Harrison v. Ginsberg
| Decision Date | 22 January 1982 |
| Docket Number | No. 15349,15349 |
| Citation | 286 S.E.2d 276,169 W.Va. 162 |
| Court | West Virginia Supreme Court |
| Parties | Robin HARRISON v. Leon H. GINSBERG, Commissioner, West Virginia Department of Welfare, in his Official Capacity; James F. Bragg, State Hearing Officer, Member Board of Review of the West Virginia Department of Welfare, in his Official Capacity. |
Syllabus by the Court
1. The manner in which a state administers a federal assistance program must be consistent with federal law.
2. A final agency decision which affects the substantial rights of an individual must contain findings of fact on all the pertinent issues and a reasoned explanation of the ultimate conclusion reached.
3. On certiorari the circuit court is required to make an independent review of both law and fact in order to render judgment as law and justice may require.
Heidi Weintraub, Charleston, for appellant.
Chauncey H. Browning, Jr., Atty. Gen., and Billie Gray, Asst. Atty. Gen., Charleston, for appellees.
This case is here on an appeal from a decision of the Circuit Court of Kanawha County that affirmed an administrative decision of the West Virginia Department of Welfare finding the appellant ineligible for benefits under the Aid to Families with Dependent Children program. The Department of Welfare's decision denying appellant benefits was based on its finding that the appellant did not qualify under the Department of Welfare's definition of "incapacity." The circuit court held that the Department of Welfare's decision was not arbitrary, capricious, or contrary to the law and evidence, and affirmed the administrative decision. The appellant contends the circuit court's decision is in error because: (1) the state hearing officer failed to consider the appellant's vocational history and other relevant factors in determining incapacity as required by state and federal law; (2) the evidence conclusively established that the appellant met the applicable federal standard of incapacity; and (3) the circuit court applied an incorrect standard of review. We agree with the appellant's first and last contentions and reverse.
The appellant, Robin Harrison, is a 26 year old male, married, with one child. He suffers from fibrous dysplasia, a disease where healthy bone is replaced by an abnormal proliferation of fibrous tissue resulting in expansion and distortion of the bone structure. The appellant has suffered from the disease for 15 years. The medical evidence indicates it has deformed his left foot and also is present in his rib area and left arm.
The appellant was last employed in a permanent position by Leslie Brothers Equipment Company, in Cowen, West Virginia. Although the appellant performed a number of different jobs during the six years he was employed by Leslie Brothers, his primary work was a heavy equipment mechanic. This job required lifting loads of 50 to 70 pounds, walking, stooping, and bending over. While with Leslie Brothers, the appellant worked for a time in the parts room selling parts to bulldozer and other heavy equipment. However the appellant did not adapt to this work and returned to mechanical work after six months in the parts room.
The appellant ceased work at Leslie Brothers on August 1, 1979, when he broke his diseased left arm for the third time and surgery was required to repair it. He has not worked full time since that date, and his family presently subsists solely on food stamps. The appellant's wife has her own medical problems, and is also unemployed.
On February 11, 1980, the appellant applied for benefits under the Aid to Families with Dependent Children program (AFDC). The AFDC program is a creation of federal statute administered by the states under a scheme of cooperative federalism. It is designed to furnish financial assistance, rehabilitation, and other services to needy children and the parents or relatives with whom they are living, to help maintain and strengthen family life, and to help the parents or relatives to become self-supporting. 42 U.S.C.A. § 601 (1974). A "needy child" under the AFDC program must be one whose parent--father or mother--has died, has a physical or mental incapacity, or is continually absent from the home. 45 C.F.R. § 233.90(c)(1)(i) (1980).
The appellant applied for AFDC benefits on the grounds that he was an incapacitated father suffering from a severe impairment which substantially reduced his ability to care for his child, and prevented him from working full-time at a job. On April 8, 1980, the State Department of Welfare Area Review Team (ART) denied the appellant's request for benefits on the grounds that he was not "incapacitated" as required by department regulations, but found that he should be limited to light work.
