Justia Public Benefits Opinion Summaries

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Mote served in the Air Force, 1961-1965, participating in missions to Vietnam, where Agent Orange was deployed. Mote later developed coronary artery disease and lung cancer. In 2010, Mote filed a disability claim based. In 2013, Mote filed his Notice of Disagreement with the denial of that claim. He died months later. Mrs. Mote substituted for his claim and filed a dependency-and-indemnity compensation claim. The VA denied Mrs. Mote’s claim in 2015; she filed her Notice of Disagreement and requested a Board of Veterans’ Appeals “Travel Board hearing.”Mote sought mandamus relief, 28 U.S.C. 1651, alleging unreasonable delay. The Veterans Court denied the petition, applying the “Costanza” standard. The government claimed, due to limited resources, it “could not predict how long” Mote might have to wait for a hearing. The Federal Circuit consolidated her appeal with others and held that the Veterans Court should use the Telecommunications Research & Action Center v. FCC (TRAC) standard to evaluate unreasonable-delay mandamus petitions rather than the Costanza standard. On remand, Mote requested a “reasoned decision” from the Board (within 45 days) and periodic progress reports. In March 2019. the Board scheduled her Travel Board hearing for May 2019. The Veterans Court dismissed Mrs. Mote’s mandamus petition without applying the TRAC standard. The Board subsequently remanded for further factual findings.The Federal Circuit again remanded, for a TRAC analysis, noting that Mote sought progress reports, in addition to a decision, and that the Veterans Court was not powerless to fashion other relief, such as a more lenient, specific, deadline. Whether a delay is so egregious as to justify the extraordinary writ depends on issues that are likely to arise frequently among veterans. The Veterans Court is uniquely well-positioned to address these issues first. View "Mote v. Wilkie" on Justia Law

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McAllister injured his knee while working as a sous chef for a restaurant. The injury occurred as he stood up from a kneeling position while attempting to retrieve food that had been misplaced in the cooler. He had previously had surgery on the knee and had received workers’ compensation benefits at that time. An arbitrator awarded him workers’ compensation benefits but the Illinois Workers’ Compensation Commission reversed, finding that the injury did not “arise out of” his employment. The circuit court and the Appellate Court, Workers’ Compensation Commission Division, affirmed.The Illinois Supreme Court reversed. The injury arose out of an employment-related risk; the acts that caused the injury were risks incident to his employment because these were acts his employer might reasonably expect him to perform in fulfilling his assigned job duties. McAllister was responsible for arranging the walk-in cooler and had a duty to find misplaced food. The court overruled certain cases to the extent that they held that injuries attributable to common bodily movements or routine everyday activities, such as bending, twisting, reaching, or standing up from a kneeling position, are not compensable unless a claimant can prove that he was exposed to a risk of injury from these common bodily movements or routine everyday activities to a greater extent than the general public. View "McAllister v. Illinois Workers' Compensation Commission" on Justia Law

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Peeters sought disability benefits, citing degenerative disc disease in the lumbar spine, degenerative joint disease of the right shoulder, depressive disorder, post-traumatic stress disorder, generalized anxiety disorder, and learning disabilities. Peeters has not sustained gainful employment since 2014. After a hearing, an ALJ denied Peeters disability benefits in 2016. On stipulated remand, the Appeals Council instructed the ALJ to reconsider Peeters’ maximum residual functional capacity, obtain evidence and examples of jobs Peeters could perform from a vocational expert, provide a new hearing, and issue a new decision. At the second hearing in 2018, the ALJ issued a 15-page decision denying Peeters disability benefits because he failed to meet the severity requirements of 20 C.F.R. pt. 404 and 20 C.F.R. pt. 416.The district court and Seventh Circuit affirmed the denial as supported by substantial evidence. The court upheld the greater weight given to the opinions of six state agency psychologists who evaluated Peeters; three found Peeters would have moderate limitations completing a normal workday and carrying out detailed instructions, but could handle simple two to three-step instructions, while three found Peeters capable of performing light work. View "Peeters v. Saul" on Justia Law

