G.R. v. Agency for Persons with Disabilities

• Decision Date: 02 December 2020
• Docket Number: No. 3D20-532,3D20-532
• Citation: 315 So.3d 107
• Parties: G.R., etc., Appellant, v. AGENCY FOR PERSONS WITH DISABILITIES, etc., et al., Appellees.
• Court: Florida District Court of Appeals

315 So.3d 107

G.R., etc., Appellant,

v.AGENCY FOR PERSONS WITH DISABILITIES, etc., et al., Appellees.

No. 3D20-532

District Court of Appeal of Florida, Third District.

Opinion filed December 2, 2020.

Manuel Ramirez, Legal Guardian for appellant, G.R.

Jada Williams (Tallahassee), Senior Attorney, for appellee Agency for Persons with Disabilities.

Before EMAS, C.J., and HENDON and MILLER, JJ.

EMAS, C.J.

G.R. appeals from a final order of the Florida Department of Children and Families’ Office of Appeal Hearings, affirming a decision by the Agency for Persons with Disabilities ("the Agency") to deny G.R.’s application for enrollment in a Medicaid waiver program for persons with disabilities. We affirm.

BACKGROUND AND PROCEEDINGS

On February 1, 2019, forty-two-year-old G.R. applied through his legal guardian for enrollment in the Individual Budgeting Home and Community Based Services ("HCBS") waiver, which provides funding for persons with specified developmental disabilities under section 393.063, Florida Statutes (2019). This was at least the third time G.R. had applied for such benefits, as he was denied benefits on the same basis in 2009 and 2012.

The Agency again denied G.R.’s application, concluding that he was not eligible for the benefits because the documents submitted on G.R.’s behalf failed to establish he had one of the defined disabilities under section 393.063(24). G.R. sought review of this denial, asserting, inter alia, that the Agency failed to consider some of the relevant information pertaining to his intellectual disability. Following a review, the Department of Children and Families’ Office of Appeal Hearings issued a final order denying G.R.’s administrative appeal. This appeal followed.

DISCUSSION AND ANALYSIS

We review an agency's conclusions of law de novo and we review the record to determine whether competent substantial evidence supports the agency's decision. A.C. v. Agency for Health Care Admin., 44 Fla. L. Weekly D2279, ––– So.3d ––––, ––––, 2019 WL 4291692, at *4 (Fla. 3d DCA 2019). In doing so, "we give no deference to agency interpretations of statutes or rules." Id. (citing MB Doral, LLC v. Dep't of Bus. & Prof'l Regulation, Div. of Alcoholic Beverages & Tobacco, 295 So. 3d 850, 853 (Fla. 1st DCA 2020) (noting: "With the passage of article V, section 21 of the Florida Constitution, the previously afforded deference to the agency's interpretation of the statutes it implements has been abolished; our review is de novo.")). See also M.T. v. Agency for Persons with Disabilities, 212 So. 3d 413 (Fla. 3d DCA 2016) ; A.W. v. Agency for Persons with Disabilities, 288 So. 3d 91 (Fla. 1st DCA 2019).

"A petitioner whose application for benefits or payments is denied must establish her position ‘by a preponderance of the evidence, to the satisfaction of the hearing officer.’ " A.W., 288 So. 3d at 93 (quoting Fla. Admin. Code R. 65-2.060(1) ). Chapter 393 of the Florida Statutes establishes the framework for providing benefits to individuals with developmental disabilities. To be eligible for such benefits, an individual must qualify as a statutorily defined individual with a "developmental disability." Section 393.063(12) defines this term as "a disorder or syndrome that is attributable to intellectual disability ... that manifests before the age of 18; and that constitutes a substantial handicap that can reasonably be expected to continue indefinitely."

The term "intellectual disability" is further defined in section 393.063(24) to mean "significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior which manifests before the age of 18 and can reasonably be expected to continue indefinitely." See also Fla. Admin. Code R. 65G-4.014 and 65G-4.017 (further delineating eligibility requirements). Of note, a full scale IQ score of 70 or below on an individually administered intelligence test is considered an intellectual disability, but in assessing this score, the Agency may rely on clinical judgment "when there is a great deal of variability between IQ scores on different IQ tests or different administrations of the same IQ test." Fla. Admin. Code R. 65G-4.017(3).

The Agency denied G.R.’s application because it determined that he did not meet the requisite definition of an individual with an intellectual disability. Specifically, the Agency noted that there was no reliable record during G.R.’s developmental years consistent with an intellectual deficit. The hearing officer, on appeal, agreed, finding that none of the records provided support a finding of intellectual disability manifesting before the age of 18, and that all information regarding G.R.’s status prior to the age of 18 fails to reference any testing methods to support a diagnosis of "learning deficits" or "mental retardation," facts which the hearing officer nevertheless determined were contradicted by the fact that G.R. obtained a G.E.D., had average grades, and a teacher recommendation letter indicating he had "average intellectual capacity." As indicated earlier, G.R. had the burden to establish his eligibility by a preponderance of the evidence. See M.T., 212 So. 3d at 415 ; Fla. Admin. Code R. 65-2.060(1) ).

Dr. Arias, who performed the evaluation of G.R. in 2012, testified that, at the time, G.R. was thirty-five years old. Dr. Arias diagnosed...