This is a review of a decision by the court of appeals,
Sheely v. DHSS,
The court of appeals reversed; holding DHSS was not a party in the action, and that "there is no express statutory authorization allowing attorney fees and costs to be taxed against a state agency acting in its adjudicative capacity."
Id.
Four principal issues are presented. First, did the circuit court have jurisdiction to award costs and fees pursuant to sec. 814.245(3), Stats.? We hold the circuit court did have jurisdiction. The circuit court retains jurisdiction to assess costs and fees pursuant to sec. 814.245(3) once it has remanded a decision by DHSS bаck for further proceedings and it need not explicitly state it is retaining such jurisdiction. Second, was DHSS a party to the action as described in sec. 814.245(3)? We hold that DHSS was a party when the circuit court held the determination by DHSS was invalid and remanded the cause back to DHSS. Third, may fees and costs be
The facts are undisputed. In September of 1985, Sheely applied to the Juneau County Department of Social Services (Juneau County) 3 for Medical Assistance (M.A.), also known as Medicaid.
Medicaid is a joint federal and state program which provides payment for medical services to eligible persons. The program was created in 1965 under Title XIX of the Social Security Act to provide assistance to both categorically needy and medically needy individuals . . .. Wisconsin's plan includes both groups.
The "categorically needy" are those individuals or families who are eligible for medicaid because they are eligible for Aid to Families with Dependent children ("AFDC") or Supplemental Security Income ("SSI") benefits . . .. Also included within this class are individuals who are excluded from AFDC or SSI because of an eligibility requirement that does not apply to medicaid. The "medically needy" are those individuals not receiving AFDC or SSI, but whose income and resources, in comparison to their medical expenses, are within the limits established by the Department of Health and Human Services . . .. Coverage of this latter class of persons is optional for a state which participates in the program.
Crippen v. Kheder,
Sheely applied as "medically needy" under sec. 49.47(4), Stats. 4 Ms. Sheely also applied to the Social Security Administration for Supplemental Security Income (SSI). 5
Based on her medical record, the State Bureau of Social Security Disability Insurance (BSSDI), a division
Ms. Sheely appealed for an administrative hearing to review the determination by Juneau County. In a decision designated "a final administrative decision of the [DHSS]," a hearing examiner held "[t]he determination of [BSSDI] must be sustained." Sheely then requested a rehearing of the decision by DHSS pursuant to sec. 227.12, Stats. This request was denied by "a final administrative decision of the [DHSS]'.' on March 31, 1986.
Ms. Sheely next petitioned the Circuit Court of Juneau County "to review a final decision of the Wisconsin Depаrtment of Health and Social Services (DHSS) dated March 31,1986.” DHSS was named the defendant and appeared in court as such. In a memorandum decision dated October 2, 1986, the circuit court held the hearing examiner "failed to apply the correct legal standards to all the facts of the case." It found the hearing examiner "relied on the Medical Vocational Guidelines, known as the "grid" (See 20 C.F.R., part 404, subpart P, Appendix 2) to find that jobs existed which Sheely could perform. However, some of [Sheely's] impairments,. . . were non-exertional. Because of these non-exertional disabilities, the grid should not have been used." The case was remanded back to DHSS for further proceedings.
Subsequent to the circuit court's order, but prior to any further proceedings, a federal administrative law judge found Sheely "had been under a 'disability' as
Sheely then petitioned the circuit court on June 4, 1987, pursuant to sec. 814.245(3), Stats., to recover costs and attorney's fees for the circuit court's prior review of the matter. According to the memorandum decision of September 23, 1987, the only issues contested were: whether DHSS was a party to the action and whether its conclusion that Sheely was not disabled was substantially justified. It does not appear that DHSS contested whether Sheely was a "prevailing party." The circuit court concluded that Sheely was a "prevailing party" and that DHSS's determination that Sheely was without a disability was not "substantially justified" because the "position had no reasonable basis in law or fact." It also held it could award costs and fees against DHSS "whether or not costs [were] available within the administrative proceedings." DHSS did not challenge the
The court of appeals reversed.
Sheely,
At orаl argument, a newly assigned attorney representing DHSS for the first time questioned whether the circuit court had jurisdiction to award costs. Counsel for Sheely was unaware of this argument until that moment. This court requested supplemental briefs on the issue and the parties supplied such briefs.
This is the first time this court has reviewed Wisconsin's Equal Access to Justice Act, secs. 814.245 and 227.485, Stats. The court of appeals has, however, reviewed it in
Kitsemble v. DHSS,
A construction of a statute or the application of statute to a particular set of facts is a question of law which this court reviews without deference to the lower courts' determination.
Minuteman, Inc. v. Alexander,
JURISDICTION
At oral argument DHSS first argued the circuit court lacked jurisdiction to assess costs pursuant to sec. 814.245, Stats. Section 814.245(6) states that "a party seeking an award under this section shall, within 30 days after final judgment in the action, submit to the clerk" an itemized application for fees and other expenses. DHSS asserts Sheely failed to apply for costs within thirty days after the circuit court's remand became final and therefore the circuit court lacked jurisdiction. We disagree.
