PUBLISHED
OPINION
COURT OF
APPEALS
DECISION
DATED AND FILED
November
24, 1999
Marilyn L. Graves
Clerk, Court of Appeals
of
Wisconsin
NOTICE
This opinion is subject to further editing. If published, the official version will
appear in the bound volume of the Official Reports.
A party may file with
the Supreme Court a petition to review an adverse decision by the Court of Appeals. See
§ 808.10 and Rule 809.62, Stats.
No. 99-0627
STATE OF
WISCONSIN IN COURT OF APPEALS
DISTRICT
II
Janice Mack,
Petitioner-Appellant,
v.
Wisconsin Department of
Health & Family
Services,
Respondent-Respondent.
APPEAL from an order of the circuit court for Kenosha County: BRUCE E.
SCHROEDER, Judge. Reversed.
Before Brown, P.J., Nettesheim and Anderson, JJ.
¶1. ANDERSON, J. Through no fault of her own, Janice Mack, a
seventy-six-year-old, disabled individual, was overpaid $837.80 in state Supplemental
Security Income (SSI) benefits. Once the Wisconsin Department of Health & Family
Services (DHFS) realized the error, it notified Mack and determined that, following its
written policy, it would recoup these funds by deducting 10% of Mack's future SSI benefits
payments until the overpayment amount was recovered. Mack objected that DHFS was not
authorized to administratively recoup the overpayment from her SSI benefits. A DHFS
hearing examiner and the circuit court disagreed. To the contrary, we determine that a
statutory right or an administrative rule must exist before an administrative recoupment can
take place and reverse.
¶2. Wisconsin has opted to complement an eligible individual's federal SSI
benefits by paying him or her an additional sum or a state SSI benefit. See
§ 49.77, Stats. Section 49.77 authorizes DHFS to pay benefits,
Mack argues, but does not authorize it to recoup overpayments. Mack notes that, in some
circumstances, the legislature has specifically granted agencies the authority to recover public
assistance benefits. See §49.195(3), Stats. (directing the Department to
recover overpayments made under §49.19, .148, .155, .157). Because
DHFS is not statutorily granted a right to recover state SSI overpayments, Mack argues that
DHFS has exceeded its authority by administratively doing so.
¶3. When considering the nature and scope of an agency's authority, we are
presented with an issue of statutory construction. See DILHR v.
LIRC, 155 Wis.2d 256, 263, 456 N.W.2d 162, 165 (Ct. App. 1990). We
review statutory construction questions de novo. See id.
¶4. We agree with Mack that there is no statutory authority for DHFS to
administratively recover its overpayment from Mack's future benefits payments. The statute
explains state SSI eligibility and payment levels and provides DHFS the option to allow the
federal government to administer the distribution of payments. See §
49.77, Stats. The statute does not cover the situation presented in this
case.
¶5. However, this does not end our inquiry. DHFS responds by contending
that even if it does not have statutory authority for its action, it still has a common law right
of recovery of the erroneous overpayments. It further notes that the chosen method of
repayment, deducting 10% from Mack's future benefits payments, is consistent with its
written policy.
¶6. Indeed, an administrative agency generally possesses a common law right
of recoupment to recover erroneous payments of public funds. See Kenosha County
Dep't of Soc. Servs. v. Kenosha Nat'l Bank, 95 Wis.2d 275, 279-80, 290
N.W.2d 693, 695 (1980). Mack does not dispute that a common law right of recoupment
exists, but does dispute the manner in which DHFS has sought to exercise its common law
right. In particular, she takes issue with DHFS's administrative method of recovery. She
argues that DHFS could sue her to exercise its common law recoupment right or it could
administratively reclaim the funds pursuant to a statute or rule. Because there is no
governing statute or rule, she claims that DHFS's administrative benefits repayment
deduction was unauthorized. We agree.
