Zackary Courtois v. D.s.h.s., State Of Washington

Court of Appeals of Washington·Decided September 12, 2017·No. 49280-6·Unpublished

Opinion

Filed

Washington State

Court of Appeals

Division Two

September 12, 2017

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

DIVISION II

ZACKARY COURTOIS, No. 49280-6-II

Appellant, UNPUBLISHED OPINION v.

DEPARTMENT OF SOCIAL & HEALTH, SERVICES,

Respondent.

BJORGEN, C.J. — This appeal involves the narrow issue of whether the superior court abused its discretion by declining to award attorney fees to Zackary Courtois under the Equal Access to Justice Act (EAJA), 5 U.S.C. 504.

From a young age, Courtois, due to his disabilities, received benefits from the Developmental Disabilities Administration (DDA), which is a part of the Department of Social and Health Services (Department). Upon reaching the age of 18, the Department determined that Courtois was no longer eligible for DDA benefits. Courtois appealed that decision to an administrative law judge (ALJ) and, subsequently, to the Department’s Board of Appeals (Board). Both affirmed the Department’s action.

On appeal to superior court, the Department’s denial of benefits was reversed on two bases: first, that the Department had committed an error of law in interpreting and applying the dual diagnoses regulations, WAC 388-823-0720, -0740, and second, that substantial evidence did not support its finding that Courtois’ adaptive skills test was not administered and evaluated by a qualified professional. Courtois then moved the superior court for an award of attorney fees under the EAJA. The superior court declined to award attorney fees because it determined that the Department’s actions were substantially justified.

Courtois appeals the order denying EAJA attorney fees. He contends that the superior court abused its discretion because its prior determinations that the Department committed an error of law and that one of its findings was not supported by substantial evidence compelled the conclusion that the Department’s position was not substantially justified.

We hold that the superior court did not abuse its discretion in denying attorney fees under the EAJA. Accordingly, we affirm.

FACTS

In 2002 Courtois began receiving services from DDA. In November 2014 DDA determined that Courtois no longer met DDA eligibility criteria to receive disability benefits. Katherine,1 Courtois’ mother, contested that determination, believing Courtois’ recent autism diagnosis qualified him for DDA benefits.

To aid in setting out the remaining facts of the appeal, we first summarize the legal principles governing the benefits at issue.

1 Because Katherine and Zachary have the same last name, we refer to Katherine by her first name. No disrespect is intended.

I. PERTINENT LAW

In order to qualify for DDA benefits, an individual must show that he or she has been diagnosed with an intellectual disability that “[r]esults in substantial limitations.” See WAC 388- 823-0015; WAC 388-823-0200. One such eligible condition is autism. See WAC 388-823- 0500. In order to show that an individual’s autism “[r]esults in substantial limitations,” WAC 388-823-0015(1)(c), the individual must submit documentation showing (1) an adaptive skills test score of more than two standard deviations below the mean and (2) a Full Scale Intelligence Quotient (FSIQ) score of more than one standard deviation below the mean. See WAC 388-823- 0510; see WAC 388-823-0210. The adaptive test “must be administered and scored by professionals who have a background in individual assessment, human development and behavior, and tests and measurements, as well as an understanding of individuals with disabilities.” WAC 388-823-0740(1)(a).

The adaptive skills and FSIQ scores cannot be attributable to an unrelated “mental illness or other psychiatric condition occurring at any age; or other illness or injury occurring after age eighteen.” WAC 388-823-0720, -0740. If an individual is “dually diagnosed” with a qualifying condition and other unrelated conditions, the individual must provide “acceptable documentation” that the qualifying condition, measured by the FSIQ and adaptive skills tests, would meet the requirements for DDA eligibility without the influence of the unrelated conditions. WAC 388-823-0720(2)(a), -0740(2)(a). “Acceptable documentation”

means written reports or statements that are directly related to the subject at issue, reasonable in light of all the evidence, and from a source of appropriate authority.

The determination of whether a document is acceptable is made by DDA.

WAC 388-823-0720 (2)(b), -0740(2)(b). “If no documentation is provided or DDA determines that the documentation is not acceptable[,] DDA will deny eligibility. The determination may be challenged through an administrative appeal.” WAC 388-823-0720(2)(c), -0740(2)(c).

II. HISTORY OF COURTOIS’ DIAGNOSES Throughout his life, Dr. Heather Sue Daniels was Courtois’ primary doctor and diagnosed him with a variety of conditions. Daniels diagnosed him with attention deficit hyperactivity disorder (ADHD) in 2002 and “Static Encephalopathy secondary [due] to poor early nutrition with failure to thrive” in 2004. Clerk’s Papers (CP) at 296. In 2007, Daniels stated that “as he grows older he seems to be coalescing into an Asperger Syndrome picture[,]” and again diagnosed him with ADHD and static encephalopathy as well as about nine other new conditions.2 CP at 299.

In August 2013, when the Department was determining whether Courtois should continue to receive DDA benefits, Daniels provided the following summary of Courtois’ diagnoses over his lifetime, classifying them under different developmental categories:

Early Childhood Failure to Thrive

Static Encephalopathy with development delay

Mid Childhood ADHD

Asperger’s (Autism Spectrum Disorder)

New issues in the last two years Sleep Disorder

Brain Tumor

2 These other diagnoses include cognitive impairment, obsessive compulsive disorder, speechlanguage disorder, social learning disorder, sleep disorder, fine and gross motor dyspraxia, status post failure to thrive, status post gastroesophageal reflux disease, and small stature.

Seizure Disorder

Episodes of memory loss with seizures

CP at 315.

The Department asked Daniels to clarify Courtois’ current diagnoses. In response, in December 2013, Daniels submitted the following diagnoses pertinent to Courtois’ eligibility for DDA benefits:

1. Encephalopathy . . . (brain damage) from inadequate feeding in infancy, with seizure disorder and brain tumor 2. Autism Spectrum Disorder 3. Lack of Common Sense

See CP at 316.

In September 2014 Daniels completed a questionnaire and checklist, which implicitly continued to diagnose Courtois with autism spectrum disorder. However, she did not rule out encephalopathy, stating, “Zach’s social communications are better explained by [autism] than his other disabilities.” See CP at 191 (emphasis added).

III. FSIQ AND ADAPTIVE SKILLS TESTS In February 2013 Courtois received a neuropsychological evaluation, reflecting a FSIQ score of 80. This score was more than one standard deviation below the mean. See WAC 388- 823-0510(2).

In April 2014 Courtois received an adaptive skills assessment. His mother, Katherine, provided the ratings of Courtois’ adaptive skills. Brian Rice, a psychologist, scored and interpreted those ratings. Rice found that Courtois scored in the extremely low range of adaptive functioning and qualified as more than two standard deviations below the mean. WAC 388-823- 0510(1).

IV. APPEALS PROCESS

In November 2014 the Department denied Courtois DDA benefits. Katherine contested this determination, believing that Courtois qualified for DDA services because of his autism diagnosis.

The matter went before an ALJ, who received testimony from witnesses and admitted numerous exhibits, establishing the facts discussed in Parts I-III above. In addition, Daniels testified that Courtois “only needs one . . . diagnosis . . . for his behavior stuff,” which was “[a]utism spectrum disorder.” CP at 528-29.

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Zackary Courtois v. D.s.h.s., State Of Washington, (Wash. Ct. App. 2017).

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