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John served in the Army in the 1960s. In 1972, John and Roberta married. In 2001, they separated. In 2005, a New York court issued a Separation Judgment, requiring John to pay Roberta $300 per month in spousal maintenance. In 2006, the VA granted John service connection for various disabilities; he began receiving monthly compensation. The New York court held a hearing where both parties appeared with counsel with a proposed settlement. That Stipulation provided that no later than December 2006 John was to pay Roberta $7,000 for past and future maintenance, health insurance, and other obligations. John made the payment. In 2010, following John’s relocation, a Pennsylvania state court issued a Divorce Decree.In 2008, Roberta had filed a VA claim for apportionment, 38 U.S.C. 5307, of John’s disability benefits. John objected, arguing only that the 2006 Stipulation “precluded” the claim. The VA denied Roberta’s claim, despite her demonstrated financial need, concluding she had “voluntarily renounced" maintenance or support. The Board of Veterans’ Appeals granted Roberta special apportionment from the 2008 date of her claim until the date of her 2010 divorce. The Veterans Court and Federal Circuit affirmed. A state court domestic relations separation agreement plays no role in VA’s determination of entitlement to special apportionment. John’s remedy lay in state court where he could sue for breach of contract. Special apportionment turns not on the veteran’s degree of support but on the dependent’s showing of hardship. View "Batcher v. Wilkie" on Justia Law

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The plaintiffs sought Social Security disability and/or supplemental security income benefits. In each case, the application was denied, and an ALJ upheld the denial. The Appeals Council denied relief. The plaintiffs sought judicial review. While the appeals were pending, the plaintiffs moved to raise an issue they had not raised during administrative hearings--a challenge to the ALJs’ appointments, citing the Supreme Court’s 2018 "Lucia" decision that SEC ALJs had not been appointed in a constitutionally legitimate manner and that remand for a de novo hearing before a different ALJ was required. The district courts agreed that the Appointments Clause challenges were forfeited and affirmed the denials of benefits.The Sixth Circuit vacated and remanded for new hearings before constitutionally appointed ALJs other than the ALJs who presided over the first hearings. There is no question that Social Security ALJs are inferior officers who were required to be, but were not, appointed consistently with the Appointments Clause. There are no statutory or regulatory exhaustion requirements governing Social Security proceedings and, while a court may still impose an implied exhaustion rule, such a requirement is inappropriate because the regulations provide no notice to claimants that their failure to raise an Appointments Clause challenge at the ALJ level will preclude them from later seeking a judicial decision on the issue. View "Flack v. Commissioner of Social Security" on Justia Law

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Graham served in the Marine Corps from 1967-1970 and has been receiving disability compensation benefits since 2001. The VA regional office (RO) informed Graham in 2009 that authorities had identified him as a fugitive felon and the subject of an outstanding warrant issued in 1992. That warrant was withdrawn in February 2009. In May 2009, the RO issued a rating decision that retroactively discontinued Graham’s compensation from December 2001 through February 2009, due to his then-fugitive felon status, and informed Graham that he had been improperly paid $199,158.70 and that his monthly compensation would be partially withheld to pay back the debt.Graham appointed Gumpenberger as his representative on appeal and signed a direct-pay agreement stating that Gumpenberger’s fee would be “20 percent of all past-due benefits awarded … as a result of winning … as provided in 38 C.F.R. 14.636.” In 2013, the Board reversed the RO’s debt ruling, finding that Graham was not a fugitive felon for VA purposes because he had never been aware of the outstanding warrant. The VA had recouped $65,464 from Graham’s monthly benefits. The Veterans Court and Federal Circuit affirmed the RO’s determination that Gumpenberger was entitled to a fee of $13,092.80. Although the total debt invalidated was $199,158.70, the past-due benefit, per 38 U.S.C. 5904(d)(1), being awarded was $65,464. View "Gumpenberger v. Wilkie" on Justia Law

