Schreur v. Department of Human Services

795 N.W.2d 192, 289 Mich. App. 1
CourtMichigan Court of Appeals
DecidedJune 22, 2010
DocketDocket No. 285792
StatusPublished

This text of 795 N.W.2d 192 (Schreur v. Department of Human Services) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Schreur v. Department of Human Services, 795 N.W.2d 192, 289 Mich. App. 1 (Mich. Ct. App. 2010).

Opinion

Per Curiam.

Respondent, the Department of Human Services (the Department) appeals by leave granted a circuit court order that held that the Department failed to provide proper notice to petitioner, Amanda Schreur, of her right to request a hearing regarding a denial of her application for Medicaid benefits. This Court also granted the Department’s motion for a stay of the benefit payments.1 We reverse.

I. BASIC FACTS AND PROCEDURAL HISTORY

On April 29, 2005, Schreur filed an application for Medicaid disability benefits. Schreur, then 24 years old, had undergone back surgery in January 2005 to remove a tumor from her spine. She claimed that she was physically unable to work because she suffered from low back pain and weakness. Schreur could not stand or walk for more than a half-hour before her back got sore, [4]*4but she had no problem sitting for long periods. Previously, Schreur had worked at a day-care center. Schreur sought benefits retroactively, in part, from January 2005 forward. It is undisputed that at the time of Schreur’s application, she was not already a recipient of Medicaid disability benefits.

On June 10, 2005, the Department mailed Schreur notice that it had denied her application for Medicaid benefits because her disability was not “expected to last for at least 12 consecutive months” and would not prevent her from “working in any substantial gainful employment.” At the top of the form, there was a short statement to the applicant: “If you do not understand the information in this notice, please contact me immediately. If you wish, you may meet with my manager and me to discuss the action(s) taken on your application.” (Presumably, “me” referred to the specialist who signed and provided her contact information on the form.)

The notice also contained several “Manual Policy References.” On the line marked “PEM” (acronym for Program Eligibility Manual), was typed “400 500 166.” On the line marked “PAM” (acronym for Program Administrative Manual), was typed “110 115.” Below the Manual Policy References was the following statement: “If your application is being denied, you may apply for assistance if your circumstances changes [sic].”

The backside of the notice further provided, “Procedures For Requesting A Fair Hearing.” Specifically, the notice stated:

If you believe this action is illegal, you may request a hearing within 90 days of the date of this notice.... All... requests for a hearing must be made IN WRITING and signed and dated by you.
***
[5]*5Complete the “Request for Hearing” section below or any other written request. State that you want a hearing on the decision made by the Agency and briefly explain your reasons.

Immediately beneath this section was a form to fill out to request a hearing.

Schreur did not request a hearing within 90 days. Instead, she waited until June 13, 2006, to mail her request for review of the Department’s decision to deny her application. The Department received the request on June 15, 2006. Therefore, Schreur filed her hearing request 368 days after the date of the notice and 278 days after expiration of the 90-day period for requesting a hearing.

On December 14, 2006, an administrative hearing was held regarding Schreur’s substantive claim of disability and to determine whether Schreur’s hearing request was timely. Schreur argued that her hearing request was timely because the Department’s denial notice contained incorrect citations to the Department’s administrative and eligibility manuals, which, she contended, made the notice inadequate and ineffective to start the 90-day period to request a hearing. More specifically, according to Schreur, the citations to the Department’s policy manuals, PAM and PEM, were not relevant to the denial of Schreur’s application for assistance because they did not pertain to disability determinations. Indeed, the Department concedes that manual item PEM 400 refers to assets, PEM 500 refers to income, PEM 166 refers to aged, blind, and disabled individuals, PAM 110 explains application filing and registration procedures, and PAM 115 explains application processing. Rather clearly, these manual items do not directly pertain to disability determinations.

[6]*6The Department explained that the notice is “a Word document that workers often pre-fill. . ., and they just use the same [form] over and over again.” The Department argued that the notice was adequate because it explained the reason for the denial of the application: that the impairment “has not lasted nor is expected to last for at least 12 consecutive months and does not prevent working in any substantial gainful employment.” According to the Department, the notice informed Schreur of her right to a hearing and the 90 days she had to request a hearing. The Department argued that the incorrect manual citations should have prompted Schreur to request a hearing if she was confused about the reason for the denial of her application. In other words, according to the Department, the incorrect citations should have simply been an additional basis to request a hearing.

Citing Mich Admin Code, R 400.902, R 400.903, and R 400.904, the hearing referee explained that “[a]ny hearing request which protests a denial, reduction, or termination of benefits must be filed within 90 days of the mailing of the negative action notice.” The referee rejected Schreur’s argument that the Department’s failure to cite the correct policy manual provisions underlying its decision to deny Schreur’s Medicaid benefits application rendered the notice provided insufficient or defective. The referee reasoned that, although the Department was required to cite the specific provisions underlying its decision, the failure to do so merely constituted an additional ground on which to request a hearing to contest the Department’s decision. The referee stated, “[T]he 90 day period to request a hearing applies to any issues connected with [the Department]^ actions of which the claimant has been notified of [sic], and that would include an omission of the [7]*7specific manual item(s) on which the action is based on [sic].” The referee found that the notice explained the specific reason for the denial and informed Schreur of her right to request a hearing within 90 days. Accordingly, the hearing referee issued an order dismissing Schreur’s request for a hearing as untimely.

Schreur then filed a petition for review in the Bay Circuit Court. Schreur argued that the policy manual citation errors in the notice made it inadequate and defective and “tolled” the period that she had in which to request a hearing. Schreur agreed with the circuit court’s assessment of her position that, if the section for manual references had said “PEM 260,” it would have been a proper and adequate notice because PEM 260 covers Medicaid disability and sets forth the regulations regarding how a person is determined to be disabled under the Department’s policy. Schreur readily acknowledged that she could have filed a request for a hearing within 90 days, but Schreur’s counsel had decided to rely on the citation errors and waited a year to request a hearing in order to give her client an advantage. More specifically, Schreur’s counsel explained:

Part of the elements in defining disability are that you have to have a severe impairment which has lasted or will continue to last for a year.

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Bluebook (online)
795 N.W.2d 192, 289 Mich. App. 1, Counsel Stack Legal Research, https://law.counselstack.com/opinion/schreur-v-department-of-human-services-michctapp-2010.