Section 814.245, Stats., contains substantially similar language as that in 5 USC sec. 405(c)(2) (1985).
8
There appear to be different approaches in the federal courts as to which moment is significant when measuring the thirty day jurisdictional requirement. Some courts permit the taxation of costs if a party successfully obtains a remand from a federal district court.
See Bohn v. Heckler,
When a court vacates an administrative decision and remands the matter for reconsideration, the successful party generally should not recover attorney's fees at that particular time since the claimant's rights and liabilities and those of the government have not yet been determined.
Brown v. Secretary of Health and Human Services,
"Fees may be awarded 'only to a party who has established his entitlement to some relief on the merits of his claims.' "
Id.
at 883 quoting
Hanrahan v. Hampton,
Here, Sheely concurrently petitioned the circuit court for both a final judgment and an award of fees and costs. In
Auke Bay Concerned Citizen's v. Marsh,
DHSS also argues that the determination of whether Sheely is a "prevailing party" presents a jurisdictional question. We disagree. Whether a party is a "prevailing party" is a question on the merits of the case as to whether that party received the benefits or relief requested.
Here Sheely is a "prevailing party." She asked the circuit court to review DHSS's determination that she was not "disabled" and not qualified for medical assistance. The circuit court held DHSS had incorrectly determined her status and ordered a remand. Subsequently a federal administrative judge concluded Sheely was "disabled" and she received medical assistance pursuant to sec. 49.46(l)(a), Stats. DHSS did not refute this "disability" determination and closed its file. Sheely ultimately received the rеsult and relief she initially requested and therefore she is a "prevailing party."
DHSS IS A PARTY
The court of appeals held that Juneau County, not DHSS, was a party to this action as enunciated in sec. 814.245, Stats.
Sheely,
ADJUDICATIVE CAPACITY OF DHSS.
The court of appeals also held that "section 814.245(3) . . . does not allow attorney fees and costs to be assessed against an agency acting in its adjudicative capacity."
Id.
Section 814.245(3), Stats., provides:
814.245 Actions by state agencies . . .. (3) If an individual, a small nonprofit corporation or a small business is the prevailing party in any action by a state agency or in any proceeding for judicial reviеw under s. 227.485(6) and submits a motion for costs under this section, the court shall award costs to the prevailing party, unless the court finds that the state agency was substantially justified in taking its position or that special circumstances exist that would make the award unjust.
Section 227.485(6), Stats., provides:
227.485 Costs to certain prevailing parties . . .. (6) A final decision under sub. (5) is subject to judicial review under s. 227.52. If the individual ... is the prevailing party in the proceeding for judicial review, the court shall make the findings applicable under s. 814.245 and, if appropriate, award costs related to that proceeding under s. 814.245, regardless of who petitions for judicial review. In addition, the court on review may modify the order for payment of costs in the final decision under sub. (5).
Section 227.485(5), Stats., states in part:
(5) The decision on the merits of the case shall be placed in a proposed decision and submitted under s. 227.47 and 227.48 . . . The hearing examiner shall determine the amount of costs using the criteria specified in s. 814.245(5) and include an order for payment of costs in the final decision. (Emphasis added.)
The court of appeals interpreted sec. 227.485(5), Stats., and sec. 227.485(3) as only applying to situations
A statute is ambiguous, if more than one reasonable meaning can be attributed to a statute.
West Allis School Dist. v. DILHR,
The Legislative Reference Bureau Analysis of 1985 Special Session Senate Bill 10, which was enacted and created sec. 814.245, Stats., states:
This bill provides procedures for awarding a more complete recovery of actual costs for individuals and small businesses if they prevail in an administrative contested case proceeding or judicial review of a contested case proceeding, regardless of who initiates the proceeding or review . . ..
In
Berman v. Schweiker,
The purposes of the Act are threefold: (1) to encourage private litigants to pursue their administrative and civil actions against the government and not be deterred by the prospect of having to absorb the cost of their own attorneys' fees; (2) to compensate parties for the cost of defending against unreasonable government action; and (3) to deter the federal government from prosecuting or defending cases in which its position is not substantially justified.
To adopt the court of appeals' interpretation of the statute would clearly frustrate the intention of the legislature when it was enacted. Under the court of appeals' reasoning, one could only collect attorney's fees if such fees were requested from a hearing examiner. It would eliminate those claimants who desire to overturn an adverse administrative decision by an agency on judicial review. This idea is contrary to the legislature's purpose in enacting the statute. We conclude the correct interpretation is one which permits an unsuccessful claimant at an administrative hearing to petition for judicial review, and if successful to be eligible to receive costs and fees pursuаnt to sec. 814.245, Stats., without having requested an award of costs by a hearing examiner. As such, Sheely is eligible for attorney's fees and costs pursuant to sec. 814.245(3).
