Caiola v. Department of Social & Health Services

562 P.2d 988, 17 Wash. App. 346, 1977 Wash. App. LEXIS 1576
Court of Appeals of Washington·Decided March 28, 1977·No. No. 3919-1·Published·Cited by 3 cases

Opinion

Per Curiam.

This is an appeal from an affirmance of a Department of Social and Health Services determination to reduce an AFDC grant to recoup a fraudulent overpayment.

Madeline A. Caiola applied for and received public assistance benefits in the category of Aid to Families with Dependent Children for a two-person household, which consisted of Ms. Caiola and her 3-year-old daughter, from February 1972 through June 1972. Ms. Caiola was subsequently married. Her husband moved in with her and her daughter, and worked periodically after moving in. Ms. Caiola also went to work after her marriage. None of these new developments were reported promptly to the department.

[348] Sometime after the husband moved out of the Caiola household, Ms. Caiola called the department and informed them of the prior unreported events. On March 3, 1973, Ms. Caiola was advised that an overpayment of public assistance was established in the amount of $1,325 as a result of fraud. Ms. Caiola acknowledged that assistance was received when not eligible, but she disputed that it was a fraudulent overpayment. Ms. Caiola was notified by the department that the AFDC grant was to be reduced by 10 percent until a mandatory recoupment of 125 percent of all assistance paid during the period in question was recovered. Ms. Caiola requested and received a hearing concerning whether her failure to notify the department constituted fraud and whether, in any event, a mandatory deduction of 10 percent could be recovered from the AFDC grant. The department concluded in an administrative decision that fraud had been committed and that it could recoup its loss through a mandatory deduction.

Ms. Caiola filed a petition for review with the trial court. The trial court affirmed the department determination and entered findings of fact stating in part:

2.4 Appellant in the fair hearing admitted willfully withholding the information regarding her income and eligibility to receive payment of an AFDC grant from the Department of Social and Health Services for the period in question and in the amounts alleged by the Department.

Ms. Caiola now appeals.

I. Judicial Review

Judicial review of an administrative decision is governed by RCW 34.04.130. Schuffenhauer v. Department of Employment Security, 86 Wn.2d 233, 543 P.2d 343 (1975). To overturn the department's determination, we must find that it acted arbitrarily and capriciously. A finding by an administrative body can be held to be arbitrary and capricious only if there is no support for it in the record and it is a willful and unreasonable action in disregard of facts and [349] circumstances. Smith v. Hollenbeck, 48 Wn.2d 461, 464, 294 P.2d 921 (1956).

In light of the above standard of review, the issues raised are (1) whether the overpayment was fraudulent; (2) are deductions from an AFDC grant a penalty for the beneficiary-child and are they authorized; and (3) is the State authorized in recouping 125 percent of the overpayment, 25 percent of which is a penalty.

II. Fraudulent Overpayment

Evidence on the record shows Ms. Caiola did not report (1) the fact of remarriage, (2) the fact of an employed husband, or (3) the fact of self-employment until 1 month after her husband left the household. Ms. Caiola admits these facts, yet contends her husband coerced her into not reporting and that therefore her actions were not voluntary, but were done under duress. The trial court rejected this contention and found instead that Ms. Caiola willfully withheld information and intended to deceive the department. The pertinent administrative regulation on this point is WAC 388-44-020, which reads in pertinent part:

When a local office finds that an applicant or recipient has misstated or failed to reveal any material fact affecting eligibility or need, it shall presume that such act was done intentionally.

The department ruled that the bare allegation of duress was not sufficient to rebut the presumption of an intentional deception on Ms. Caiola's part. As a result of the deceit and concealment of the recipient, she was paid $1,060 more than she was entitled to receive. The evidence of this was clear, cogent and convincing, and fraud as defined under RCW 74.04.300 was established. In light of the record, we find no basis for substituting our judgment for that of the department.

III. Child-Recipient Is Not Penalized

The petitioner contends she is merely an agent for the Department of Social and Health Services for the exclusive purpose of providing the dependent child with [350] appropriate financial support under the AFDC program, and therefore that to allow the department to deduct moneys from the AFDC grant would be to penalize the child-recipient and subvert the purpose of the whole AFDC program. This contention is rejected. An AFDC grant is determined on the basis of an "assistance unit" pursuant to RCW 74.12.010.1 This "assistance unit" consists of both the dependent child and the needy parent or relative with whom the child lives. The department's proposed reduction in the AFDC grant, authorized by RCW 74.04.300 and [351] WAC 388-44-035,2 would still leave a larger amount than that allowed for a child living with a relative who was not in need. The standards of WAC 388-28-140 as it then read were not violated since sufficient aid was available for the food, shelter and household maintenance of the dependent child so long as the recipient petitioner properly applied the awarded allotment. As a result, the child is not being penalized here, for the lawful authorization for the child remains the same.

IV. Authorization of the Recoupment

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Caiola v. Department of Social & Health Services, 562 P.2d 988, 17 Wash. App. 346, 1977 Wash. App. LEXIS 1576 (Wash. Ct. App. 1977).

562 P.2d 988 (Caiola v. Department of Social & Health Services) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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