Justia Public Benefits Opinion Summaries

This case arose from an appeal against the grant of summary judgment by a district court on a claim related to disability benefits. The appellant, Emily Seago, had contended that Nancy Berryhill was unlawfully serving as the acting Social Security Commissioner in July 2018 when she ratified the appointment of the Administrative Law Judge who later denied Seago’s claim.The United States Court of Appeals for the Fifth Circuit rejected Seago's argument and affirmed the district court’s grant of summary judgment. The court held that Berryhill was lawfully serving as Acting SSA Commissioner under 5 U.S.C. § 3346(a)(2) when she ratified the appointments of all SSA Administrative Law Judges in July 2018.The court noted that 5 U.S.C. § 3346(a) provides for two independent periods of acting service, during the 210-day period following a vacancy, and for the duration of a nomination's pendency in the Senate. The court found that these periods can operate independently, as indicated by the use of the word "or" to separate the two subsections. The court noted that the statutory text does not suggest that service under one subsection excludes someone from also serving under the other.The court also found that this interpretation aligned with the statutory purpose, providing an incentive for the President to submit timely nominations without denying vital public services to the American people due to delays in the Senate confirmation process. View "Seago v. O'Malley" on Justia Law

The United States Court of Appeals for the Ninth Circuit affirmed the decision of the district court, which upheld the Commissioner of Social Security's denial of a claimant's application for supplemental security income. The claimant argued that the Social Security Administration's 2017 revised regulations for evaluating medical opinions were partially invalid because they did not provide a reasoned explanation for permitting an administrative law judge to avoid articulating how he or she accounts for the "examining relationship" or "specialization" factors under the Social Security Act or the Administrative Procedure Act (“APA”). The court found that the Commissioner's decision to promulgate the 2017 medical evidence regulations fell within his wide latitude to make rules and regulations, particularly those governing the nature and extent of the proofs and evidence to establish the right to benefits. The court also joined the Eleventh Circuit in holding that the regulations were valid under the APA, as the agency's response to public comment and reasoned explanation for the regulatory changes established that the regulations were not arbitrary or capricious. View "CROSS V. O'MALLEY" on Justia Law

Erik Bertaud, who suffered serious injuries when a tree branch fell on his head, applied for disability insurance benefits and supplemental security income from the Social Security Administration. His application was denied, and he appealed. The Appeals Council remanded the case twice, but after the third denial, Bertaud's request for review was denied, making the ALJ's decision the final decision of the Commissioner. Bertaud then sought judicial review, arguing that the ALJ had failed to develop the record of his disability, pointing to over 800 pages of new medical evidence. The district court denied Bertaud's motion for summary judgment and affirmed the Commissioner's decision, and Bertaud appealed to the United States Court of Appeals for the Seventh Circuit.The court held that although an ALJ has a duty to develop a full and fair record, this duty is limited when the claimant is represented by an attorney. The claimant's duty to submit evidence is ongoing and covers any additional related evidence they become aware of. The court noted that Bertaud was represented and his attorney had confirmed that the evidence was complete and supplemented the record when necessary. Therefore, the court concluded that the ALJ did not fail to develop Bertaud's medical record. The court affirmed the district court's decision denying Bertaud's motion for summary judgment and affirming the decision of the Commissioner. View "Bertaud v. O'Malley" on Justia Law

The case involves the plaintiff-appellant, Chris Martin, who suffered a back injury in June 2016 and stopped working. He sought medical attention in February 2018 and was diagnosed with a spine disorder in May 2018. Martin applied for Social Security disability benefits and was awarded supplemental security income after an administrative law judge (ALJ) found him disabled under the Social Security Act's stringent definition. However, he was denied disability insurance benefits because his insured status for those benefits had expired on December 31, 2017, a few weeks before he was found to have been disabled. Martin appealed, arguing that the ALJ should have consulted an additional medical expert to determine whether he was disabled earlier, before his insured status lapsed. The United States Court of Appeals for the Seventh Circuit concluded that the ALJ did not abuse her discretion in deciding not to consult another medical expert. The court explained that Social Security Ruling 18–01p allows an ALJ to decide whether to consult an additional medical expert to answer that question. Therefore, the court affirmed the denial of disability insurance benefits. View "Martin v. Kijakazi" on Justia Law

