Opinion
HHBCV165017401S
04-13-2017
Istrate Ionescu v. Commissioner of Social Services
UNPUBLISHED OPINION
MEMORANDUM OF DECISION
Sheila A. Huddleston, Judge.
The plaintiff, Istrate Ionescu, appeals, pursuant to General Statutes § 4-183, from the decision of the Department of Social Services (department) to discontinue his cash assistance benefits under the state-administered general assistance (SAGA) program because he refused to apply for Social Security benefits for which he appeared to be eligible. On appeal, the plaintiff claims that (1) collateral estoppel principles bar the department from denying him benefits because it had previously provided such benefits when he was eligible for Social Security under similar circumstances; (2) the department's regulations are vague and ambiguous because the department previously granted him benefits; (3) the department acted arbitrarily and capriciously in requiring him to apply for Social Security benefits in 2015 when it had not done so in 2012, 2013, or 2014; (4) the department cannot require him to apply for Social Security benefits when federal law does not require that he apply for such benefits; and (5) the department cannot require him to apply for Social Security benefits because he has an expectation of privacy in the status of his Social Security benefits. The department refutes each of these arguments and contends that its hearing officer correctly applied the relevant law to the undisputed facts of the case. For the reasons stated below, the court concludes that collateral estoppel does not apply; that the law and regulations are clear; that state law requires the plaintiff to seek benefits for which he may be eligible before receiving SAGA benefits, which are wholly funded and administered by the state; and that the department's requirement that the plaintiff apply for Social Security benefits does not violate federal privacy regulations. The appeal must therefore be dismissed.
FACTS AND PROCEDURAL HISTORY
The record reveals the following facts and procedural history. The plaintiff received benefits for cash assistance under the SAGA program from 2011 through 2015. ROR, pg. 59. He was initially found to be eligible for SAGA under General Statutes § 17b-194(a)(2)(A) because he was over fifty-five and chronically unemployed. Id., 40. In July 2015, he became sixty-five years old. Id., 2. On October 20, 2015, the department completed a review of the plaintiff's application for renewal of his benefits. Id., 2. On October 23, 2015, the department mailed him a W-1348 " Verification We Need" form (W-1348), requesting proof that he had applied for Social Security benefits because he had turned sixty-five. Id. The requested information was due by November 3, 2015. Id. The plaintiff failed to provide proof of a Social Security application, and on November 9, 2015, the department sent him a notice that his SAGA benefits would be discontinued effective November 30, 2015. Id. The notice advised him that " you did not return the required verification we asked for" and " you must apply for Social Security Benefits in order to determine eligibility for SAGA cash." Id.
On November 21, 2015, the plaintiff requested an administrative hearing to contest the department's decision. Id., 1. The department's Office of Legal Counsel, Regulations, and Administrative Hearings issued a notice scheduling a hearing for December 15, 2015. Id. At the plaintiff's request, the hearing was rescheduled to January 7, 2016, while the department's legal staff researched the plaintiff's legal arguments. Id., 1-2, 40-50, 82-87. At the hearing on January 7, 2016, the plaintiff and two department representatives were present. Id., 1-2. The plaintiff argued that the department's decision was inconsistent with court decisions that have held that the state cannot impose more strenuous eligibility requirements for Medicaid than the federal government does. Id., 88-106. He also argued that the department was estopped from denying him benefits because he had previously been awarded benefits despite his eligibility for Social Security benefits. Id., 89-94. The hearing officer concluded, to the contrary, that the department appropriately followed the procedures and applied the eligibility requirements in its uniform policy manual (policy manual or UPM) in denying a renewal of the plaintiff's SAGA benefits. Id., 3-4. The plaintiff was aggrieved by the decision and filed a timely appeal to this court.
