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Drouin v. Commissioner, Maine Department of Health and Human Services

Superior Court of Maine, Androscoggin

October 24, 2014




This matter is before the court on Petitioner Rebecca L. Drouin's Rule 80C appeal of the Decision of the Maine Department of Health and Human Services ("DHHS") finding that Ms. Drouin is ineligible for MaineCare benefits based upon disability. Pursuant to 5 M.RS. § 11001 et seq., Ms. Drouin is asking that the court reverse the decision made by DHHS. DHHS has opposed Ms. Drouin's Appeal. The court held a hearing on this matter, and has reviewed the record as well as the filings from both parties. For the foregoing reasons, the court vacates the Respondent's Decision.

I. Factual and Procedural Background

The following facts are gathered from the record on appeal:

Ms. Drouin is 40-years-old and has been diagnosed with late-stage liver disease. As a result of the late stage liver disease, she suffers from chronic fatigue, body aches, mood instability and hair loss. She has also alleged problems with memory and concentration. As a result of her condition, Ms. Drouin cannot lift heavy objects, she reports that she naps at least once daily, and according to her doctor, she requires frequent breaks.

Ms. Drouin has a GED, and she has previously worked as a waitress, flagger, and process server. Her last day of work was on-October 26, 2012.

Ms. Drouin applied for MaineCare benefits based on disability on or around January 28, 2013, and her application was denied on March 15, 2013. Ms. Drouin requested reconsideration by reapplying on March 19, 2013. On April 24, 2013, Ms. Drouin was notified that her application had been denied, as DHHS determined that she could do sedentary work. On June 5, 2013, Ms. Drouin appealed the decision. On September 3, 2013, a hearing was held with a DHHS administrative hearing officer (the "Hearing Officer") where Ms. Drouin, her boyfriend Theodore McGlaughlin, and a DHHS disability claims adjudicator, Cheri Rodrigue, who had completed the 5 Step Process Form for Ms. Drouin, testified. Ms. Rodrigue is not medically trained. Both the Department and Ms. Drouin submitted written closing arguments following the hearing.

On September 26, 2013, the Hearing Officer issued a Decision finding that DHHS "was correct when it determined that Rebecca Drouin did not meet the disability criteria for Social Security-related MaineCare benefits." (Dec. at 3)(emphasis in the original). Ms. Drouin subsequently appealed the Decision on October 28, 2013.

II. Standard of Review

In its appellate capacity, the court reviews agency decisions for "abuse of discretion, error of law, or findings not supported by the evidence." Rangeley Crossroads Coal. v. Land Use Reg. Comm'n, 2008 ME 115, 10, 955 A.2d 223.

The burden of proof is on a petitioner to prove that "no competent evidence supports the [agency's] decision and that the record compels a contrary conclusion." Bischoff v. Maine State Ret. Sys., 661 A.2d 167, 170 (Me. 1995). "Inconsistent evidence will not render an agency decision unsupported." Id. "Judges may not substitute their judgment for that of the agency merely because the evidence could give rise to more than one result." Gulick v. Bd. of Envtl. Prot., 452 A.2d 1202, 1209 (Me. 1982).

The court must give great deference to an agency's construction of a statute it is charged with administering. Rangeley Crossroads Coal, 2008 ME 115, ¶10, 955 A.2d 223. "A court will 'not vacate an agency's decision unless it: violates the Constitution or statutes; exceeds the agency's authority; is procedurally unlawful; is arbitrary or capricious; constitutes an abuse of discretion; is affected by bias or an error of law; or is unsupported by the evidence in the record.'" Kroeger v. Dep 't of Environmental Prot., 2005 ME 50, ¶ 7, 870 A.2d 566 (quoted in Alexander, Maine Appellate Practice § 452 at 312 (4th ed. 2013)); see also 5 M.R.S.A. § 11007(4)(c).

Where there have been multiple levels of administrative decision-making, the most recent decision will be the one subject to Superior Court review, if the most recent decision-maker had de novo capacity and/or the authority to conduct additional fact-finding. See Alexander, Maine Appellate Practice § 455(b) at 315; see also ...

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