DHSS WAS NOT SUBSTANTIALLY JUSTIFIED
The court of appeals did not decide the issue of
The circuit court held that Sheely was a prevailing party. It also concluded that DHSS's position that Sheely was not "disabled" under Title XVI was not "substantially justified." It noted that DHSS could only meet its burden by presenting testimony by a vocational expert because Sheely suffered from "non-exertional impairments." In such a situation, the application of the "grid" was inappropriate and therefore the circuit court held DHSS was not substantially justified in its position.
The United States Supreme Court has held that under the EAJA an appellate court must review a trial court's determination on whether а government agency's position was "substantially justified" as a question of an abuse of discretion.
Pierce v. Underwood,
" 'Substantially justified' means having a reasonable basis in law and fact." Sec. 814.245(2)(e), Stats. 1985-86.
See also Phil Smidt & Son, Inc. v. NLRB,
Here the position advocated by DHSS that Sheely was not "disabled" by its application of the "grid" to her exertional and nоn-exertional impairments has no reasonable basis in law. In its introduction, the "grid" notes that it may not be applicable where an individual's limitations include certain mental, sensory, or skin impairments, i.e., non-exertional impairments.
See
20 CFR part 404, Subpart P., App. 2, sec. 200.00(e). In
Washing
Finally, Sheely has asked this court to award her costs, including reasonable attorney's fees, for pursuing this appeal. Such costs are awarded. Section 814.245, Stats., does not expressly authorize the awarding of appellate costs incurred on an appeal of the initial award of costs by the circuit court. This court, in
In Matter of Estate of Trotalli,
CONCLUSION
We hold that the circuit court had jurisdiction to tax costs and fees against DHSS pursuant to sec. 814.245(3), Stats. We also conclude that DHSS was a party to the action and is liable for such costs and fees in a judicial review of one of its administrative decisions. We further hold that Linda Sheely was a prevailing party and DHSS's position was not substantially justified. Sheely's request for costs and fees in pursuit of this appeal is also granted.
By the Court. — The decision by the court of appeals is reversed and the order awarding costs and fees by the circuit court is reinstated. Sheely is further awarded costs and reasonable attorney's fees incurred in this appeal.
Notes
As the court of appeals noted, "the document appealed from is entitled 'Memorandum of Decision of Motion for Costs.' "
Id.
Section 814.245(3), Stats., provides:
814.245 Actions by state agencies ... (3) If an individuаl, a small nonprofit corporation or a small business is the prevailing party in any action by a state agency or in any proceeding for judicial review under s. 227.485(6) and submits a motion for costs under this section, the court shall award costs to the prevailing party, unless the court finds that the state agency was substantially justified in takingits position or that special circumstances exist that would make the award unjust.
The court of appeals held that Juneau County was the party to the action and not DHSS.
Sheely,
The duties and powers relating to social services and welfare are expressly delegated to the counties in sec. 46.22, Stats. 1985-86. Conspicuously absent from the many programs is medical assistance. Rather, DHSS is given the express responsibility to "[a]dminister public assistance as provided in ch. 49." Section 46.03(5), Stats. 1985-86. Under chapter 49, DHSS may delеgate some administrative functions relating to medical assistance, but "determination of eligibility for benefits [of the medical assistance program] is uniquely reserved to DHSS."
Behnke v. DHSS,
Section 49.47, Stats. 1985-86 provides:
49.47 Medical assistance; medically indigent. . .. (4) Eligibility. (a) Any individual who meets the limitations on income and resources under pars, (b) and (c) shall be eligible for medical assistance under this section if such individual is:. . .4. Blind or totally and permanently disabled as defined under federal Title XVI.
Indigent persons receive the payment of disability benefits under SSI.
Bowen v. Yuckert,
The record contains very little information about Sheely's аpplication for SSI. A general explanation of this procedure is contained in
Bowen v. Yuckert,
Section 49.46(1) (a)4, Stats., provides:
49.46 Medical assistance; recipients of social security aids. (1) Eligibility, (a) The following shall receive medical assistance under this section: ... 4. Any person receiving benefits under s. 49.177 or federal Title XVI [SSI].
5 USC sec. 504(c)(2) (1985) provides in part:
504. Costs and fees of parties... (c)... (2) If a party otherthan the United States is dissatisfied with a determination of fees and other expenses made under subsection (a), that party may, within 30 days after the determination is made, appeal the determination to the court of the United States having jurisdiction to review the merits of the underlying decision of the agency adversary adjudication.
5 USC sec. 504(c)(1) states, "If a court reviews the underlying decision of the adversary adjudication, an award for fees and other expenses may be made only pursuant to section 2412(d)(3) of title 28, United States Code." 28 USC sec. 2412(d) also requires a thirty day limit to file for costs and fees.
This case is not one which addresses whether "special circumstances" exist that would make the award "unjust."
In
Behnke v. DHSS,