STANDARD OF REVIEW
Judicial review of an administrative agency's action is governed by the Uniform Administrative Procedure Act (UAPA), General Statutes § § 4-166 through 4-189. Section 4-183(j) establishes the standard by which courts are to review administrative decisions. It provides in relevant part: " The court shall not substitute its judgment for that of the agency as to the weight of the evidence on questions of fact. The court shall affirm the decision of the agency unless the court finds that substantial rights of the person appealing have been prejudiced because the administrative findings, inferences, conclusions, or decisions are: (1) In violation of constitutional or statutory provisions; (2) in excess of the statutory authority of the agency; (3) made upon unlawful procedure; (4) affected by other error of law; (5) clearly erroneous in view of the reliable, probative, and substantial evidence on the whole record; or (6) arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted exercise of discretion."
The scope of judicial review of administrative action is very restricted. Bancroft v. Commissioner of Motor Vehicles, 48 Conn.App. 391, 399, 710 A.2d 807, cert. denied, 245 Conn. 917, 717 A.2d 234 (1998). " [R]eview of an administrative agency decision requires a court to determine whether there is substantial evidence in the administrative record to support the agency's findings of basic fact and whether the conclusions drawn from those facts are reasonable . . . Neither [the Supreme Court] nor the trial court may retry the case or substitute its own judgment for that of the administrative agency on the weight of the evidence or questions of fact . . . Our ultimate duty is to determine, in view of all of the evidence, whether the agency, in issuing its order, acted unreasonably, arbitrarily, illegally or in abuse of its discretion." (Internal quotation marks omitted.) Murphy v. Commissioner of Motor Vehicles, 254 Conn. 333, 343, 757 A.2d 561 (2000) .
" Even for conclusions of law, [t]he court's ultimate duty is only to decide whether, in light of the evidence, the [agency] has acted unreasonably, arbitrarily, illegally, or in abuse of its discretion . . . [Thus] [c]onclusions of law reached by the administrative agency must stand if the court determines that they resulted from a correct application of the law to the facts found and could reasonably and logically follow from such facts." (Internal quotation marks omitted.) Chairperson, Connecticut Medical Examining Board v. Freedom of Information Commission, 310 Conn. 276, 281-82, 77 A.3d 121 (2013).
DISCUSSION
SAGA is a general assistance program that provides subsistence benefits as a last resort to indigent individuals who are not eligible for other programs. " General assistance programs are state run public assistance programs, which operate according to state legislative directives." Moore v. Ganim, 233 Conn. 557, 562 n.5, 660 A.2d 742 (1995). Such programs " provide assistance to needy persons who do not qualify for federal categorical assistance, such as Supplemental Security Income (SSI) or Aid to Families with Dependent Children (AFDC), or whose assistance under these programs is inadequate." Id. To be eligible for general assistance, an applicant must have assets and income that are below certain levels. See id. " In addition, the state requires all applicants to apply for federally funded programs for which they may be eligible." Id.
General Statutes § 17b-190 directs the department's commissioner to implement a state-administered general assistance program. General Statutes § 17b-191(b) provides in relevant part: " No person shall be eligible for cash assistance under the program if eligible for cash assistance under any other state or federal cash assistance program." The department's policy manual states in relevant part: " [A]pplicants for and recipients of SCA . . . must apply for, or cooperate in applying for, potential benefits from any source including SSI, and other cash programs administered by the department." (Emphasis added.) UPM § 8080.35(F)(2).
SCA refers to the state-administered general assistance cash program. See UPM § 8080.01 (defining terms).
I
The record indicates that the plaintiff was first granted SAGA benefits in 2011, when he was less than sixty-two years old, but greater than fifty-five years old, and that his benefits were renewed annually until 2015, when a department staff member noted that he was eligible to receive Social Security benefits and issued the request for verification directing him to apply for Social Security. Under federal law, an individual who qualifies for Social Security benefits first becomes eligible to receive those benefits at age sixty-two. See 42 U.S.C. § 402(a). The plaintiff asserts that the department is collaterally estopped from denying him benefits based on his refusal to apply for Social Security benefits because it granted him SAGA cash benefits in earlier years--2012 through 2015--when he was over sixty-two and therefore eligible for Social Security benefits. The department disagrees, arguing that the doctrines of res judicata and collateral estoppel do not apply to non-adjudicated administrative decisions. It further argues that the department is not bound to repeat a mistake where there has not been a case or controversy that has been fully and fairly litigated and finally decided. The court agrees with the department.
