Case Name: PUBLIC EMPLOYEES' RETIREMENT SYSTEM, Appellant v. Sara G. McCLURE, Appellee
Court: Mississippi Court of Appeals
Jurisdiction: Mississippi
Decision Date: 2007-05-15
Citations: 968 So. 2d 510
Docket Number: No. 2005-CC-02189-COA
Parties: PUBLIC EMPLOYEES’ RETIREMENT SYSTEM, Appellant v. Sara G. McCLURE, Appellee.
Judges: Before KING, C.J., CHANDLER and ISHEE, JJ.
Reporter: Southern Reporter, Second Series
Volume: 968
Pages: 510–519

Head Matter:
PUBLIC EMPLOYEES’ RETIREMENT SYSTEM, Appellant v. Sara G. McCLURE, Appellee.
No. 2005-CC-02189-COA.
Court of Appeals of Mississippi.
May 15, 2007.
Rehearing Denied Sept. 4, 2007.
Office of the Attorney General by Mary Margaret Bowers, attorney for appellant.
Sara G. McClure, Appellee, pro se.
Before KING, C.J., CHANDLER and ISHEE, JJ.

Opinion:
KING, C.J.,
for the Court.
¶ 1. The Public Employees' Retirement System of Mississippi (PERS) appeals the Hinds County Circuit Court's decision to award disability retirement benefits to Sara McClure. This decision reversed a finding by the PERS Board of Trustees that McClure was not disabled. Finding no error in the trial court's decision to reverse the PERS determination, this Court affirms the award of disability benefits.
FACTS
¶ 2. Sara McClure was employed as a special education teacher for more than twenty-eight years. For twelve of these years, she taught developmentally delayed children ages three to five years old in the Clarksdale; Mississippi Public School District. Because of her increased problems with blood pressure and diabetes, McClure applied for Regular Age Limited Disability benefits with the Public Employees' Retirement System in November 2000. McClure testified that, although she loved her job, she no longer believed her health would allow her to continue employment at the school. She feared her health would continue to decline and she was not as effective as she had once been. McClure noticed she was in better control of her health problems when school was out for the summer months.
¶ 3. McClure had an extensive history of medical problems dating back to 1989. McClure was diagnosed with bilateral adrenal hyperplasia, insulin dependant diabetes, and hypertension. The medical records submitted by McClure include a letter from Dr. Charles Nause, McClure's longtime primary physician. In his letter, Dr. Nause recommended that McClure stop teaching because high stress levels associated with her job were compromising her health. - Dr. - Nause stated, "Sarah has been a patient of mine for nearly ten years — I do think her job is contributing to instability in her medical condition and leading to continued deterioration of her health. I recommend that she not work as a result of her illness that she suffers from."
¶ 4. Shirley Morris, McClure's principal, supported McClure's disability claim as well. Morris often made accommodations for McClure during the school work days by allowing her to come to work late on days when her blood sugar level was severely elevated. Morris also allowed McClure to rest during the school work day by allowing her to lie down while the students took their afternoon naps.
¶ 5. McClure testified that, during the fall semester prior to filing her appeal, she missed twenty-two days of work due to illness. On one particular occasion in August 2001, McClure's blood pressure reached 240/110 while she was at work. She experienced numbness on her face as well as specks of blood surfacing on her arms. McClure was made to rest on the floor in hopes that her blood pressure would lower. Later, she was hospitalized for several days. She continued to experience medical problems as a result of the severely elevated blood pressure level.
¶ 6. On February 8, 2001, PERS's medical board denied McClure's claim, and she appealed this decision before the Disability Appeals Committee. The Disability Appeals Committee made a recommendation to the PERS Board of Trustees to deny McClure's request for disability. In their finding's, the Appeals Committee acknowledged that McClure had a history of unregulated blood sugar and blood pressure levels, despite her compliance with her doctor's treatment. However, the Committee noted that McClure had not terminated her employment at the time she filed her appeal and was still performing her work duties! The Committee expressed "great concern" about McClure's medical treatment plan and believed that McClure's health situation would only improve with appropriate treatment from a hypertension expert. The committee noted the following in its findings:
There will always be swings in [McClure's] blood sugar of 70 — 400, but she is now able to work and with proper management, she will continue to be able to work. We believe staying at home is not a proper management program. The current lack of medical management does not have to be a permanent situation.
¶ 7. The Committee did not believe the evidence supported finding McClure was disabled. The Committee reasoned that a hypertension specialist would be able to evaluate McClure and place her on a better treatment program that would improve her health.
¶ 8. The PERS Board of Trustees adopted the recommendation of the Disability Appeals Committee to deny McClure disability benefits. On January 9, 2002, McClure appealed the Board's decision to the Hinds County Circuit Court. The circuit court reversed the order of the PERS Board of Trustees, finding McClure presented sufficient evidence to support her disability claim. The court found PERS's decision to deny disability benefits was arbitrary and capricious because it was not supported by substantial evidence. According to the court, the record was clear that McClure was unable to perform her employment duties and she continued to struggle with her health, despite her medication. The court made note that McClure's treating physician and employer verified her health claims as well. PERS timely filed this present appeal of the circuit court's decision.
