Axilrod v. STATE, DEPARTMENT OF CHILDREN AND FAMILY SERVICES

799 So. 2d 1103, 2001 Fla. App. LEXIS 16058, 2001 WL 1417521
CourtDistrict Court of Appeal of Florida
DecidedNovember 14, 2001
Docket4D01-1885
StatusPublished
Cited by7 cases

This text of 799 So. 2d 1103 (Axilrod v. STATE, DEPARTMENT OF CHILDREN AND FAMILY SERVICES) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Axilrod v. STATE, DEPARTMENT OF CHILDREN AND FAMILY SERVICES, 799 So. 2d 1103, 2001 Fla. App. LEXIS 16058, 2001 WL 1417521 (Fla. Ct. App. 2001).

Opinion

799 So.2d 1103 (2001)

Allen AXILROD, Appellant,
v.
STATE of Florida, DEPARTMENT OF CHILDREN AND FAMILY SERVICES, Appellee.

No. 4D01-1885.

District Court of Appeal of Florida, Fourth District.

November 14, 2001.

*1106 Allen Axilrod, Port St. Lucie, pro se.

Laurel Hopper, Department of Children and Family Services, Ft. Pierce, for appellee.

ALTONAGA, CECILIA M., Associate Judge.

This is an appeal from a final order of the Office of Appeal Hearings of the State of Florida Department of Children and Families (Department), affirming action denying appellant, Allen Axilrod, Medicaid benefits through the Department SSI-Related Medicaid Program[1] on the basis that appellant does not meet required disability criteria. The issues raised on appeal are whether the hearing officer's findings are supported by competent substantial evidence and whether he properly applied sequential evaluation criteria to deny benefits. For the reasons that follow, we reverse.

On October 31, 2000, appellant, a fortyeight year old dump truck driver, was involved in a motor vehicle accident and was admitted to St. Lucie Medical Center where he was treated for a complex fracture and dislocation to his right hip. Appellant's treating physician, Dr. Moore, referred appellant to Tampa General Hospital where he later had surgery on his right hip, right knee and right leg. A plate and screws were inserted to hold the fracture in appellant's leg in place. A small fragment fracture was also located in appellant's neck at the C4 vertebrae. Appellant was taking Percoset, a painkiller, and was seeing an orthopedic specialist, Dr. DePasquale.

On November 9, 2000, appellant applied for SSI Related Medicaid Program benefits. Florida's Medicaid Program is designed to provide Medicaid benefits to individuals and families who meet certain guidelines and are aged, blind or disabled, but are otherwise ineligible either for AFDC or Supplemental Security Income (SSI) programs. See Scordas v. State, Dep't of Health & Rehabilitative Servs., 649 So.2d 894, 895 (Fla. 1st DCA 1995); Walker v. Dep't of Health & Rehabilitative Servs., 533 So.2d 836 (Fla. 1st DCA 1988) (Walker I), appeal after remand, 554 So.2d 1202 (Fla. 1st DCA 1989)(Walker II). Florida's definition of disability is similar to the definition of disability in the SSI regulations. See Edlin v. Dep't of Health & Rehabilitative Servs., 633 So.2d 1185, 1186 (Fla. 1st DCA 1994). In evaluating claims for the Medicaid Program, the Department is required to apply all SSI-related criteria. See Scordas, 649 So.2d at 895.

Appellant's medical bills exceeded $200,000.00 and he last worked in June 2000. The Department completed a disability report on appellant and sent it to the Office of Disability Determination *1107 (hereinafter "ODD"), on December 21, 2000. Dr. Moore, who did not treat the appellant after the initial emergency room visit, noted in a questionnaire from ODD that appellant's condition was a temporary disability and that he would be able to return to work within a year. On February 21, 2001, ODD completed its findings and notified the Department that appellant did not meet the disability criteria based on a finding that appellant's impairments would not last more than twelve months. In a de novo review of these findings, a hearing was held before a hearing officer in April 2001. The hearing officer affirmed ODD's denial of benefits, finding that appellant did not meet the definition of disability contained in 20 C.F.R. § 416.905, and as analyzed pursuant to the disability evaluation criteria of 20 C.F.R. § 416.920.

Disability is
[t]he inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve months. To meet this definition, you must have a severe impairment, which makes you unable to do your previous work or any other substantial gainful activity which exists in the national economy....

20 C.F.R. § 416.905(a). The Department engages in a five-step analysis contained in 20 C.F.R. § 416.920, to determine whether a claimant is disabled and thus entitled to benefits. The five-step sequential analysis asks the following questions:

1. Is the claimant presently unemployed?
2. Is the claimant's impairment severe?
3. Does the claimant's impairment meet or equal one of the specific impairments set forth in 20 C.F.R. Pt. 404, Subpt. P, App. 1?
4. Is the claimant unable to perform his or her former occupation?
5. Is the claimant unable to perform any other work within the economy?

Scordas, 649 So.2d at 895 (quoting McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir.1986)). An affirmative answer to any of the questions leads to the next question, or, in the case of steps three and five, to a finding of disability. A negative answer to any questions other than to step three leads to the finding of not disabled. See McDaniel, 800 F.2d at 1030; 20 C.F.R. § 416.920(a)-(f). The first two steps are threshold inquiries; indeed, step two allows only those claims based on the most trivial of impairments to be rejected. See McDaniel, 800 F.2d at 1031. A non-severe impairment is "[a]n impairment or combination of impairments" that "does not significantly limit your physical or mental ability to do basic work activities." 20 C.F.R. § 416.921. To satisfy the second step of the inquiry, a claimant carries a "mild burden." Muckenthaler v. State, Dep't of Children & Families, 732 So.2d 362, 363 (Fla. 2d DCA 1999). "An impairment is not severe only if the abnormality is so slight and its effect so minimal that it would clearly not be expected to interfere with the individual's ability to work, irrespective of age, education or work experience." Id. (quoting McDaniel, 800 F.2d at 1031).

Under step three of the analysis, evidence of the claimant's impairments is compared to a list of impairments presumed severe enough to preclude any gainful work. See Howson v. Dep't of Children & Families, 743 So.2d 564, 567 (Fla. 5th DCA 1999). A claimant is disabled if he or she has an impairment that is listed or that is equal to a listed impairment. See id. (emphasis added). Where a claimant has more than one impairment, but each does not meet or equal *1108 the severity of any of the listed impairments, then the impairments must be evaluated in combination. See Walker I, 533 So.2d at 837-38.

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799 So. 2d 1103, 2001 Fla. App. LEXIS 16058, 2001 WL 1417521, Counsel Stack Legal Research, https://law.counselstack.com/opinion/axilrod-v-state-department-of-children-and-family-services-fladistctapp-2001.