ORDERS:
ORDER
STATEMENT OF THE CASE
Ms. Arledge applied for Medicaid benefits on March 23, 1999, under the "Low Income Families" eligibility category. Her
application for Medicaid was denied on March 30, 1999. Ms. Arledge filed an appeal of the Medicaid denial, which was
referred to the DHHS Division of Appeals and Hearings. The appeal was assigned to a Hearing Officer (Mr. Vastine
Crouch), who scheduled a fair hearing for 9:00 a.m. on June 1, 1999 at the Lexington County Department of Social
Services. A proper notice concerning this scheduled hearing was mailed to Ms. Arledge by the Hearing Officer on April 28,
1999. The record on appeal contains a "return receipt" card from the United States Postal Service (PS Form 3811: a/k/a
"green card") signed by Ms. Arledge indicating her receipt of this notice on April 29, 1999. Despite having received actual
notice of the hearing in a timely manner, Ms. Arledge failed to appear. As a result, the Hearing Officer issued an Order on
June 8, 1999 dismissing the appeal.
By letter filed with the Administrative Law Judge Division on June 21, 1999, Ms. Arledge timely appealed the dismissal of
her case. A hearing was held before me on October 28, 1999. Ms. Arledge appeared at that hearing and argued on her own
behalf. DHHS was represented by Charles M. Black, Jr., Assistant General Counsel for the agency.
DISCUSSION
The duly-promulgated DHHS regulations concerning the conduct of appeals and hearings confer broad authority upon the
Hearing Officer:
A Hearing Officer has the authority, among other things, to: direct all procedures; issue interlocutory orders; schedule
hearings and conferences; preside at formal proceedings; rule on procedural and evidentiary issues; require the submission of
briefs and/or proposed findings of fact and conclusions of law; call witnesses and cross-examine any witnesses; recess,
continue, and conclude any proceedings; dismiss any appeal for failure to comply with requirements under this Subarticle.
27 S. C. Code Ann. Regs. 126-154 (Supp. 1998) (emphasis added). In addition to the authority conferred upon the Hearing
Officer by the DHHS regulations, the federal regulations governing the Medicaid Program explicitly authorize the dismissal
of an appeal under the circumstances present in this case: "The agency may deny or dismiss a request for a hearing if: ...(b)
The applicant or recipient fails to appear at a scheduled hearing without good cause." 42 C.F.R. § 431.223 (1986).
Ms. Arledge does not dispute the fact that she failed to appear at a scheduled hearing in this matter. Thus, the Hearing
Officer's action in dismissing the appeal was clearly within the scope of his authority if Ms. Arledge did not have "good
cause" for not attending the scheduled hearing.
Ms. Arledge asserts that her failure to appear at the scheduled hearing was the result of advice given to her by an unidentified
employee of the federal Social Security Administration, who allegedly told her that her appearance at the Medicaid hearing
before DHHS was not necessary. This erroneous advice appears to stem from confusion over the fact that Ms. Arledge was
simultaneously pursuing a federal administrative appeal with respect to the denial of her application for Supplemental
Security Income benefits. Therefore, in determining whether to dismiss this case, the Hearing Officer must determine
whether Ms. Arledge's failure to appear at the DHHS hearing was the result of excusable neglect. See, Goodson v.
American Bankers Insurance Company of Florida, 295 S.C. 400, 368 S.E. 2d 687 (Ct. App. 1988) If there is good cause to
support that determination, the Hearing Officer's dismissal must be upheld.
In Goodson, the South Carolina Court of Appeals reviewed a party's claim of excusable neglect in failing to appear at the
trial of its case. Mr. Goodson sued American Bankers Insurance Company of Florida (American) in connection with the sale
of collateral that had been posted by Goodson. American responded to the suit in an answer that was signed by a employee
who was not an attorney. This answer failed to include American's address as required by court rules. As a result,
American did not appear at trial, and Goodson was awarded damages by the jury. American attempted to have the verdict
set aside, claiming that it never received notice of the trial date. (Goodson disputed this fact, claiming that notice had been
sent to American.) When the presiding judge allowed the verdict to stand, American appealed, arguing that the employee's
failure to include American's address was excusable neglect because she was not an attorney. According to American, this
excusable neglect was the cause of its failure to appear at trial. The South Carolina Court of Appeals found that the facts of
the case did not amount to excusable neglect, stating that "[l]ack of familiarity with legal proceedings is unacceptable and the
court will not hold a layman to any lesser standard than is applied to an attorney." Goodson, 368 S.E. 2d at 689 (with
references to H. Lightsey, J. Flanagan, South Carolina Civil Procedure, 400 (2nd Ed. 1985) and McCall v. A-T-O, Inc., 276
S.C. 143, 276 S.E. 2d 529 (1981)).
In light of the ruling by the Court of Appeals in Goodson, the most that can be said of the facts of the present case is that
reasonable minds may differ as to whether Ms. Arledge's reported reliance upon information allegedly provided to her by the
federal Social Security Administration staff constitutes "good cause" for her failure to appear at the hearing that had been
scheduled in connection with her application to the State of South Carolina for Medicaid benefits. The Hearing Officer's
factual finding that this excuse did not rise to the level of "good cause" cannot be overturned simply on the basis that
someone else might have decided the issue differently when faced with the same circumstances, particularly since laymen are
not to be held to a lesser standard of adherence to a tribunal's procedures. No showing has been made that the Hearing
Officer's decision was arbitrary or capricious, or that it was otherwise affected by any error -- either of law or of fact --
substantial enough to warrant a reversal.
ORDER
For the reasons discussed above, the June 8, 1999 DHHS Hearing Officer's decision to dismiss Ms. Arledge's appeal was
within the scope of his discretion and authority and is hereby affirmed. Any additional grounds for appeal raised by the
Petitioner that are not specifically discussed in this Order are denied.
AND IT IS SO ORDERED.
______________________________
Ralph King Anderson, III.
Administrative Law Judge
December 7, 1999
Columbia, South Carolina |
