Justia Public Benefits Opinion Summaries

Petitioners, veterans Joshua Bufkin and Norman Thornton, applied for service-connected PTSD disability benefits from the Department of Veterans Affairs (VA). Bufkin's claim was denied due to insufficient evidence linking his PTSD to his military service. Thornton, who already received benefits, sought an increased disability rating, which the VA denied. Both cases were reviewed de novo by the Board of Veterans’ Appeals, which upheld the VA's decisions. Bufkin and Thornton then appealed to the U.S. Court of Appeals for Veterans Claims, arguing that the evidence was in "approximate balance" and they were entitled to the benefit of the doubt.The Veterans Court affirmed the Board's decisions, finding no clear error in the approximate-balance determinations. Petitioners appealed to the Federal Circuit, challenging the Veterans Court's interpretation of 38 U.S.C. §7261(b)(1). They argued that the Veterans Court should review the entire record de novo to determine if the evidence was in approximate balance. The Federal Circuit rejected this argument and affirmed the Veterans Court's decisions.The Supreme Court of the United States reviewed the case and held that the VA's determination of whether evidence is in "approximate balance" is predominantly a factual determination, subject to clear-error review. The Court clarified that the Veterans Court must review the VA's application of the benefit-of-the-doubt rule using the same standards as other determinations: de novo for legal issues and clear error for factual issues. The judgment of the Federal Circuit was affirmed. View "Bufkin v. Collins" on Justia Law

Rhonda and Robert Notgrass fraudulently obtained benefits from the Pandemic Unemployment Assistance program by falsely claiming unemployment due to the COVID-19 pandemic. Robert, a minister, and Rhonda, his wife, were ineligible for these benefits as Robert was fired for reasons unrelated to the pandemic, and Rhonda had not lost her job. They both pleaded guilty to misdemeanors and were sentenced to probation by the district court.The United States District Court for the Southern District of West Virginia sentenced the Notgrasses to five years of probation, including several conditions. The Notgrasses appealed four of these conditions: obtaining permission before leaving their judicial district, prohibition on possessing dangerous weapons, registering with an unemployment agency, and Robert's participation in a supervised mental-health treatment program. They argued that these conditions were both procedurally and substantively unreasonable.The United States Court of Appeals for the Fourth Circuit reviewed the case. The court first determined that the Notgrasses' appellate waiver did not cover challenges to probation conditions, allowing the appeal to proceed. On the merits, the court found that the district court had adequately explained the conditions in light of the Notgrasses' objections. The travel-permission and weapons prohibition conditions were standard and self-evident, while the unemployment registration and mental-health treatment conditions were tailored to the Notgrasses' specific circumstances. The court held that all four conditions were reasonably related to the § 3553(a) sentencing factors and were not an abuse of discretion.The Fourth Circuit affirmed the district court's sentences, finding the probation conditions both procedurally and substantively reasonable. View "US v. Notgrass" on Justia Law

Dan Lee Gearhart and Kristin A. Marlar divorced in September 2018, with Gearhart ordered to pay monthly child support. Gearhart applied for Social Security Disability Insurance (SSDI) benefits for himself and his children, which were approved after the divorce, with payments retroactive to August 2018. The children’s benefits were paid to Marlar as their representative payee. Gearhart stopped making child support payments, believing the SSDI payments covered his obligation. In May 2022, Gearhart petitioned the magistrate court to credit the SSDI payments against his child support arrearage, effectively reducing it to $0.00. Marlar opposed this, arguing it constituted a retroactive modification of child support.The magistrate court credited the SSDI payments against Gearhart’s arrearage, eliminating his outstanding balance. Marlar appealed to the district court, which reversed the magistrate court’s decision, concluding that Idaho Code section 32-709 prohibited retroactive modification of child support. The district court remanded the case with instructions to deny the application of SSDI payments as a credit against Gearhart’s arrearage.The Supreme Court of Idaho reviewed the case and reversed the district court’s decision. The Supreme Court held that Idaho Code section 32-709 did not apply to Gearhart’s petition because he was not seeking a modification of his child support obligation but rather a credit for SSDI payments already made. The court concluded that section 32-709(2) did not limit the magistrate court’s discretion to credit SSDI benefits against the child support arrearage. The case was remanded to the district court with instructions to reinstate the magistrate court’s judgment crediting the SSDI payments against Gearhart’s arrearage. Neither party was awarded attorney fees on appeal. View "Marlar v. Gearhart" on Justia Law