STANDARD OF REVIEW
¶ 9. This Court is held to the same standard as lower courts when reviewing administrative agency decisions. Miss. Sierra Club, Inc. v. Miss. Dep't of Envtl. Quality, 819 So.2d 515, 519(¶ 15) (Miss.2002). We do not re-weigh the facts of the case. Public Employees Ret. Sys. v. Shurden,, 822 So.2d 258, 263(1113) (Miss. 2002). We may only "review an administrative agency's order to determine whether the order was (1) supported by substantial evidence, (2) arbitrary or capricious, (3) beyond the power of the lower authority to make, or (4) violated some statutory or constitutional right of the complaining party." Public Employees' Ret. Sys. v. Burt, 919 So.2d 1150, 1156(¶ 16) (Miss.Ct. App.2005).
¶ 10. We perform a limited appellate review of agency decisions but the Court is not subjected to "wearing blinders." Public Employees' Ret. Sys. v. Howard, 905 So.2d 1279, 1284(¶ 15) (Miss.2005). An agency's decision will be deemed arbi trary and capricious if it is not based on substantial evidence. Public Employees' Ret. Sys. v. Allen, 834 So.2d 50, 53(1110) (Miss.Ct.App.2002). Substantial evidence is defined as "such relevant evidence as reasonable minds might accept as adequate to support a conclusion." Shurden, 822 So.2d at 264(¶ 14).
ANALYSIS
Whether the circuit court err in finding that PERS acted arbitrarily and capriciously in denying McClure's claim for disability benefits.
¶ 11. PERS alleges the trial court did not have authority to reverse the denial of McClure's request for benefits because PERS's decision was supported by substantial evidence and it was not arbitrary or capricious. The PERS Disability Appeals Committee, comprised of two physicians and one nurse/attorney, reviewed McClure's medical reports and determined there was a lack of evidence to support McClure's claim of disability. PERS argues the trial court erred by impermissibly re-weighing the evidence in finding that McClure presented sufficient evidence of disability. . .
¶ 12. McClure contends that she presented sufficient evidence of disability and that the PERS" Board's decision denying disability benefits was not supported by substantial evidence in the record. According to the appellate record, McClure's examining physician, Dr. Nause, and her employer, Morris, indicated McClure could no longer perform her employment duties because the work was compromising her health. McClure argues that PERS presented no contradictory evidence that suggests McClure is not disabled, and therefore, the decision to deny benefits is arbitrary and capricious.
¶ 13. The law does not require PERS to present evidence to contradict McClure's assertions of disability, however, PERS decisions must be based on substantial evidence, as it is found in the record. Public Employees' Ret. Sys. v. Thomas, 809 So.2d 690, 694(1114)(Miss.Ct.App.2001).
¶ 14. The PERS Medical Board applies the following definition to determine disability:
[T]he inability to perform the usual duties of employment or the incapacity to perform such lesser duties, if any, as the employer, in its discretion, may assign without material reduction in compensation, or the incapacity to perform the duties of any employment by the Public Employees' Retirement System (Section 25-22-101 et seq.) that is actually offered and is within the same gen eral territorial work area, without material reduction in compensation.
Miss.Code Ann. § 25-ll-113(a)(Rev.2006).
¶ 15. McClure provided very detailed testimony and medical records that she suffered from bilateral adrenal hyperpla-sia, insulin dependant diabetes and hypertension. These illnesses prevented her from performing "the usual duties of her employment." McClure testified that she is no longer effective on her job, despite the fact that she was proactive in treating her illnesses. At her job, McClure was responsible for the basic care of three and four year old, developmentally delayed children and she had to perform tasks ranging from feeding the children to lifting the children up and changing their diapers. McClure testified that she felt better in the summer time when school was out because those times gave her opportunities to relax from the stresses of her job. During the school year, she only had the opportunities to rest on the weekends, rarely enough time for her body to recuperate from a stressful week. Besides her work at school, McClure noted that her housework at home had suffered because of her illnesses as well.
¶ 16. McClure also presented evidence that her employer could not offer her any comparable employment "without material reduction in compensation." McClure's principal, Morris, indicated that the school could offer "no accommodations for the job that Mrs. McClure [was] trained to do."
¶ 17. The PERS Appeals Committee made findings that McClure was not disabled solely from reviewing McClure's medical records and other documents filed with her disabilities request. Although Section 25-11-113 allows the PERS Medical Board to conduct an actual physical examination of the claimant, neither the PERS medical board nor any independent physician examined McClure. Dr. Nause, McClure's physician for nearly ten years, presented the only opinion in the record.