The case before the Supreme Court of the State of Delaware concerned an appeal by Carrah LeBoon Odell against an order from the Superior Court of the State of Delaware. The order affirmed a decision made by the Unemployment Insurance Appeal Board (UIAB) that upheld decisions by an appeals referee concluding that Odell was liable to repay overpaid unemployment benefits totaling $7,139.Odell had originally filed a claim for unemployment insurance benefits after her employer, Allied Universal, reduced her hours. She later obtained a second job at Rater Labs and reported income from both employers to the Department of Labor. She received traditional unemployment benefits and Federal Pandemic Unemployment Compensation under the CARES Act for a period. It was later determined that Odell’s total income during the period was too high to qualify for unemployment benefits, and the benefits she received were therefore an overpayment subject to recoupment by the Department.Odell appealed the overpayment determinations, admitting that she was ineligible for traditional unemployment benefits during the period in question because her income was too high. She requested a waiver of the obligation to repay the benefits, arguing that she met the conditions for a repayment waiver established by the US Department of Labor’s instructions to states regarding processing overpayment waivers under the CARES Act.The UIAB affirmed the appeals referee’s decision. Odell then appealed to the Superior Court, which also affirmed the Board’s decision.Odell appealed to the Supreme Court of the State of Delaware, which concluded that the Board’s decision was supported by substantial evidence and free from legal error. The Supreme Court ruled that Odell was liable for repayment, regardless of the cause of the overpayment. Her arguments concerning the Department’s computer system and discovery relating to that system did not establish reversible error. Furthermore, her argument that her repayment obligation should have been waived did not establish reversible error as repayment waivers were not available at the time of the proceedings below.Therefore, the Supreme Court affirmed the judgment of the Superior Court. View "Odell v. Unemployment Insurance Appeal Board" on Justia Law

This is a dispute regarding a claim for Disability Insurance Benefits and Supplemental Security Income under the Social Security Act, brought by the plaintiff-appellant, Heather Tutwiler. The United States Court of Appeals for the Seventh Circuit affirmed the lower court's ruling that Ms. Tutwiler was not disabled within the meaning of the Social Security Act. The court found that the plaintiff had not engaged in substantial gainful employment since the onset date of her condition, and that her impairments significantly limited her ability to perform basic work activities. However, these impairments did not meet or equal the severity of any impairments listed in the Social Security regulations that lead to automatic findings of disability. The court noted that Ms. Tutwiler had the residual functional capacity to perform sedentary work with some additional restrictions. The court also found that jobs within Ms. Tutwiler’s abilities existed in the economy in such numbers that she was not disabled under the Social Security Act. The court held that the ALJ's decision was supported by substantial evidence and was not otherwise contrary to law. View "Tutwiler v. Kijakazi" on Justia Law

Plaintiff, proceeding pro se, filed suit against multiple private entities and government officials, including, as relevant to the instant appeal, the Social Security Commissioner, a Social Security claims representative, the Secretary of the Treasury, and the Secretary of Education (the “Federal Defendants”), asserting a number of claims relating to the Social Security Administration’s (SSA) allegedly improper withholding of his disability benefits.   The Fifth Circuit affirmed. The court concluded that it did not have subject matter jurisdiction over Mr. Chambers’ claims against the Social Security Administration representatives concerning his Social Security benefits and that Plaintiff has failed to state a claim as to its remaining claims against the Federal Defendants. The court explained that while the lack of jurisdiction is a sufficient basis on which to affirm the district court, Plaintiff’s broad challenges to “any of [the court’s] holdings dismissing the federal government defendants” warrant but a brief note. The court found no error in the district court’s dismissal of the Treasury Secretary, given its purely ministerial role in administering the offset for Plaintiff’s outstanding loan, or its dismissal of the Secretary of Education, given Plaintiff’s similar failure to exhaust administrative remedies with that department and failure to advance a colorable constitutional violation. View "Chambers v. Kijakazi" on Justia Law

