Hillman v. Health & Social Services Department

590 P.2d 179, 92 N.M. 480
CourtNew Mexico Court of Appeals
DecidedJanuary 16, 1979
Docket3364
StatusPublished
Cited by14 cases

This text of 590 P.2d 179 (Hillman v. Health & Social Services Department) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hillman v. Health & Social Services Department, 590 P.2d 179, 92 N.M. 480 (N.M. Ct. App. 1979).

Opinions

OPINION

LOPEZ, Judge.

Appellant, Mrs. Faun Hillman, appeals a decision of appellee, Health and Social Services Department and Fernando C. De Baca, the Department’s Executive Director, denying her General Assistance benefits under the New Mexico Public Assistance Act, §§ 27-2-1 et seq., N.M.S.A. 1978. We reverse and remand.

Section 27-3-4F(l), (2), (3) N.M.S.A. 1978 gives this Court the power to set aside a decision of appellee if it proves to be “(1) arbitrary, capricious or an abuse of discretion; (2) not supported by substantial evidence in the record as a whole; or (3) otherwise not in accordance with law.” All of appellant’s arguments for reversal are based upon the contention that appellee’s decision was not in accordance with law.

Recitation of the following facts is essential for a clear understanding of this case. Based upon a determination of temporary disability, appellant was receiving General Assistance benefits (Category 05) in Dona Ana County. See §§ 27-2-7A(2) and 27-2-8, N.M.S.A. 1978. The agency in this county sent appellant an Advance Notice of termination. Appellant requested a fair hearing and benefits were continued pending the administrative appeal. See § 27-3-3, N.M.S.A. 1978. The agency based its termination upon a statement from a doctor that appellant was no longer disabled, that she had refused prescribed psychological evaluations and that X-rays were not significant to support a claim of disability. A fair hearing was held and the medical statement was admitted into evidence. Appellant also testified. At the end of the fair hearing, the hearing officer decided to refer this statement, testimony, and other offered material to the Incapacity Review Unit for a recommendation as to whether other physical examinations of appellant should be authorized. The Incapacity Review Unit concluded that the submitted information was completely inadequate to determine appellant’s continued eligibility for Category 05 benefits. Consequently, it recommended that appellant submit to a psycho-diagnostic and orthopedic examination. In addition, it requested that a social summary accompany the reports of these examinations. This information was deemed necessary before a decision could be made on her fair hearing. Acting upon the belief that the decision of appellant’s continued eligibility was to be made on evidence introduced outside the fair hearing, appellant refused to consent to the requested examinations. When this refusal was communicated to appellee, it failed to advise appellant of any opportunity for examining the reports, the doctors preparing the report, the case-worker preparing the social summary and the members of the Incapacity Review Unit upon whose recommendation the county agency’s decision would be based. Based upon appellant’s refused consent, the Executive Director terminated appellant’s benefits. This termination was made on a document entitled “Fair Hearing Decision.” A judicial appeal to this Court followed. See § 27-3-4, N.M.S.A. 1978.

Appellant presents three points for reversal: (1) appellee’s fair hearing decision violated its own regulations; (2) appellee’s fair hearing decision violated statutory and administrative law; and (3) appellee's fair hearing decision violated the Due Process Clause of the Fourteenth Amendment to the United States Constitution. The first point is dispositive of this appeal. Therefore, we make no decision concerning the other points. With respect to the last point, we follow the principle that a court will not decide constitutional questions unless necessary to a disposition of the case. Property Tax Department v. Molycorp, Inc., 89 N.M. 603, 555 P.2d 903 (1976); Huey v. Lente, 85 N.M. 597, 514 P.2d 1093 (1973); see also Railroad Comm’n v. Pullman Co., 312 U.S. 496, 61 S.Ct. 643, 85 L.Ed. 971 (1941).

In discussing those considerations involved under appellant’s first point, we note that appellee is bound by its own regulations. Martinez v. Health and Social Services Department, 90 N.M. 345, 563 P.2d 608 (Ct.App.), cert. denied, 90 N.M. 636, 567 P.2d 485 (1977). The following are those regulations pertinent to appellant’s contention:

275.31 — RIGHT TO FAIR HEARING — Every applicant or recipient may request and obtain a fair hearing with respect to any Agency action concerning . . the determination of his eligibility for assistance . The right to a fair hearing includes the right to be advised of the nature and availability of such a hearing, to receive any needed help in preparing for or participating in it, to have a hearing which fully safeguards his opportunity to present his case, to have prompt notice and implementation of the decision based on the hearing, and to be advised that he may invoke judicial review (Emphasis added)
275.33 — AUTHORITY FOR DECISION-MAKING FOLLOWING HEARING — The Executive Director makes the final administrative decision on the information provided in a fair hearing. (Emphasis added)
275.472 — INFORMATION PRESENTED — All information presented or used by the county office . . during the course of the hearing must be heard by or, if written, must be available to the claimant or his representative for examination prior to the hearing as well as during the hearing itself. No other information may be a part of the hearing record or used in making a decision on the case.
In instances when the client is appealing a decision involving medical care or a medical condition, the client has the right to know the facts about any documents on which the decision was based. The medical report may be examined following receipt of a fair hearing request by the client and/or his representative, prior to or during the hearing, or the medical report may be read aloud during the hearing.
When the hearing involves medical issues, such as those concerning a diagnosis, an examining physician’s report, or the Incapacity Review Unit’s decision, a medical assessment other than of the person or persons involved in making the original decision will be obtained at the Department’s expense from a source satisfactory to the claimant, if the hearing officer considers it necessary, and made a part of the record. (Emphasis added)

We have presented at some length the foregoing regulations to show the specificity governing the conduct of a fair hearing, the requisites for inclusion of information into the fair hearing record, and the information which can be considered in making a final decision of eligibility.

Based upon these regulations, it is obvious that any decision terminating a claimant’s benefits must be based on a hearing which fully protects the claimant’s opportunity to present his case. Specifically included in this opportunity is the option to examine all medical reports prior to or during the hearing. In addition, since medical reports are written information, they cannot be made “a part of the hearing record or used in making a decision on the case” unless they have been made available for such examination. Section 275.472, Public Assistance Manual, Vol. II-A.

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Hillman v. Health & Social Services Department
590 P.2d 179 (New Mexico Court of Appeals, 1979)

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Bluebook (online)
590 P.2d 179, 92 N.M. 480, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hillman-v-health-social-services-department-nmctapp-1979.