Justia Public Benefits Opinion Summaries

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Gudinas served in the Army, 1966-1968. In 2005, the VA determined that Gudinas suffered from service-connected PTSD and awarded him a 50 percent disability rating plus a 10 percent disability rating for service-connected tinnitus. In 2014, Gudinas filed an unsuccessful claim for service-connected sleep apnea. Gudinas timely filed a notice of disagreement. Gudinas sent a letter indicating that the claim was secondary to his service-connected PTSD, requested increased compensation for total disability based on individual unemployability (TDIU), and sought to increase his PTSD disability rating. The VA denied the TDIU claim but increased his PTSD disability rating to 100 percent, effective October 2015. Gudinas argued that 38 C.F.R. 3.156(b) entitled him to an effective date of May 2014, because his October 2015 submission constituted new and material evidence relating to his May 2014 claim.The Board of Veterans’ Appeals rejected that argument, noting that Gudinas’s May 2014 claim did “not mention a psychiatric disability” (PTSD), and that the claim contained no reference to an increase in the PTSD rating. The Veterans Court and Federal Circuit affirmed. Even if Gudinas’s claim for sleep apnea were considered secondary to his PTSD claim, the two claims would not need to be treated as the same claim for purposes of determining their effective dates; the Board is not required to explicitly determine whether a submission constitutes “new and material evidence” where, as here, the conditions underlying the two claims have no apparent connection. View "Gudinas v. McDonough" on Justia Law

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Deborah Dorr requested to reopen an unemployment appeal hearing that was to address Dorr’s appeal of the Idaho Department of Labor’s (“IDOL”) decision denying Dorr’s request to backdate her Pandemic Unemployment Assistance claim. After Dorr failed to appear at the hearing, IDOL dismissed her appeal and subsequently denied her request to reopen the hearing. Dorr appealed IDOL’s denial of her request to reopen, and the Idaho Industrial Commission (“the Commission”) affirmed. The Commission determined due process was satisfied and agreed with IDOL that Dorr’s own negligence was insufficient cause to reopen the hearing. Appealing pro se, Dorr petitioned the Idaho Supreme Court for relief. The Supreme Court concluded Dorr’s briefing did not meet the standard for an appeal under Idaho Appellate Rule 35(a)(6) and as such, her arguments were forfeited. The Commission’s decision upholding the Appeal Examiner’s denial of Dorr’s request to reopen her appeal hearing was affirmed. View "Dorr v. IDOL" on Justia Law

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Kristin Anton appealed a district court judgment affirming an order by Job Service North Dakota denying Anton pandemic unemployment assistance benefits. Anton stopped working on March 12, 2020 when the public schools closed due to the COVID-19 pandemic. Anton stopped working because she relied on the school system to provide childcare for at least one of her children. Her employer, Heart River Cleaning, did not close and did not hold Anton’s position for her while she stayed home to watch her children. Anton challenged the finding that she had failed to prove she was entitled to pandemic unemployment benefits under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). Finding no reversible error, the North Dakota Supreme Court affirmed the district court. View "Anton v. Klipfel, et. al." on Justia Law

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In 2017 Durham, age 46, applied for Social Security disability benefits, she had been diagnosed with diabetes and hypertension. She had also seen medical professionals about neck pain and heart palpitations. She had been experiencing shortness of breath and lightheadedness and was referred to a cardiologist, who counseled her to reduce her caffeine intake and to adopt a healthy lifestyle. Durham continued to have intermittent symptoms and, in 2019, was admitted to a hospital due to “exertional shortness of breath and palpitations.” Testing disclosed that Durham had no cardiac instability, “no acute problems, [and] no functional limitations.”An Administrative Law Judge concluded that Durham’s diabetes, hypertension, and tachycardia were limiting, but not disabling, conditions. The district court and Seventh Circuit upheld the denial of benefits as supported by substantial evidence. The court rejected arguments that the ALJ relied on outdated evidence and overstepped his authority by interpreting, without supporting medical opinions, the results of medical tests. The record reveals that the ALJ carefully considered Durham’s entire medical history and relied on the opinions of her treating physicians in reaching his conclusions about her physical limitations. View "Durham v. Kijakazi" on Justia Law

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Claimant an Arizona woman in her forties filed an application for Social Security disability insurance benefits and supplemental security income. The agency repeatedly denied the claimant’s claims. The district court affirmed the ALJ’s decision, concluding that the ALJ reached a reasonable determination based on substantial evidence in the record. On appeal, the claimant argues that the ALJ erred by insufficiently supporting his analysis, failing to account for the claimant’s symptoms and limitations in the residual functional capacity (RFC) assessment, improperly discounting the opinion of one medical provider while giving undue weight to the opinion of another, and failing to satisfy the “clear and convincing” standard for rejecting subjective symptom testimony.   The Ninth Circuit affirmed. The court held that the ALJ did not err in discounting the opinion of the claimant’s treating physician because the “extreme limitations” described by the physician were incompatible with the rest of the objective medical evidence. Likewise, the ALJ did not err in giving significant weight to the opinion of the consultative examiner because the examiner’s determination that the claimant could perform light-exertion work was consistent with the objective medical evidence. Finally, the ALJ provided “clear and convincing” reasons for discounting Claimant’s subjective pain testimony. The claimant’s self-reported limitations were inconsistent with (1) the objective medical evidence, (2) her self-reported daily activities, and (3) her generally conservative treatment plan. View "MISTY SMARTT V. KILOLO KIJAKAZI" on Justia Law

