Justia Public Benefits Opinion Summaries

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The Fifth Circuit affirmed the district court's decision upholding the Commissioner's denial of supplemental security income and disability insurance benefits to plaintiff. The court explained that, although the ALJ did not mention the Stone standard, it did cite Social Security Ruling (SSR) 85-28, 1985 WL 56856 (Jan. 1, 1985), a policy statement issued to clarify the agency’s process for determining non-severe impairments. The court held that SSR 85-28 comports with the Stone standard. The court also held that, even if the ALJ failed to properly apply the Stone standard, the error is harmless. In this case, plaintiff does not meaningfully address how the ALJ's application of SSR 85-28 (instead of citing Stone) produced a different outcome in her case. View "Keel v. Saul" on Justia Law

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The Fourth Circuit reversed the district court's decision affirming the ALJ's determination that plaintiff's disability had ceased as of March 31, 2013. The court concluded that the ALJ committed two legal errors: first, the ALJ erred by failing to consider each of the factors listed in 20 C.F.R. 404.1527(c) before affording only negligible weight to the medical opinion of one of plaintiff's treating physicians; and second, the ALJ erred by assessing plaintiff's residual functional capacity (RFC) pursuant to an incorrect framework and without explaining his RFC-related findings in the manner required by Social Security regulations. Accordingly, the court remanded for further administrative proceedings. View "Dowling v. Commissioner of Social Security Administration" on Justia Law

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Zellweger applied for disability benefits in 2013, claiming a per se disabling spinal condition equivalent to Listing 1.04. His amended onset date was August 28, 2013. His last-insured status expired on September 30, 2013, so the application presented a narrow question: whether he was disabled during the one-month period from August 28 to September 30 (42 U.S.C. 416(i)(3)(B)). The primary medical basis for his application was cervical and lumbar degenerative disc disease.An ALJ denied his claim, concluding that the medical evidence did not meet the criteria for Listing 1.04 and that Zellweger could perform light work. A magistrate reversed, ruling that the ALJ’s discussion was too cursory at step three of the sequential analysis prescribed in the agency regulations: assessing whether the claimant has an impairment that meets or medically equals one of the Listings. Although the ALJ explained his reasoning more thoroughly later in his decision, the magistrate refused to consider that discussion.The Seventh Circuit reversed and remanded. The sequential process is not so rigidly compartmentalized. Nothing prohibits a reviewing court from reading an ALJ’s decision holistically. The ALJ thoroughly analyzed the medical evidence at the step in the sequential analysis that addresses the claimant’s residual functional capacity. That analysis elaborated on the more cursory discussion at step three and was easily adequate to support the ALJ’s rejection of a per se disability under Listing 1.04. View "Zellweger v. Saul" on Justia Law

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James-Cornelius sought compensation under the National Vaccine Injury Compensation Program, alleging that her 17-year-old son, E.J., had suffered dysautonomia, postural orthostatic tachycardia syndrome (POTS), and other symptoms as a result of receiving three shots of the HPV vaccine, Gardasil®. While there are no records of medical visits between his first and second vaccinations, the records document his medical visits, symptoms, and diagnoses after his third vaccination. The petition identified medical articles hypothesizing that HPV vaccines can cause dysautonomia and POTS and alleged that the increasing severity of his symptoms is “evidence of re-challenge” and that the pattern of worsening reactions is “strongly probative of a causal relationship” between the vaccine and E.J.’s symptoms, some of which were listed as potential Gardasil® side effects.James-Cornelius unsuccessfully attempted to obtain medical records relating to urgent care visits that she believed occurred before E.J.’s second vaccination. She eventually dismissed her petition, explaining that “she [would] likely be unable to prove" entitlement to compensation. James-Cornelius sought $17,111.12 in attorneys’ fees and costs under 42 U.S.C. 300aa-15(e)(1), asserting that she had filed her petition in good faith and with a reasonable basis. . The Federal Circuit vacated the denial of the petition. The Special Master failed to consider relevant objective evidence. E.J.’s medical records support for James-Cornelius’s reasonable basis claim even without an express medical opinion on causation. The Special Master erroneously concluded that petitioners’ affidavits are categorically “not ‘objective" for evaluating reasonable basis. View "James-Cornelius v. Secretary of Health and Human Services" on Justia Law

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Lothridge applied for disability insurance benefits and supplemental security income in 2013 when she was 33 years old. She asserted that she was disabled by fibromyalgia, COPD, asthma, and hypertension. She was diagnosed with bipolar disorder, learning disabilities, significant problems with decision-making, moderate problems with social functioning, and problems with remote memory. She had worked as a CNA, a daycare worker, a cashier, and a telemarketer. She had tried, unsuccessfully. to earn her GED. Hip and back pain caused her to stop working in 2009.After an ALJ denied her application, a district judge remanded for further explanation of how the ALJ considered Lothridge’s periodic non-compliance with treatments. The ALJ again denied the application, finding that Lothridge could still perform light work with certain limitations. A district judge affirmed.The Seventh Circuit vacated. In assessing Lothridge’s impairments using the five-step disability analysis, the ALJ found moderate limitations in concentration, persistence, and pace. In determining her residual functional capacity, the ALJ failed to take those limitations into account. The jobs that the ALJ determined that Lothridge could still perform would require the ability to stay on-task for at least 90% of the workday and would have little tolerance for tardiness or absences. The ALJ made no determination of whether Lothridge is capable of meeting these requirements. View "Lothridge v. Saul" on Justia Law