¶ 18. PERS did not question Dr. Nause's treatment of McClure. The board simply believed that a hypertension specialist would present a better course of treatment. Nothing in the record substantiates this belief. The medical board physicians made the following finding:
Obviously, from the medical records, most of Dr. Nause, a real problem exists with the management of Ms. McClure's hypertension and diabetes. We recognize from Ms. McClure's testimony that she has seen Dr. Goodman for regulation of her diabetes and we applaud her for this. But we have great concern about the total treatment that Ms. McClure is receiving. We understand that medications treating diabetes adversely affect blood pressure medicines and vice versa. While we have no complaints with Dr. Nause, we do believe that Ms. McClure would benefit from a total evaluation by a hypertension expert. Hypertension experts generally have a better overall treatment plan. We note that Ms. McClure is functioning at her job now, but it is our opinion that the situation should only improve with appropriate treatment.
¶ 19. PERS does not offer any medical evidence that suggests the alternative treatment would, in fact, restore McClure to a level of functioning capacity. PERS relies on evidence that hypertension experts "generally have a better overall treatment." The board, in its findings, acknowledged that McClure had previously been examined by Dr. Goodman of Memphis, TN, who is a diabetes expert. According to McClure's testimony, she began seeing Dr. Goodman in 1989 and he developed a treatment plan which Dr. Nause would assist in implementing. PERS now argues that this treatment is ineffective and McClure would be better served by finding a hypertension specialist. PERS's argument is based chiefly on its finding that "medications treating diabetes adversely affect blood pressure medicines and vice versa."
¶20. This Court has previously found that the evidence relied on by PERS's in disability determinations cannot be established solely "within the confines of the doctors' heads." Thomas, 809 So.2d at 694(¶ 14). In Thomas, this Court rejected PERS argument that the claimant was not disabled due to the belief that diabetes was a manageable disease, if properly managed, and because the claimant had functioned so long with the disease, the disease must not have been as debilitating as claimed. Id. at 694(¶ 16). This Court acknowledged that, while PERS has the power to weigh witness testimonies, even to the point of disagreeing with assessments, the record must contain substantial evidence upon which PERS relies. Thomas, 809 So.2d at 696(¶ 23).
¶ 21. In this present appeal, PERS's finding that McClure should improve with the treatment of a hypertension specialist is a determination made without the benefit of an actual physical examination. PERS does not reference any evidence, medical or otherwise, found within the confines of the record which support this general assertion.
¶ 22. The supreme court has also held "PERS cannot choose to ignore the only evidence in the record from the examining physician, especially where it chose not to exercise its right to an independent medical evaluation" under Section 25-11-113(1)(c). Public Employees' Ret. Sys. v. Dearman, 846 So.2d 1014, 1018(¶ 11) (Miss.2003). Although PERS uses its Medical Board and Disability Appeals Committee as fact finders in disability determinations, "their opinions [are] not conclusive." Id. at 1018(¶ 11). "The lack of substantial evidence supporting the decision to deny permanent disability benefits [will] render the decision arbitrary and capricious." Id. at 1018(¶ 12). ¶ 23.
¶ 23. The evidence in this case does not support PERS's decision to deny McClure disability benefits. McClure presented sufficient evidence that she satisfied the disability requirements under the statutory definition. The PERS medical board did not conduct an independent examination of McClure and failed to provide any contradictory testimony to that of her physician who treated her for over ten years. This Court has previously found that PERS could not reject the only evidence of disability presented by the claimant when there is "no contrary view of the evidence offered" unless the offered evidence was so outrageous or absurd that no reasonable person would believe it. Thomas, 809 So.2d 690 at 696(¶ 23).
¶ 24. We may not substitute our judgment for that of PERS, and we may only review its decisions if there is a finding that the decision was (1) unsupported by substantial evidence, (2) arbitrary or capricious, (3) reached beyond the scope or power given to PERS, or (4) in violation of one's constitutional rights. Public Employees' Ret. Sys. v. Stamps, 898 So.2d 664(¶ 27) (Miss.2005). We find PERS's decision to deny McClure disability benefits was unsupported by substantial evidence and arbitrary and capricious. We have not re-weighed the facts of the case and neither do we find the trial court re-weighed the facts. We have examined the actual evidence in the record, as opposed to the ideas that maybe secreted in the minds of others. For these reasons, we affirm the trial court's decision which reversed the PERS decision to deny McClure benefits.
¶ 25. THE JUDGMENT OF THE CIRCUIT COURT OF HINDS COUNTY IS AFFIRMED. ALL COSTS OF THIS APPEAL ARE ASSESSED TO THE APPELLANT.
LEE AND MYERS, P.JJ., IRVING, CHANDLER, BARNES, ISHEE, ROBERTS AND CARLTON, JJ., CONCUR. GRIFFIS, J., DISSENTS WITH SEPARATE WRITTEN OPINION.
. At the time McClure filed for disability, she had accumulated 10.25 years of retirement eligibility.
. The record indicates that from August 8, 2001 until December 7, 2001, McClure missed the following days of work: August— one half a day, September — three days, October — fourteen days, November — three days, and December — one and a half days, for a total of twenty-two days of absence.