Opinion ID: 1855579
Heading Depth: 1
Heading Rank: 4

Heading: Were the applicable standards of law followed in this case, particularly was the decision of PERS supported by substantial evidence?

Text: ¶ 6. This Court's standard of review of an administrative agency's findings and decisions is well established. An agency's conclusions must remain undisturbed unless the agency's order 1) is not supported by substantial evidence, 2) is arbitrary or capricious, 3) is beyond the scope or power granted to the agency, or 4) violates one's constitutional rights. Sprouse v. Mississippi Employment Sec. Comm'n, 639 So.2d 901, 902 (Miss.1994); Mississippi Comm'n on Envtl. Quality v. Chickasaw County Bd. of Supervisors, 621 So.2d 1211, 1215 (Miss.1993); Mississippi Employment Sec. Comm'n v. PDN, Inc., 586 So.2d 838, 840 (Miss.1991). This Court may neither substitute its own judgment for that of the agency which rendered the decision, nor reweigh the facts of the case. Mississippi Pub. Serv. Comm'n v. Merchants Truck Line, Inc., 598 So.2d 778, 782 (Miss.1992). There is a rebuttable presumption in favor of the action of an administrative agency and the burden of proof is on the one challenging its action. Ricks v. Mississippi State Dep't of Health, 719 So.2d 173, 177 (Miss. 1998) (quoting County Bd. of Educ. of Alcorn County v. Parents & Custodians of Students at Rienzi Sch. Attendance Ctr., 251 Miss. 195, 205, 168 So.2d 814, 818 (1964)). [This Court] give[s] due deference to the factual findings of the administrative agency and to the [judge], who adopted the same findings. State Farm Ins. Co. v. Gay, 526 So.2d 534, 535 (Miss. 1988). ¶ 7. As noted above, Mrs. Fulce asserts that she suffers from a number of ailments. It is her contention that these ailments are so severe as to render her permanently disabled, and thus, eligible for disability benefits from PERS. The SSA found her to be disabled based on (1) injuries suffered in a September, 1987, automobile accident, (2) cervical cancer discovered in 1993, and (3) depression, as diagnosed in 1994. Regarding injuries sustained in the automobile accident, she suffered no neurological problems secondary to the injury, and follow up visits with her treating physician through 1988 revealed that she was doing well and not having any neck pain. Regarding her cervical cancer, follow-up exams through 1994 revealed that she was doing well post-operatively. Mrs. Fulce admits her cancer is in remission. Regarding her depression, she stated that she takes medication on a daily basis for this condition. However, the only time she has ever been examined by a psychologist or psychiatrist was in 1994 (when she was diagnosed as suffering from depression). ¶ 8. Furthermore, Mrs. Fulce asserts that she significantly suffers from diarrhea, sleep apnea, and diabetes. Mrs. Fulce states that the radiation treatment she received because of her cancer burned her colon, causing her diarrhea problems. Although she says this problem is serious, she admitted to the Appeals Committee that she takes over-the-counter Immodium, and that is the only medicine she has ever tried for her diarrhea. Additionally, she admits that other than undergoing a colonoscopy to initially address her problem, she has never followed up with a gastrointestinal doctor regarding her diarrhea. Because of her sleeping disorder, she has a CPAP machine, which effectively helps her sleep. When she uses the CPAP, she does very well. However, she told the Appeals Committee that she only uses it anywhere from one to three times a week, and on the nights that she does not use it, she feels sleepy the next day. Mrs. Fulce informed the Appeals Committee that she was diagnosed as a non-insulin dependent diabetic. She takes Glucontrol two times a day to control this condition. ¶ 9. In addition to these conditions, Mrs. Fulce also claims to suffer from various bodily pains and abnormalities. Notwithstanding these asserted ailments, she admitted to the Appeals Committee that the only physician she would ever go to, regardless of the problem, was a gynecologist. She further stated that in the year prior to her appeal, she had only been to this doctor twice, once for her annual cancer exam, and the other time was when she was diagnosed with diabetes. ¶ 10. Undoubtedly, Mrs. Fulce has suffered from a wide range of medical ailments in the past. However, the lack of recent medical documentation in the record makes it impossible for this Court to determine whether she is presently disabled, and therefore, ineligible for PERS disability benefits. She had not been under the continuous care of a physician for some time prior to 1998. In her 1996 and 1997 Statements of Reexamination by Physician, the reporting physician was of the opinion that Mrs. Fulce was still totally and permanently disabled. However, these reports are extremely brief and provide very little information regarding adverse medical conditions. Similarly, the PERS orders terminating Mrs. Fulce's benefits offer little which would assist this Court in its present review. The fact that Mrs. Fulce continues to receive SSA benefits is not helpful on this issue. At the time Mrs. Fulce was approved for PERS disability benefits, it was the policy of PERS to accept a SSA determination of disability in lieu of a similar determination by its own Medical Board, when considering an initial award of benefits. Miss.Code Ann. § 25-11-113(6) deals with re-examination of recipients, and provides that if the Medical Board finds, after re-examination of a disability benefits recipient, that the individual is able to return to work, the Board of Trustees, upon certification of the Medical Board's findings, may terminate the individual's disability benefits. Based on the lack of sufficient medical information in the record presently before this Court, we are unable to determine whether the decision of PERS was supported by substantial evidence. Accordingly, we remand this matter back to PERS, so that it may reconsider Mrs. Fulce's present condition once she has been thoroughly reexamined by the appropriate medical personnel.