Plaintiff first applied for disability insurance benefits on September 3, 2019, alleging a disability onset date of December 1, 2017. His date last insured for the purpose of benefits eligibility was June 30, 2018. The Social Security Administration (“SSA”) denied his application initially and on reconsideration, and he requested an administrative hearing. After the December 14, 2020, hearing, the ALJ determined that Plaintiff was not disabled. The Social Security Appeals Council denied Plaintiff’s request for review. Plaintiff then sought review in the district court, and the district court granted the Commissioner’s motion for summary judgment. This appeal followed.   The Ninth Circuit reversed. The panel explained that at step two of the sequential analysis, claimants need only make a de minimis showing for the ALJ’s analysis to proceed past this step and that properly denying a claim at step two requires an unambiguous record showing only minimal limitations. The seven-month period for which Plaintiff seeks disability benefits falls within a two-and-a-half-year gap in his medical treatment records. The panel held that Plaintiff made the requisite showing to meet step two’s low bar, where he submitted evidence that he suffered from multiple chronic medical conditions that both preceded and succeeded the gap in his treatment. The panel concluded that this cumulative evidence was enough to establish that Plaintiff’s claim was nonfrivolous and to require the ALJ to proceed to step three. Therefore, the ALJ’s denial of Plaintiff’s claim at step two was premature. View "BRIAN GLANDEN V. KILOLO KIJAKAZI" on Justia Law

Fitschen was diagnosed with advanced cancer and stopped working. In 2000 the Social Security Administration (SSA) found Fitschen eligible for disability benefits. Fitschen returned to work in 2001 but continued to receive benefits for a nine-month “trial work period,” 42 U.S.C. 422(c)(4). After that period, he could continue to work and receive benefits for another 36-month period if his wages did not exceed the level at which a person is deemed to be capable of engaging in substantial work activity. The SSA's 2003 review determined that Fitschen had engaged in substantial work and should not have received benefits for much of 2002-2003. The SSA notified him of his overpayment liability but his benefits continued because he had again ceased substantial work. Fitschen again returned to work in 2004 but did not report the change. The SSA initiated another review in 2007 and suspended his benefits. The SSA may waive recovery of overpayments if the recipient was without fault.In 2019 the Commissioner of Social Security found Fitschen liable for an overpayment of $50,289.70 and declined to waive recovery. The district court and Seventh Circuit affirmed, rejecting an argument that the SSA was procedurally barred from recovering the overpayment because it failed to comply with its “reopening” regulation; the overpayment assessment did not “reopen” Fitschen’s initial eligibility determination or any later determination concerning the continuation or recomputation of his benefits. Substantial evidence supports the finding that Fitschen was at fault. View "Fitschen v. Kijakazi" on Justia Law

Bell served on active duty from 1952-1954 in the Army, and from 1955-1957 in the Air Force. During service, Bell sustained a lower back injury. Years later Bell filed a VA claim for entitlement to service connection for a lumbar spine disability and received a 20% disability rating, effective March 2017. In a December 2019 internal memorandum, the agency requested an administrative review by the Director of Compensation Service on the issue of entitlement to an extra-schedular rating for Bell’s lumbar spine disability under 38 C.F.R. 3.321(b)(1); the agency recommended denying entitlement to an extra-schedular rating. The Director issued an advisory opinion denying entitlement, finding that the “lumbar spine disability picture does not demonstrate an unusual or exceptional disability pattern that would render application of the regular rating criteria impractical.” The regional office denied entitlement to an extra-schedular disability evaluation.The Board of Veterans’ Appeals the Veterans Court, and the Federal Circuit affirmed the decision. Bell “d[id] not present any argument, under any applicable authority,” why the denial should be reversed. The regulation authorizing the Director of Compensation Service to approve an extra-schedular rating does not prohibit the Director from considering recommendations from agency officials before making this decision. View "Bell v. McDonough" on Justia Law