Opinion ID: 2326824
Heading Depth: 1
Heading Rank: 3

Heading: Claims Examiner as a Quasi-judicial Officer

Text: This court reviews the decisions of OAH to determine whether they are [a]rbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law. D.C.Code § 2-510(a)(3)(A) (2001); see also Rodriguez v. Filene's Basement Inc., 905 A.2d 177, 181 n. 4 (D.C.2006) (the standards of review prescribed in this section of the District of Columbia Administrative Procedure Act apply to review of OAH decisions under D.C.Code § 2-1831.16(g)). We must affirm an OAH decision when (1) OAH made findings of fact on each materially contested issue of fact, (2) substantial evidence supports each finding, and (3) OAH's conclusions flow rationally from its findings of fact. Rodriguez, 905 A.2d at 180. We defer to the agency's findings so long as they are supported by substantial evidence in the record considered as a whole. Cooper v. District of Columbia Dep't of Employment Servs., 588 A.2d 1172, 1174 (D.C.1991); see D.C.Code § 2-510(a)(3)(E). Substantial evidence is more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Canlas v. District of Columbia Dep't of Employment Servs., 723 A.2d 1210, 1211 (D.C.1999) (quoting Dell v. Dep't of Employment Servs., 499 A.2d 102, 108 (D.C.1985) (quotation marks and citation omitted)).
OAH's primary reason for precluding Ms. Dodd from testifying was that she would be switching roles from neutral decision-maker to advocate and would be subject to cross examination . . . as to . . . [her] analytical process. The ALJ explained that, [h]aving acted as a neutral quasi-judicial officer, Ms. Dodd was prohibited by law from prosecuting DOES' case before me at the second hearing on November 10, 2004 when Ms. Madison failed to appear. In its order denying reconsideration, OAH cited United States Supreme Court cases involving judges who presided over cases although they had a disqualifying interest. [1] It also cited Federal Rule of Evidence 605, which prohibits a judge from testifying in a trial over which she or he presides. Each of these explanations assumes that claims examiners are neutral, quasi-judicial officers. That proposition is neither self-evident nor is it made clear by the statutes and regulations that govern unemployment compensation cases. Moreover, we have not been presented with a factual record to support that conclusion. The District of Columbia Unemployment Compensation Act provides that the initial determination of a claim for benefits shall be made by an agent of the Director [of DOES] designated . . . for such purpose. . . . D.C.Code § 51-111(b). DOES regulations in turn require that the Director shall make an initial determination of eligibility promptly, 7 DCMR § 305.1 (2004), after an informal hearing, § 305.2, also referred to as a predetermination fact-finding interview, id., where evidence is received to determine whether an otherwise eligible claimant is subject to disqualification, id. Although these regulations make clear that the examiner considers evidence and makes the initial determination, they are silent on whether the examiner must perform her duties as though she were a quasi-judicial officer. Federal law also imposes obligations on states that administer unemployment compensation programs financed in part by grants from the United States pursuant to the Social Security Act, 42 U.S.C. §§ 501-503. California Dep't of Human Resources Development v. Java, 402 U.S. 121, 125, 91 S.Ct. 1347, 28 L.Ed.2d 666 (1971). These include use of methods of administration . . . reasonably calculated to insure full payment of unemployment compensation when due. 42 U.S.C. § 503(a)(1) (2000). Applicable federal statutes and regulations provide broad guidance on administering such programs, but they do not require that states make initial determinations to grant or deny claims in any particular manner. See 20 C.F.R. §§ 602.1-602.43 (regulations governing quality control in the federal-state unemployment insurance system). The state agency is required to investigate the claim, to take the initiative in the discovery of information, and to do so promptly so that the payment of benefits is not unduly delayed. 20 C.F.R. Pt. 602, App. A (Part V, Section 6013 of the Employment Security Manual). Nothing brought to our attention precludes a claims examiner from performing this investigation, making the initial determination of whether benefits are due, and later presenting DOES's evidence at a review hearing. By contrast, where a claimant has already been denied benefits, the Social Security Act guarantees him the [o]pportunity for a fair hearing, before an impartial tribunal. 