The petitioner, Lin Luo, sought review of a final order from the Office of Administrative Hearings (OAH) that determined her ineligible for unemployment benefits from April 5, 2023, to June 28, 2023. Luo was terminated from her position at the American Chemical Society (ACS) and received post-termination payments under an Agreement and General Release. The OAH administrative law judge (ALJ) classified these payments as severance pay, which disqualified her from receiving unemployment benefits. Luo argued that the payments were settlement payments for sexual harassment claims, not severance pay.The Department of Employment Services (DOES) initially found Luo ineligible for benefits for a slightly different period. Luo appealed to OAH, where the ALJ held a hearing and excluded Luo's evidence of her harassment claims, citing the parol evidence rule. The ALJ concluded that the Agreement's language unambiguously indicated the payments were severance pay, based on Luo's years of service and lack of advance notice of termination. The ALJ also noted that the Agreement included a release of claims against ACS and found that Luo signed the Agreement without fraud, duress, or mutual mistake.The District of Columbia Court of Appeals reviewed the case and found that the ALJ erred in not considering parol evidence regarding the nature of the payments. The court noted that the parol evidence rule does not preclude evidence showing that factual recitals in an agreement are untrue. The court concluded that the ALJ should have considered Luo's testimony and evidence about her harassment claims to determine the parties' intent regarding the payments. The court vacated the OAH orders and remanded the case for further proceedings to consider this evidence. View "Luo v. District of Columbia Department of Employment Services" on Justia Law

Several unemployed workers in Alabama applied for unemployment benefits and claimed that the Alabama Department of Labor unlawfully delayed processing their claims. They sued the Alabama Secretary of Labor in state court under 42 U.S.C. §1983, arguing that the delays violated their due process and federal statutory rights. They sought a court order to expedite the processing of their claims. The Secretary moved to dismiss the complaint, arguing that the claimants had not satisfied the administrative-exhaustion requirement under Alabama law. The state trial court granted the motion and dismissed the complaint.The claimants appealed to the Alabama Supreme Court, which affirmed the dismissal on the grounds of failure to exhaust administrative remedies. The court concluded that §1983 did not preempt the state's administrative-exhaustion requirement, effectively preventing the claimants from suing to expedite the administrative process until they had completed it.The Supreme Court of the United States reviewed the case and held that state courts may not deny §1983 claims on failure-to-exhaust grounds when the application of a state exhaustion requirement effectively immunizes state officials from such claims. The Court reasoned that Alabama's exhaustion requirement, as applied, prevented claimants from challenging delays in the administrative process, thus immunizing state officials from §1983 suits. The Court reversed the Alabama Supreme Court's decision and remanded the case for further proceedings consistent with its opinion. View "Williams v. Reed" on Justia Law

Ken Lick Coal Company employed Bob Reed from 1973 to 1986, during which he was exposed to coal dust. Reed later worked for Green Valley Hydro Seeding & Reclamation and JPR, where he continued to be exposed to coal dust. Reed developed breathing problems and filed three claims for black-lung benefits. His first claim in 1986 was denied. His second claim in 2007 was initially granted but later denied by an administrative law judge who found Reed did not have pneumoconiosis. Reed's third claim in 2018 was pursued by his widow after his death.The district director awarded benefits and designated Ken Lick as the responsible operator. An administrative law judge upheld this decision, finding Reed had over 15 years of coal-mine employment, including his work with Green Valley and JPR. The judge also found that Ken Lick had stipulated to being the responsible operator during Reed's second claim, which the judge deemed binding in the third claim.The United States Court of Appeals for the Sixth Circuit reviewed the case. The court held that the administrative law judge erred in treating Ken Lick's prior stipulation as binding. The court found that the stipulation was a legal conclusion rather than a factual one, and thus, the judge had the authority to disregard it. The court noted that the administrative law judge would not have required Ken Lick to pay the benefits but for the stipulation. Consequently, the Sixth Circuit granted Ken Lick's petition for review and transferred the liability for Reed's claim to the Black Lung Disability Trust Fund. View "Ken Lick Coal Co. v. OWCP" on Justia Law

Dale Staten, a coal miner for nearly thirty years, retired in 2000 and passed away in January 2017 from respiratory failure after a two-week hospitalization. His widow, Bernadette Staten, filed for survivor benefits under the Black Lung Benefits Act. A Department of Labor administrative law judge (ALJ) awarded benefits, concluding that Bernadette qualified for a statutory presumption that Dale died from black lung disease due to his extensive underground mining work and total disability at the time of his death. The Benefits Review Board affirmed the ALJ's decision in a divided ruling.Consolidation Coal Company (CONSOL), Dale's former employer, challenged the ALJ's award, arguing that the 15-year presumption should only apply to chronic pulmonary conditions, not acute illnesses like Dale's respiratory failure. CONSOL contended that Dale's total disability was due to an acute condition rather than a chronic one. The ALJ had credited Dr. Sanjay Chavda's opinion that Dale was totally disabled at the time of his death, while discounting the opinions of CONSOL's experts, Dr. James Castle and Dr. Robert Farney, who argued that Dale was not disabled based on his medical history before his hospitalization.The United States Court of Appeals for the Seventh Circuit reviewed the case and affirmed the ALJ's award of benefits. The court held that the Black Lung Benefits Act does not require a claimant to prove that a miner's total disability arose from a chronic pulmonary condition to invoke the 15-year presumption. The court found that the ALJ acted within its authority in crediting Dr. Chavda's opinion and concluding that CONSOL failed to rebut the presumption that Dale's death was due to pneumoconiosis. The court denied CONSOL's petition for review and affirmed the judgment of the Benefits Review Board. View "Consolidation Coal Company v OWCP" on Justia Law