" Under the doctrine of res judicata, or claim preclusion, a former judgment on a claim, if rendered on the merits, is an absolute bar to a subsequent action on the same claim . . . Collateral estoppel, or issue preclusion, is that aspect of res judicata which prohibits the relitigation of an issue when that issue was actually litigated and necessarily determined in a prior action between the same parties upon a different claim." (Citations omitted; internal quotation marks omitted.) New England Rehabilitation Hospital of Hartford, Inc. v. Commission on Hospitals and Health Care, 226 Conn. 105, 128, 627 A.2d 1257 (1993).
" The common-law doctrine of res judicata, including the subsidiary doctrine of collateral estoppel, is designed to prevent the relitigation by the same parties of the same claims or issues. The reasons behind the doctrine as developed in the court system are fully applicable to some administrative proceedings, partially applicable to some, and not at all applicable to others. As a matter of principle, therefore, the doctrine should be applied to some administrative proceedings, modified for some, and rejected for others." K. Davis, Administrative Law Text (3d Ed. 1972), § 18.10, p. 371.
To determine whether an administrative decision has res judicata or collateral estoppel effect, a starting point is to consider whether " what the agency does resembles what a trial court does . . . A simple administrative handling of a claim, such as responding with a yes or no to a written application, is not necessarily an adjudication, even though it may involve application of law and finding or interpreting facts. Such handling may precede adjudication and may be regarded as executive or ministerial rather than as judicial." 2 R. Pierce, Administrative Law Treatise (5th Ed. 2010) § 13.3, p. 1132; see Reich v. Youghiogheny & Ohio Coal Co., 66 F.3d 111, 115 (6th Cir. 1995) (claims examiner's calculation error was not res judicata because examiner was performing ministerial function); see also Maxwell Co. v. National Labor Relations Board, 414 F.2d 477, 479 (6th Cir. 1969) (holding that the principle of res judicata has no application to administrative agencies' exercise of powers other than their quasi-judicial powers); Matter of Venes v. Community School Board of District 26, 43 N.Y.2d 520, 373 N.E.2d 987, 402 N.Y.S.2d 807 (1978) (school board was free to reconsider earlier decision not to dismiss probationary employee because action was executive, not adjudicative; no adversarial hearing was held). And, as one New York appellate court held, " [d]epartures from the rule of res judicata in administrative law spring from the peculiar necessities of the particular case or the nature of the precise power being exercised . . . Herein public policy provisions dictate that the doctrine of res judicata should not be applied. The State Tax Commission should not be precluded from correcting clerical errors to the detriment of the general taxpaying public." (Citation omitted; emphasis in the original; internal quotation marks omitted.) Matter of Turner Construction Co. v. State Tax Commission, 57 A.D.2d 201, 204-05, 394 N.Y.S.2d 78 (App.Div.3d Dept. 1977).
Application of the principles stated above leads to the conclusion that the department was not bound by the doctrine of collateral estoppel in this case. Recipients of SAGA cash benefits must reapply for the benefits at least yearly because eligibility may change for many reasons. See UPM § § 8080.15 and 1545.05 et seq. Each new application is judged on the circumstances existing at the time of the renewal application. The annual benefit determination is an executive or ministerial function, not an adjudicative function. In the plaintiff's case, his benefit determinations in 2012, 2013, and 2014 were not subjected to adjudication in an adversary proceeding, such as a fair hearing. A benefit determination that has not been subjected to adjudication is not a final decision because it is subject to correction even after the period for which it was awarded has passed.
Support for the conclusion that an initial benefit determination is not a final decision for purposes of collateral estoppel is found in the policy manual's procedures for correcting errors in benefit awards. See UPM § § 8080.70 and 7000 et seq. When it discovers an error in an award of benefits, the department may recoup overpayments made because of " agency error, " including " failing to insure that the assistance unit fulfilled certain technical or procedural eligibility requirements." UPM § 7005.10(B)(3). It is required to notify the affected person of the cause of the error and the proposed recoupment method. A person who disagrees with a recoupment decision may seek a fair hearing. See UPM § 7005.30.
