mictronics, Inc. v. S.C. Dep’t of Revenue, 345 S.C. 506, 511, 548 S.E.2d 223, 226 (Ct. App. 2001).

In the case at hand, I find that Appellant’s failure to appear at his hearing was a good faith mistake of fact that does not indicate any attempt on the part of Appellant to thwart the Department’s hearing process. In addition, Appellant promptly sought to remedy his failure to appear at the hearing by calling the hearing officer within an hour and a half after he realized that he had missed his hearing. Further, the medical records submitted by Appellant in this matter, including a recent letter from his treating physician, establish a genuine issue of fact on the question of his disability that should be resolved at a hearing. Finally, it does not appear that granting Appellant a new hearing on his disability application would unduly prejudice the Department. Although this Court recognizes the time and money expended by the Department in arranging for Appellant’s hearing in Florence, this expenditure does not outweigh the general policy in favor of disposing of claims, like that raised by Appellant, on their merits rather than on technicalities. Therefore, while this Court is well aware that “[t]here is a limit beyond which the court should not allow a litigant to consume the time of the court,” Georganne Apparel, Inc. v. Todd, 303 S.C. 87, 92, 399 S.E.2d 16, 19 (Ct. App. 1990), that limit has not yet been reached in this matter. Accordingly, I must find that the Department’s hearing officer abused his discretion in refusing to relieve Appellant from the dismissal of his case based upon his failure to attend the hearing because of his good-faith mistake of fact. See Mictronics, Inc., 345 S.C. 506, 548 S.E.2d 223 (holding that an administrative law judge abused his discretion by denying a new hearing to a litigant that had failed to appear at a scheduled hearing because it had mistakenly recorded the date of the hearing on its calendar, despite receiving both written and telephoned notices of the correct date).

ORDER

For the reasons set forth above,

IT IS HEREBY ORDERED that the above-captioned matter is REMANDED to the Department for it to relieve Appellant of the order dismissing his claim for Medicaid disability benefits and to schedule a new hearing on Appellant’s application for disability benefits before a Department hearing officer.

IT IS FURTHER ORDERED that this remand extinguishes the instant case, and that any appeal of a decision made by the Department upon remand of this matter must be filed as a new appeal with this Court.

AND IT IS SO ORDERED.

______________________________

JOHN D. GEATHERS

Administrative Law Judge

1205 Pendleton Street, Suite 224

Columbia, South Carolina 29201-3731

July 14, 2006

Columbia, South Carolina


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