Court Opinion

ID: 9682540
Source: CourtListenerOpinion
Date Created: 2023-08-24 08:13:01.185042+00
Date Added: 2024-06-11T18:17:40.005935
License: Public Domain

Steele Hays, Justice, dissenting. This illiterate, sixty-year-old woman applied for Medicaid under the Medically Needy Program. She claims to suffer from goiter of long duration, shortness of breath, dizzy spells, migraine headaches, chronic ear infection and rheumatoid and lumbar arthritis. Her employment has been limited to field work, doubtless due in part to illiteracy, but she had to give that up about fifteen years ago. She says she can do some housework, though only sporadically, and is limited in what she is physically able to do. Her brother gives her what help he can for food and medication. Appellant’s claims of disability are fully supported by several medical reports of Dr. John D. Ashley of Newport. He considers her condition to be permanent and totally disabling. Whether Dr. Ashley’s opinion is to be discounted because he is an advocate for his patient, I cannot say. He may simply have believed the appellant was totally disabled, as he reported her to be. Certainly, the burden is on the appellant to prove her entitlement to these medical benefits in the first instance. But where she has done that by independent, credible medical opinion, then an agency decision adverse to her must be supported by substantial evidence. Harris v. Daniels, 263 Ark. 897, 567 S.W.2d 954 (1978). Ark. Stat. Ann. § 5-713 (Repl. 1976). Here, I can find nothing of substance that supports the denial of benefits. The sum and substance of the evidence opposing appellant’s claim of entitlement consists of a brief printed form which recognizes some of Dr. Ashley’s findings, but goes on to state, “Based on the evidence our decision follows:” 1. Eligible ( ) 2. Ineligible (x) This “evidence” utterly fails to meet the requirements of the law in two respects: first, a one-word peremptory denial of a claim for medical benefits, so clearly needed, fails to meet, or even approach, the test of substantial evidence, which has been defined as evidence furnishing a substantial basis of fact from which the fact in issue can reasonably be inferred. The test is not satisfied by evidence which merely creates a suspicion or which amounts to no more than a scintilla or which gives equal support to inconsistent inferences. Wigmore on Evidence, 3rd Ed. vol. 9, at 300. Substantial evidence has been defined as: “Substantial evidence is evidence that is of sufficient force and character that it will, with reasonable and material certainty and precision, compel a conclusion one way or the other. It must force or induce the mind to pass beyond a suspicion or conjecture.” Ford on Evidence, vol. 4, § 549, at 2760. Second, the avowed purpose of the Administrative Procedures Act is to improve the administration of justice by providing fair procedures, including judicial review. Where a claim of benefits (whether workers’ compensation, unemployment insurance, or medical aid to the needy) is based on substantial grounds, and is denied by an agency with no explanation except that it is “denied”, any significant review by the courts as to fairness is totally destroyed. We are left in such instances to simply accept, on pure faith, an unsupported, one-word opinion that the claimant is “ineligible.” Thus, our obligation to provide meaningful appellate review is abdicated in favor of the agency. I respectfully dissent.