The policy manual provision that requires the plaintiff to apply for all benefits for which he may be eligible, UPM § 8080.35(F)(2), is found in the " Procedural Eligibility Requirements" for SAGA. As shown above, failure to require compliance with such procedural eligibility requirements is a recognized source of " agency error" in benefit awards and is one that can be corrected retrospectively through agency recoupment procedures. Although the record in this case does not indicate that the department has attempted to recoup benefits the plaintiff received based on the agency's failure to require him to apply for Social Security benefits in 2012, 2013, and 2014, it would be contrary to public policy to preclude it from correcting its error prospectively for current and future benefit years after it recognized the plaintiff's potential eligibility for Social Security benefits.
II
The plaintiff's second claim is that the relevant provisions in the policy manual must be vague and ambiguous because the department granted benefits to the plaintiff in 2011 through 2015 and then interpreted the same policies to deny them to the plaintiff in late 2015. The plaintiff's argument is meritless. He was eligible for SAGA benefits when he first applied for them in 2011, when he was older than fifty-five, chronically unemployed, and not yet sixty-two. There is nothing in the record to support his claim that the department actively decided not to require him to apply for Social Security benefits in 2012, 2013, and 2014, as opposed to merely overlooking the fact that he had become eligible to apply for Social Security. When an application processor did take note of his age in 2015, the department promptly sent out the form advising him to apply for Social Security benefits.
III
The plaintiff similarly claims that the department interprets its policy manual provisions in an arbitrary and capricious manner by not requiring him to apply for Social Security at age sixty-two, but requiring him to do so at age sixty-five. This argument fails for the same reason as his argument that the regulations are vague and ambiguous. There is nothing in the record to suggest that the department was arbitrary in its application of the eligibility provisions; rather, the record indicates that an application processing error was made. When discovered, the error was corrected by requiring the plaintiff to apply for Social Security promptly.
The plaintiff also argues that the department was arbitrary because the amount of Social Security benefits that may be available to the plaintiff are unknown. His argument misses the point. All that he was required to do was to cooperate by applying for the Social Security benefits. See UPM § 8080.35. His SAGA benefits could continue while his Social Security application was pending. See General Statutes § 17b-194(a)(2)(C). The plaintiff has not shown that the department's action was arbitrary or capricious.
IV
The plaintiff asserts that § 17b-191(b) and UPM § 8080.35(F)(2) are inconsistent with federal law because there is no requirement under federal law that he must apply for Social Security or other benefits to receive SAGA benefits. In support of that argument, he cites General Statutes § 17b-11, which authorizes the commissioner of social services to " accept any and all allotments of federal funds . . . and to take advantage of any amendments and supplements to the federal Social Security Act and of any other federal act relating to public welfare, and to conform to such federal requirements as are conditions precedent to the receipt of federal matching grants . . ." The plaintiff cites a number of cases construing state Medicaid regulations and practices in support of his argument that the department cannot impose " stricter standards for eligibility than those enumerated by pertinent Social Security federal law." Plaintiff's Brief, p. 9, citing Ahern v. Thomas, 248 Conn. 708, 733 A.2d 756 (1999); Persico v. Maher, 191 Conn. 384, 465 A.2d 308 (1983); Morgan v. White, 168 Conn. 336, 344, 362 A.2d 505 (1975). In Morgan, Ahern, and Persico, the plaintiffs were individuals whom the department of Social Services had determined to be ineligible for Medicaid benefits. In each of those cases, the Supreme Court concluded that the agency had applied standards that were stricter than federal law required and were therefore invalid. But the reason, in each of those cases, was that the state received federal funds for the Medicaid program and was required to administer the program in accordance with federal law. As explained by the Supreme Court in Semerzakis v. Commissioner of Social Services, 274 Conn. 1, 12-13, 873 A.2d 911 (2005), " Medicaid is a cooperative federal-state program through which the federal government provides financial aid to states that furnish medical assistance to eligible low-income individuals . . . States electing to participate in the program must comply with certain requirements imposed by the [medicaid] [a]ct and regulations of the Secretary of Health and Human Services." (Internal quotation marks omitted.) Unlike Medicaid, for which the state receives federal funds, general assistance programs, like SAGA, are " entirely state and locally funded." Cordero v. University of Connecticut Health Center, 308 Conn. 215, 221 n.7, 61 A.3d 514 (2013). Consequently, the state is free to impose conditions governing the eligibility of applicants for SAGA benefits.
