South Carolina              
Administrative Law Court
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SC Administrative Law Court Decisions

CAPTION:
Debra Freeman vs. SCDHHS

AGENCY:
South Carolina Department of Health and Human Services

PARTIES:
Appellant:
Debra Freeman

Respondents:
South Carolina Department of Health and Human Services
 
DOCKET NUMBER:
06-ALJ-08-0318-AP

APPEARANCES:
n/a
 

ORDERS:

ORDER OF DISMISSAL

This appeal is before the Administrative Law Court (Court) pursuant to the Notice of Appeal filed by Debra Freeman (Appellant) on April 27, 2006. Appellant appeals the March 27, 2006 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 allegations 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 May 23, 2006, 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. Appellant filed a response to the Motion on June 1, 2006.

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

June 13, 2006

Columbia, South Carolina


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