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 |