V
Finally, the plaintiff claims that the department has violated federal privacy laws by requiring him to apply for Social Security benefits, thereby disclosing information about his Social Security status. He cites 20 C.F.R. § 401.180(d) in support of his claim that he cannot be required to apply for Social Security benefits. In relevant part, that regulation provides that the Social Security Administration " will not honor state court orders as a basis for disclosure" of information protected by the federal Privacy Act. The plaintiff's reliance on that provision is mistaken, because another privacy regulation, codified at 20 C.F.R. § 401.150, authorizes the Social Security Administration to disclose information to state welfare agencies to carry out programs " similar to SSA programs." This specifically includes disclosure of benefit information to " [s]tate general assistance programs and to other income maintenance programs at all levels of government." Accordingly, the department is expressly permitted under federal regulations to obtain Social Security benefit information so that it can make determinations of eligibility for its general assistance program.
In relevant part, 20 C.F.R. § 401.150 provides:
The department argues that it can require the plaintiff to consent to the disclosure of information regarding his Social Security benefits as a condition of applying for SAGA benefits. In light of the federal regulations permitting the Social Security Administration to disclose such information to state general assistance programs, even without the subject individual's consent, the court agrees that nothing in federal law precludes the state from requiring the plaintiff to consent to disclosure of his federal benefits so that the state can ascertain his eligibility for SAGA benefits.
VI
In the final section of his brief, the plaintiff claims that he is entitled to damages, including punitive damages, against the department for violating his rights as claimed in the earlier portion of his brief. General Statutes § 4-183 does not waive the state's sovereign immunity to permit an award of damages against the state. Even if it did, the plaintiff has failed to show that the department acted unreasonably, illegally, arbitrarily or capriciously by requiring him to seek potential Social Security benefits. There is no merit to the plaintiff's claim for damages, including punitive damages.
CONCLUSION
The plaintiff has failed to meet his burden of showing that the department's denial of SAGA benefits, based on the plaintiff's refusal to apply for Social Security benefits, was in violation of any law. Nor has the plaintiff shown that the department acted unreasonably, illegally, arbitrarily or capriciously by requiring him to seek potential Social Security benefits as a condition of his continued eligibility for SAGA benefits. General assistance programs like SAGA have long been recognized as programs of last resort, intended to provide a safety net for those who are ineligible for other programs. The public interest in providing such programs requires that the programs conserve their scarce resources by ensuring that recipients are in fact unable to obtain other assistance. The plaintiff's appeal is therefore dismissed.
(a) General. The Privacy Act allows us to disclose information maintained in a system of records without your consent to any other party if such disclosure is pursuant to a routine use published in the system's notice of system of records. A 'Routine use' must be compatible with the purpose for which SSA collected the information . . . (c) . . . (2) Disclosure to carry out programs similar to SSA programs. We may disclose information for the administration of other government programs. These disclosures are pursuant to published routine uses where the use is compatible with the purpose for which the information was collected. These programs generally meet the following conditions: (ii) The information requested concerns eligibility, benefit amounts, or other matters of benefit status in a Social Security program and is relevant to determining the same matters in the other program. For example, we disclose information . . . to State general assistance programs and to other income maintenance programs at all levels of government. We also disclose for health maintenance programs like Medicaid and Medicare.See also " Privacy Act of 1974 Report of New Routine Use, 60 F.R. 2144-01, 1995 WL 3111 (January 6, 1995) (reporting routine use of Social Security beneficiary information, among other types of information).