On April 16, 1980, the appellant gave notice that he wished to have his application reviewed by the State Office Review Team (SORT), which on May 7, 1980 affirmed the decision of the ART. The appellant next requested an administrative hearing concerning the merits of his application.
A hearing was held on June 5, 1980 before a state hearing officer. At this hearing, the appellant testified that although he graduated from high school, he has never received any vocational training or training for office skills. Although he did take typing, he was forced to quit because of stiffness in his fingers. He testified to considerable pain in his left leg and in his ribs, which made breathing difficult.
Medical evidence pertaining to the appellant's condition was submitted in the form of medical reports from the treating physician, Dr. Antonio, a specialist in orthopedics; and the consulting physician, Dr. R. Paul Bennett. Neither physician was present to testify at the hearing.
Dr. Bennett's letter stated that the appellant had suffered multiple fractures of both his ribs and extremities, was suffering from fibrous dysplasia and osteoarthritis, and that he complained of constant discomfort. Dr. Bennett noted that because of the appellant's condition "he has not been able to continue in his usual line of occupation and is presently unemployed." It was Dr. Bennett's opinion that the appellant "should receive the benefits of some type of assistance till possibly other lines of occupation might become available ...."
In his report, Dr. Antonio stated that the appellant was probably unsuited to any form of heavy physical manual labor but could, in his opinion, be gainfully employed in a sedentary occupation.
Based on the report of Dr. Antonio, the hearing officer ruled in favor of the Department of Welfare, and denied the appellant AFDC benefits.
The appellant sought an appeal of the hearing officer's decision by way of writ of certiorari in the Circuit Court of Kanawha County, alleging that the hearing officer's decision was erroneous in that it did not give proper weight to the medical evidence presented on behalf of the appellant, and was contrary to state and federal regulations defining "incapacity" for AFDC purposes, by failing to consider the limited employment opportunities of handicapped individuals, and the age, education, training and experience of the appellant.
The circuit court, by order entered January 14, 1981, found that the decision of the hearing officer was not "arbitrary, capricious, or contrary to the law and evidence," and affirmed the decision as "plainly right." From that decision the appellant takes this appeal.
There are three primary issues presented by this appeal: (1) did the state hearing officer consider all the required factors in determining the alleged incapacity of the appellant; (2) must the state hearing officer's decision contain findings of fact on all pertinent issues and a reasoned explanation of the ultimate conclusion; and (3) must the circuit court, on a writ of certiorari, make an independent review of law and fact.
The federal standard for determining incapacity for AFDC purposes is found at 45 C.F.R. § 233.90(c)(iv) (1980). The regulation provides, in pertinent part:
"Physical or mental incapacity" of a parent shall be deemed to exist when one parent has a physical or mental defect, illness or impairment. The incapacity shall be supported by competent medical testimony and must be of such a debilitating nature as to reduce substantially or eliminate the parent's ability to care for the otherwise eligible child and be expected to last for a period of at least 30 days. In making the determination of ability to support, the agency shall take into account the limited employment opportunities of handicapped individuals.
The appellant contends the decision of the hearing officer denying him benefits was erroneous because in determining incapacity the hearing officer failed to consider the limited employment opportunities of handicapped individuals as required by the federal regulations.
The appellant's contention is supported by the record before this Court. The record indicates that the hearing officer relied solely upon the provisions of § 6330 of the Department of Welfare's Economic Services Manual to determine whether the appellant met the definition of incapacity. Section 6330 provides:
A child may be deprived of parental support or care by reason of the physical or mental incapacity of the parent. Incapacity exists when a parent has a physical or mental defect, illness or impairment. The incapacity must be supported by medical reports and must substantially reduce or eliminate the parent's ability to support or care for the child(ren). The incapacity must be expected to last for at least a period of thirty (30) days. In order for the deprivation factor to be based on incapacity, both parents must be residing in the home with the children for whom the application is being made except that the incapacitated parent may be temporarily out of the home for medical care or treatment.
It is readily apparent from a reading of the state and federal regulations that § 6330...
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