¶7. DHFS relies on its written policy as support for the procedure used to
recoup the benefits overpayments to Mack. DHFS's guidelines include an Overpayment
Policy. This policy states that, in certain instances, it will waive its right to recover
overpayments. The policy also specifies the guidelines for recoupment of state SSI
overpayments as follows:
The recovery of State SSI overpayments from current State
SSI recipients will be established at 10% of their monthly State SSI check, unless the
recipient agrees to a larger percentage reduction.
¶8. When an agency adopts a procedure to implement a
statute, the procedure falls under the rule-making requirements of ch. 227, Stats., entitled
ADMINISTRATIVE PROCEDURE AND REVIEW. There, the legislature directs agencies
to "promulgate as a rule each statement of general policy ... which it specifically
adopts to govern its enforcement or administration of that statute." Section 227.10(1),
Stats. A rule is defined as a "regulation, standard, statement of policy or general order
of general application which has the effect of law and which is issued by an agency to
implement, interpret or make specific legislation enforced or administered by the agency or
to govern the organization or procedure of the agency." Section 227.01(13), Stats.
For a rule to be properly promulgated, it must be subjected to a notice period, an opportunity
for public comment, legislative review and publication. See § 227.16-.21,
Stats.
¶9. DHFS argues that its Overpayment Policy should not be considered a rule
and subject to the implementation requirements in ch. 227, Stats. It distinguishes the policy
from a "rule" because, through its waiver provisions, it makes individual
determinations.
¶10. We determine that DHFS's policy is a rule for two reasons. First, the
policy satisfies the rule definition put forth in §227.01(13), Stats., and, second, the
policy is similar to that declared to be a rule in Schwartfigure v. Harnett,
632 N.E.2d 434 (N.Y. 1994). The Schwartfigure court held that a New
York State Department of Labor's policy that it would recoup overpaid benefits by setting off
50% of current benefits payments until the Department was repaid was a rule subject to that
state's Administrative Procedure Act's rule-making requirements. See id.
at 436. It concluded that the policy was a "rigid, numerical policy invariably applied
across-the-board to all claimants without regard to individual circumstances or mitigating
factors." Id.
¶11. DHFS attempts to distinguish its policy from that in
Schwartfigure by pointing to the fact that its policy is not completely rigid
because it allows for individuals to qualify for recoupment waivers.1 Although DHFS's policy may not appear as rigid
as the Schwartfigure policy, it still meets the ch. 227, Stats., definition of
a "rule." It is a "statement of policy" DHFS has issued to
"govern the organization or procedure of the agency." As such, DHFS must
follow the legislature's directives for rule promulgation.
¶12. When an administrative rule is properly promulgated, the process allows
for public input and review. In her brief, Mack succinctly describes why the formal
rule-making process is important in a time when government agencies have expanded their
policy-making functions.
The requirement of formal rulemaking requires
administrative agencies to follow a rational, public process. This requirement ensures that
administrative agencies will not issue public policy of general application in an arbitrary,
capricious, or oppressive manner. Many public policy concerns could be illuminated through
the rulemaking process. For example, the fact that State SSI is a subsistence level program,
whose benefits are exempt even from post-judgment garnishment might bear on the wisdom
of reducing current State SSI payments. [Footnote omitted.]
¶13. Because DHFS has not complied with ch. 227,
Stats., and properly promulgated the rule, DHFS lacks the authority to administratively
recoup the benefits overpayment. We reverse the circuit court's order upholding DHFS's
actions.
By the Court.-Order reversed.
Recommended for publication in the official reports.
1 Despite DHFS's argument that recoupment waivers are available to individuals who have
been overpaid benefits, it has not made this waiver information available to the benefit
recipient when it seeks to reclaim the benefits overpayment. Mack received a letter from
DHFS entitled, NOTICE OF STATE SSI OVERPAYMENT WITHHOLDING. The letter
informed her of the overpayment amount, when the overpayment was made, the percentage
of benefits that would be withheld and instructions on how to appeal the withholding
decision. The letter did not indicate that the repayment amount could be waived.