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The Supreme Court held that a Section 8 beneficiary's compensation for providing in-home care for a severely disabled adult daughter should be excluded from income in calculating the rental subsidy.Plaintiff had an adult daughter who was severally disabled and required constant supervision. Plaintiff and her daughters received housing assistance through Section 8 of the United States Housing Act, 42 U.S.C. 1437 et seq., and Plaintiff received compensation to provide in-home supportive care for her disabled daughter through the In-Home Supportive Services (IHSS) program. Plaintiff asked that the Marine Housing Authority (MHA) exclude her IHSS compensation from "income" under the federal regulations. MHA did not respond to the request and then terminated Plaintiff's housing voucher. Plaintiff filed a petition for writ of mandate seeking an order requiring MHA to reinstitute her Section 8 voucher. The trial court sustained MHA's demurrer, and the court of appeals affirmed. The Supreme Court reversed, concluding that a parent's IHSS compensation to provide care to keep a developmentally disabled child at home is excluded from income under 24 Code of Federal Regulations part 5.609(c)(16). View "Reilly v. Marin Housing Authority" on Justia Law

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Garvey served in the Army, 1966-1970. While posted in Germany, Garvey was punished for “disorderly conduct.” Garvey was posted to Vietnam, where he was convicted by special courts-martial of possessing four pounds of cannabis with intent to sell and of being absent without leave three times. Garvey was discharged as unfit for service with an “Undesirable Discharge.” He waived consideration of his case before a board of officers and acknowledged that he “may be ineligible for many or all benefits as a veteran.” In 1977, under the Special Discharge Review Program for Vietnam-era service members, Garvey’s discharge status was upgraded to “Under Honorable Conditions (General).” In 1978, a Discharge Review Board found that Garvey would not have been entitled to an upgrade under generally applicable standards. Garvey died in 2010.His widow applied for dependency and indemnity compensation and death pension benefits. The Veterans Court and Federal Circuit affirmed the denial of her claim; 38 C.F.R. 3.12(d)(4) is not contrary to 38 U.S.C. 5303, which is not the exclusive test for benefits eligibility. A former service member is ineligible for benefits unless he is a “veteran.” Under 38 U.S.C. 101(2), to be a veteran, a former service member must have been discharged “under conditions other than dishonorable.”The VA was authorized to define a discharge for willful and persistent misconduct as a discharge under “dishonorable conditions.” View "Garvey v. Wilkie" on Justia Law

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Plaintiff challenged the denial of her application for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. The ALJ found that plaintiff was not disabled because she could perform two occupations that existed in significant numbers in the economy.The Ninth Circuit held that the ALJ's identification of two occupations is insufficient to satisfy the "significant range of work" requirement of the Medical-Vocation Guidelines. The panel explained that, because plaintiff's skills were readily transferrable to only two occupations, the ALJ erred in concluding that she was not disabled. The panel reversed in part and remanded with instructions for calculation and payment of benefits for the period after plaintiff reached 55 years of age. Finally, the panel affirmed the district court's disability determination as to the time period before plaintiff reached the age of 55. View "Maxwell v. Saul" on Justia Law

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Burkhart is the widow of U.S. Army veteran David, who served honorably in the Korean War. He had no service-connected disabilities. In the late 1990s, he was admitted to a VA nursing facility, where he died. Burkhart filed a claim for dependency and indemnity compensation (DIC) benefits under 38 U.S.C. 1151, which provides for compensation related to the death or injury of a veteran in certain circumstances while the veteran was under VA care “as if such additional disability or death were service-connected.” Having determined that David’s death was due to an event “not reasonably foreseeable,” the VA granted DIC benefits.In 2007, Burkhart obtained a certificate of eligibility (COE) for home loan guaranty benefits available under chapter 37 but never finalized a loan. In 2013, she requested a new COE for a guaranty. The VA determined that she was ineligible. The Board of Veterans’ Appeals found that home loan guaranty benefits are available only to “the surviving spouse of any veteran . . . who died from a service-connected disability,” 38 U.S.C. 3701(b)(2). The Veterans Court affirmed, requesting requests for equitable relief. The Veterans Court reasoned that an “incontestability provision” (section 3721) gives only lenders receive the privilege of estoppel with respect to COEs. The Federal Circuit affirmed. Burkhart is not eligible for home loan guaranty benefits under any of the cited statutes and the Veterans Court lacked the power to grant her equitable relief. View "Burkhart v. Wilkie" on Justia Law