42 U.S.C. § 503(a)(3) (2000). The same procedures that apply to initial determinations are followed when DOES retrospectively considers whether a person has received benefits to which she was not entitled. See D.C.Code § 51-119(d)(2). Similarly, findings with respect to disqualification for knowingly failing to disclose a material fact shall be made by a claims deputy of the Director and such findings shall be subject to review in the same manner as all other disqualifications made by a claims deputy of the Director. D.C.Code § 51-119(e)(2). The ALJ assumed that Ms. Dodd was a neutral, quasi-judicial officer but did not state the legal or factual basis for this assumption. DOES has a much different understanding of the process. In its briefs, DOES describes claims examiners as active participants in the development of facts necessary to resolve claims, not passive adjudicators. It contends that the claims examiner does not conduct anything resembling a trial type hearing, administer oaths, issue subpoenas or take testimony, and that her duties are more the duties of an insurance adjustor, welfare case worker, or investigating police officer, all of whom make decisions and none of whom would be considered a judge. There is no evidence in the record clarifying the role of the claims examiner, let alone to support the ALJ's conclusion that a claims examiner is a designated neutral presiding over an adjudicative proceeding. DOES emphasizes that significant practical consequences will follow if OAH's order stands. Requiring an additional witness to testify in lieu of the claims examiner who made the initial determination would deprive DOES . . . of its most knowledgeable witness. It also would severely strain the resources of DOES. If the claims examiner is disqualified, then another member of its busy staff will have to become familiar with the case in order to appear at the appeal hearing. DOES points out that the former employer does not always appear for such hearings, and would have little, if any, relevant knowledge about issues, such as overpayment, that arose after the employment ended. According to DOES, it has been the agency's practice for over sixty years to send only the interested claims examiner to the hearing. If that is true, then the ALJ has required an enormous change in longstanding practice without sufficient legal or factual support. Lacking a sufficient factual record, we will not attempt to answer the legal questions raised by OAH's order. However, it is useful to remember that, in the field of administrative law, a government official who investigates and determines facts is not necessarily created in the judicial image. The Supreme Court has emphasized the need to observe vital differentiations between the functions of judicial and administrative tribunals. . . . Federal Communications Commission v. Pottsville Broadcasting Co., 309 U.S. 134, 144, 60 S.Ct. 437, 84 L.Ed. 656 (1940); see also Withrow v. Larkin, 421 U.S. 35, 52, 95 S.Ct. 1456, 43 L.Ed.2d 712 (1975) (The incredible variety of administrative mechanisms in this country will not yield to any single organizing principle.). Moreover, the Court has emphasized the difference between formal and informal adjudication. See Pension Benefit Guaranty Corp. v. LTV Corp., 496 U.S. 633, 655-56, 110 S.Ct. 2668, 110 L.Ed.2d 579 (1990); Richardson v. Perales, 402 U.S. 389, 400, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971) (describing system for deciding claims for social security disability benefits: There emerges an emphasis upon the informal rather than the formal. This, we think, is as it should be. . . .). See also Richard Milburn Public Charter Alternative High School v. Cafritz, 798 A.2d 531 (D.C.2002) (neither the Constitution nor the District of Columbia Administrative Procedures Act entitled petitioners to a trial-type, contested case hearing); City of West Chicago v. United States Nuclear Regulatory Commission, 701 F.2d 632, 644 (7th Cir.1983) (discussing proposition that adjudication may be either informal or formal). In a high-volume system like that at issue here, there may be room for a claims examiner to wear more than one hat. See Richardson v. Perales, 402 U.S. at 410, 91 S.Ct. 1420 (Neither are we persuaded by the advocate-judge-multiple-hat suggestion [as a basis for invalidating the administrative procedure]. It assumes too much and would bring down too many procedures designed, and working well, for a governmental structure of great and growing complexity.); Park v. District of Columbia Alcoholic Beverage Control Board, 555 A.2d 1029, 1032 (D.C.1989) (discussing multiple-hat rule); Citizens Association of Georgetown, Inc. v. District of Columbia Alcoholic Beverage Control Board, 359 A.2d 295 (D.C.1976) (same). It may be wise to separate functions when it is practical to do so, and due process sometimes may require this to be done, but our own research has revealed instances where adjudicators have played a later role in the case. See, e.g., Watergate West, Inc. v. District of Columbia Board of Zoning Adjustment, 815 A.2d 762, 764 (D.C.2003) (At a hearing before the BZA a few months later, [the Zoning Administrator] testified about the basis for his decision.) [2] ; Carroll v. District of Columbia Board of Appeals and Review, 292 A.2d 161, 163 (D.C.1972) (rejecting complaint that the Assistant Corporation Counsel who sat as a member of the Retirement Board when [petitioner's] case was heard also acted as counsel on behalf of the District of Columbia at the later hearing before the Board of Appeals and Review; in the absence of any showing that petitioner was prejudiced thereby, this combination of functions did not constitute error). Given the complexities of the issue and the lack of a sufficient record, further consideration is required.