A young adult with intellectual and developmental disabilities, referred to as G.J.F., moved to Alaska in 2021 and was referred by a homeless shelter to Volunteers of America Alaska (VOA), a nonprofit organization. VOA provided intensive case management support, including housing assistance and help with applying for government benefits. Despite initial resistance from G.J.F., a consistent therapeutic relationship was eventually established. VOA petitioned the superior court to appoint the Public Guardian as a full guardian for G.J.F., arguing that less restrictive alternatives were not feasible or adequate to meet G.J.F.'s needs.The superior court appointed a visitor and scheduled a hearing. The visitor's report and a neuropsychological evaluation indicated that G.J.F. had multiple mental health diagnoses and significant difficulties with decision-making and daily living tasks. The master recommended a full guardianship, but the Public Guardian objected, leading to an evidentiary hearing. At the hearing, VOA staff testified about the extensive support they provided to G.J.F. and the limitations of their services. The court found that VOA's services were not sustainable and that G.J.F. needed decision-making support that only a full guardian could provide.The Supreme Court of the State of Alaska reviewed the case and affirmed the superior court's order appointing the Public Guardian as a full guardian for G.J.F. The court held that the superior court did not abuse its discretion in determining that less restrictive alternatives were not feasible or adequate to meet G.J.F.'s needs. The court found that the record contained clear and convincing evidence supporting the need for a full guardianship, given G.J.F.'s significant vulnerabilities and the limitations of VOA's support. The court also noted that relying on the visitor's report, which was not admitted into evidence, was harmless error because the same information was provided through other evidence. View "In the Matter of the Protective Proceedings of G.J.F" on Justia Law

Donald Hunter, a former coal miner, applied for benefits under the Black Lung Benefits Act (BLBA) in 2019, claiming that he was totally disabled due to chronic obstructive pulmonary disease (COPD) caused by his coal mine employment. Southern Ohio Coal Company, his former employer, contested his claim, arguing that Hunter's COPD was caused by his significant history of smoking cigarettes rather than coal mine dust exposure.An Administrative Law Judge (ALJ) reviewed the case and awarded benefits to Hunter, finding that his COPD constituted legal pneumoconiosis and that it was a substantially contributing cause of his total disability. Southern Ohio Coal appealed to the Benefits Review Board (BRB), arguing that the ALJ erred in discrediting its evidence and in crediting Hunter's evidence. The BRB affirmed the ALJ's decision, holding that the ALJ had properly considered and weighed the evidence.The United States Court of Appeals for the Sixth Circuit reviewed the case. Southern Ohio Coal argued that the ALJ erred by relying on a pulmonary function test (PFT) that did not comply with regulatory quality standards and by relieving Hunter of his burden to establish entitlement to benefits. The court found that the ALJ acted within his discretion in determining that the PFT was compliant and supported Hunter's entitlement to benefits. The court also held that the ALJ did not improperly rely on regulatory guidance or flip the burden of proof to Southern Ohio Coal. The ALJ's decision was supported by substantial evidence, including expert opinions and Hunter's testimony.The Sixth Circuit denied the petition for review, affirming the ALJ's decision to award benefits to Hunter. The court held that the ALJ correctly applied the law and that his decision was supported by substantial evidence. View "Southern Ohio Coal Co. v. Office of Workers' Compensation Programs" on Justia Law

Joshua Smitson applied for social security disability benefits and supplemental security income, claiming that his asthma and chronic obstructive pulmonary disease (COPD) prevented him from working. His medical records indicated frequent episodes of shortness of breath and difficulty walking and standing for long periods. He was hospitalized for a week in 2021 due to an acute respiratory exacerbation. Smitson used a nebulizer four times a day, with each session lasting about thirty minutes. Despite his conditions, his medication regimen effectively controlled his symptoms.An administrative law judge (ALJ) denied Smitson's application for benefits, concluding that his conditions were limiting but not disabling. The ALJ found that Smitson could manage his symptoms with proper medical treatment and determined that he had the residual functional capacity (RFC) to perform "light work" with certain limitations. A vocational expert testified that jobs were available for someone with Smitson's RFC. The United States District Court for the Southern District of Indiana affirmed the ALJ's decision. After Smitson's death, his widow, Lacey Thorlton, continued the appeal.The United States Court of Appeals for the Seventh Circuit affirmed the ALJ's decision. The court emphasized that claimants bear the burden of proving their disability and that the ALJ's decision must be supported by substantial evidence. The court found that the ALJ's conclusion that Smitson could perform light work was supported by substantial evidence, including medical records showing that his conditions were well-managed with medication. The court acknowledged that the ALJ could have more directly addressed Smitson's testimony about his nebulizer use but concluded that the ALJ's decision, when viewed holistically, sufficiently considered this evidence. The court found no compelling evidence in the record to reverse the ALJ's decision. View "Thorlton v King" on Justia Law