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As part of its response to the COVID-19 pandemic, Congress enacted the Families First Coronavirus Response Act (Families First Act), which provides for emergency assistance to households participating in the Supplemental Nutrition Assistance Program (SNAP).The Ninth Circuit affirmed the district court's order denying a motion for a preliminary injunction brought by a putative class of Californians, who normally receive the maximum monthly allotment of SNAP benefits, seeking to bar the USDA from denying California's request under section 2302(a)(1) of the Families First Act to issue emergency allotments to households already receiving maximum SNAP benefits. After determining that plaintiffs had Article III standing, the panel held that the USDA, which administers SNAP, correctly interpreted the statute by concluding that it allows households receiving less than the maximum monthly allotment of SNAP benefits to be brought up to the maximum but does not permit those already receiving the maximum to be given any additional benefits. When the panel examined the Families First Act as a whole, as well as other statutes addressing emergency SNAP benefits, three considerations lead it to conclude that the government's reading of section 2302(a)(1) is more consistent with the overall statutory scheme. Therefore, because plaintiffs were unlikely to succeed on the merits of their claims, the district court did not abuse its discretion in denying a preliminary injunction. View "Hall v. United States Department of Agriculture" on Justia Law

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O’Donnell, represented by attorney Horn, challenged the Social Security Administration’s (SSA) denial of her application for disability insurance benefits. A magistrate remanded the case, awarding O’Donnell $7,493.06 in Equal Access to Justice Act (EAJA), 28 U.S.C. 2412(b), fees, paid to Horn. On remand, an ALJ found that O’Donnell was disabled. SSA determined that she was eligible for benefits dating back several months and withheld 25% of O’Donnell’s past-due benefits, $14,515.37, for possible future payment of fees under 42 U.S.C. 406(a), which authorizes SSA to award a “reasonable fee” to persons who successfully represent claimants in administrative proceedings.Horn filed an unopposed motion for authorization to collect $14,515.37 in section 406(b) fees; having already received the $7,493.06 EAJA award, Horn proposed to keep the EAJA fee, with SSA to pay the balance ($7,022.31), leaving $7,493.06 with SSA for future payment of section 406(a) fees. The magistrate’s order stated that Horn was awarded $14,515.37 under section 406(b), payable by the SSA from the past-due benefits and that “Horn will refund" to O'Donnell $7,493.06, equal to the EAJA award, so that Horn would have to look to O’Donnell, not SSA, to satisfy any future section 406(a) fees. An ALJ subsequently awarded Horn $4,925.21 under section 406(a); he had to seek that amount from O’Donnell. The Seventh Circuit affirmed. No statute requires that the court order netting; the Savings Provision contemplates a refund by the attorney. View "O'Donnell v. Saul" on Justia Law

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Plaintiff filed suit alleging that DCPS failed to provide her son with a free appropriate public education (FAPE) based on his 2017 individualized education program (IEP). The DC Circuit affirmed the district court's dismissal of the claim as moot, holding that the case presents a fact-specific challenge to particular provisions in an inoperative IEP. Furthermore, the parties agreed to a subsequent IEP and plaintiff does not seek retrospective relief. The court also held that an exception to mootness does not apply where the voluntary cessation doctrine is inapplicable and plaintiff's claim fails to meet the capable of repetition prong because the challenge focuses on a fact-specific inquiry rather than a recurring legal question. View "J. T. v. District of Columbia" on Justia Law

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The Ninth Circuit vacated the district court's judgment dismissing as time-barred plaintiff's challenge to the Appeals Council's decision affirming the denial of social security disability benefits. The district court found that declarations from plaintiff and her attorney were insufficient to rebut the presumption that she received notice five days after the denial, triggering a 60-day deadline to file a challenge in federal court.The panel held that plaintiff has made a sufficient "reasonable showing" to rebut the presumption that notice was received within five days of its issuance. In this case, the combination of circumstances—including unrebutted declarations from both plaintiff and her attorney, an officer of the court, that neither received the notice, where the face of the notice indicates that both were supposed to have been mailed copies—is sufficient to rebut the presumption and shift the burden of proving actual receipt to the government. Because the district court did not perform this burden-shifting analysis, the panel remanded for further proceedings. View "Ashe v. Saul" on Justia Law

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Dual-status military technicians are “Federal civilian employees” but must maintain National Guard membership and wear the appropriate military uniform while performing civilian technician duties. They must meet certain military requirements.Newton worked as a National Guard dual-status technician, 1980-2013, also serving as a New Jersey Army National Guard member, receiving separate military pay. In 2013, Newton retired from both. He received a pension from the Defense Finance and Accounting Service for his National Guard service and an annuity paid by the Office of Personnel Management for his dual-status technician service. The Social Security Administration (SSA) notified Newton that he qualified for retirement benefits, subject to a reduction under the Windfall Elimination Provision (WEP), 42 U.S.C. 415(a)(7)(A), because he received a separate pension payment “based in whole or in part upon" earnings not subject to Social Security tax, his civil service annuity. Newton argued that his civil service pension triggered an exception to the WEP for uniformed service.The Third Circuit held that Newton’s benefits are subject to a WEP reduction. Newton has always received two separate salaries and now receives two separate pensions. At most, Newton’s OPM civil service pension is based on service he provided while also serving in the National Guard, but not for “service as a member of a uniformed service.” View "Newton v. Commissioner Social Security" on Justia Law