1. 'On appeal of an administrative [decision] . . . findings of fact by the administrative officer are accorded deference unless the reviewing court believes the findings to be clearly wrong.' Syllabus Point 2 (in part), Muscatell v. Cline, 196 W.Va. 588, 474 S.E.2d 518 (1996). Syllabus Point 2, Choma v. West Virginia Div. of Motor Vehicles, 210 W.Va. 256, 557 S.E.2d 310 (2001).
2. Evidentiary findings made at an administrative hearing should not be reversed unless they are clearly wrong. Syllabus Point 1, Francis O. Day Co., Inc. v. Director, Div. of Envtl. Prot., 191 W.Va. 134, 443 S.E.2d 602 (1994).
3. Pursuant to the applicable regulation, 162 C.S.R. § 2-3.2.b (2004): Evidence demonstrating that the member has been awarded disability benefits by the Social Security Administration establishes a presumption rebuttable by medical evidence or opinion to the contrary, that the member suffers from a mental or physical incapacitation for service under the Teachers Retirement System.
This case is before this Court upon appeal of a final order of the Circuit Court of Kanawha County entered on January 5, 2005. In that order, the circuit court upheld an administrative decision of the appellee, the West Virginia Consolidated Public Retirement Board (hereinafter, the Board), denying the claim of the appellant, Peggy Ann Mayhorn, for disability retirement benefits. In this appeal, Ms. Mayhorn contends that she is entitled to disability retirement benefits because the Board failed to properly consider the weight- lifting restrictions placed on her by her physician and the presumption of disability resulting from the fact that the Social Security Administration granted her a disability award. After reviewing the facts of the case, the issues presented, and the relevant statutory and case law, this Court reverses the decision of the circuit court and remands this case for further proceedings consistent with this opinion.
For members of the Teachers' Retirement System mentally or
physically incapacitated for service means a member's inability
to engage in substantial gainful activity by reason of any
medically determinable physical or mental impairment that can
be expected to result in death, or has lasted and can be expected
to last for a continuous period of not less than twelve months.
In order for a member of the Teachers' Retirement System to be
eligible to be retired by the Board on account of the incapacity,
the evidence must demonstrate that the member's incapacity is
so severe that he or she is likely to be permanently unable to
perform the duties of the position which the member occupied
immediately prior to his or her disabling illness or injury.
Evidence demonstrating that the member has been awarded
disability benefits by the Social Security Administration
establishes a presumption rebuttable by medical evidence or
opinion to the contrary, that the member suffers from a mental
or physical incapacitation for service under the Teachers
Retirement System. (See footnote 1)
With regard to her disability retirement application, Ms. Mayhorn maintains that her weight-lifting restrictions, continuing heart problems, and the rest of her disabling conditions make it certain that she will never be able to return to work as a cook. Specifically, she contends that she satisfies the statutory requirement of ten years of service and argues that the Board erred by finding she did not meet the statutory requirement that a Board appointed physician show that she was mentally or physically incapacitated. See W.Va. Code § 18-7A-25.
Ms. Mayhorn says that the reports from both of the Board's physicians fail to take into consideration the weight-lifting restrictions that disqualified her from resuming her position as a cook. Moreover, she maintains that Dr. Walden did not thoroughly evaluate her heart condition and that neither physician gave any weight to the presumption of disability provided by the fact that the Social Security Administration granted her disability benefits. Thus, Ms. Mayhorn argues that this case should be remanded for further consideration of her application for disability benefits. See 162 C.S.R. § 2-3.2.b, supra.
Conversely, the Board contends that pursuant to West Virginia Code § 29A-5- 4, review of administrative agency decisions should be given great deference and should not be disturbed on appeal unless clearly wrong or arbitrary and capricious. Moreover, the Board argues that this Court has cautioned that a circuit court which is reviewing the factual findings of an administrative agency must not substitute its judgment for that of the hearing examiner. Woo v. Putnam County Board of Education, 202 W.Va. 409, 411, 504 S.E.2d 644, 646 (1998).
The Board also states that W.Va. Code § 18-7A-25 requires a physician selected by the Board to be of the opinion that a member is totally and likely permanently incapacitated for service in their job position. In this case, both Dr. Jeffrey and Dr. Walden shared the opinion that Ms. Mayhorn did not meet the statutory disability standard. Moreover, the Board points out that according to 162 C.S.R. § 2-3.2.b, the award of a Social Security disability award simply creates a presumption that can be rebutted by contrary medical opinion, and in this case it was rebutted by the Board's doctors. Thus, the Board maintains that the adoption of Hearing Officer DeBolt's recommended decision was not error and that the factual findings set forth therein were supported by the substantial, reliable, and probative evidence of record. Finally, the Board argues that pursuant to the provisions of W.Va. Code § 29A-5-4, this Court should reject Ms. Mayhorn's request for a reversal of the circuit court's order.
In this case, in spite of the evidence presented by the Board's two doctors, the Board unequivocally admits that neither of those doctors considered the fact that Ms. Mayhorn had been found to be disabled by the Social Security Administration. We do wish to acknowledge, however, that neither doctor gave any consideration to her Social Security disability award due to the fact that her application for those benefits was still pending at the time of their evaluations. Nonetheless, as discussed above, the Board's rules and regulations at the time of Ms. Mayhorn's appeal provided, and we now hold, pursuant to the applicable regulation, 162 C.S.R. § 2-3.2.b (2004): Evidence demonstrating that the member has been awarded disability benefits by the Social Security Administration establishes a presumption rebuttable by medical evidence or opinion to the contrary, that the member suffers from a mental or physical incapacitation for service under the Teachers Retirement System.
Since it is an undisputed fact that neither the Board's physicians nor the Board itself gave any consideration to the presumption which automatically attaches to Ms. Mayhorn's Social Security disability award, we believe the circuit court erred in rendering its decision which upheld the Board's denial of disability benefits. Thus, this case must be remanded for further consideration of Ms. Mayhorn's application for disability benefits giving full consideration to her Social Security disability award which carries with it a presumption of mental or physical incapacitation for service under the Teachers' Retirement System, and thus, under the West Virginia Consolidated Public Retirement Board. Upon remand, pursuant to the 2004 version of 162 C.S.R. § 2-3.2.b that applies to this case, the receipt of Social Security disability benefits by Ms. Mayhorn creates a presumption that she suffers from a mental or physical incapacitation for service under the Teachers' Retirement System that may be rebutted by medical evidence or opinion to the contrary.
Reversed and Remanded With Directions.