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Rhone served in the military 1950-1953 and 1959-1988. In 1986, Rhone and JoAnne, divorced; the Florida Divorce Decree stated that JoAnne would receive 40% of Rhone’s military retirement benefits. In 1988, Rhone left military service due to disability. To receive disability compensation, Rhone waived part of his military retirement pay (38 U.S.C. 5305). The state court denied Rhone’s motion to modify the Divorce Decree, stating that the payment of retirement benefits constituted alimony, not a property division. The state court issued a Continuing Writ of Garnishment directing the VA to withhold that payment from Rhone’s retirement pay. The VA determined that the order obliged the VA to make payments from Rhone’s disability compensation. After Rhone attempted to avoid garnishment by renouncing benefits, in 2002 the VA determined that Rhone's compensation benefits were not subject to garnishment and had been erroneously withheld. Rhone was reimbursed for $27,664. In 2005, the VA determined that it must comply with the alimony award and resumed garnishing Rhone’s disability compensation.The Board of Veterans’ Appeals issued a 2020 decision, finding the 1991 order “valid on its face” and providing for “permanent periodic alimony” so that the VA legally garnished Rhone’s disability compensation under 42 U.S.C. 659(a); (h)(1)(A)(ii)(V). The Veterans Court and Federal Circuit affirmed, finding no due process violation. The statutes authorize the VA to withhold a portion of a veteran’s VA disability payment for alimony or child support pursuant to legal process when a veteran has waived a portion of military retirement pay to receive VA benefits. The VA lacks jurisdiction to decide questions associated with a state garnishment order. View "Rhone v. McDonough" on Justia Law

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Claimant argued that the administrative law judge (“ALJ”) erred by rejecting the uncontested opinion of a non-examining physician, that supported her claim. Under the pre-2017 regulations that apply to the claim, ALJs are required to give greater weight to certain medical opinions. To reject the uncontested opinion of an examining or treating doctor, an ALJ must provide “clear and convincing” reasons supported by substantial evidence.   The Ninth Circuit affirmed the district court’s decision affirming the denial of claimant’s application for disability benefits under Title II of the Social Security Act. The panel held that the “clear and convincing” standard did not apply to the physician’s opinion because he never treated or examined claimant. Rather his opinion was based solely on a review of claimant’s medical records. The panel held that nothing in the relevant regulations required an ALJ to defer to an opinion from a non-treating, non-examining medical source. In rejecting the physician’s opinion, the ALJ cited specific contradictive medical evidence in the record. In making these findings, the ALJ cited the record at length. The panel concluded that this satisfied the requirements of Sousa v. Callahan, 143 F.3d 1240, 1244 (9th Cir. 1998), the relevant regulations, and the substantial evidence standard. Further, the panel concluded that the district court properly concluded that the ALJ’s denial of benefits was supported by substantial evidence View "RUTH FARLOW V. KILOLO KIJAKAZI" on Justia Law

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Milhem applied for Social Security disability insurance benefits, alleging that several conditions limited her ability to work. Milihem, age 38, had completed three years of college and had previously worked as a canvasser, receptionist, portrait photographer, and graphic designer. A vocational expert concluded that the evidence supported limiting Milhem’s work to that which can be learned in 30 days or less, that Milhem could stand or walk for at least two hours in an eight-hour workday, and that Milhem “could make judgments commensurate with functions of simple, repetitive tasks”; such an individual could not perform Milhem’s past work, but could work as a router, price marker, and cafeteria attendant, of which there were approximately 53,000, 307,000, and 63,000 jobs in the national economy, respectively. Changing the exertion level to sedentary, the expert testified, would include the work of an addresser, table worker, or document preparer, of which there were approximately 19,000, 23,000, and 47,000 jobs in the national economy, respectively.Based on this testimony, and “considering [Milhem’s] age, education, work experience, and residual functional capacity,” the ALJ found that there were a significant number of jobs that Milhem could perform, so Milhem was not under a qualifying disability. The district court upheld that determination. The Seventh Circuit affirmed. A reasonable person would accept 89,000 jobs in the national economy, a figure supported by substantial evidence, as a significant number. Other circuits have accepted similar numbers as significant. View "Milhem v. Kijakazi" on Justia Law

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In this case arising out of the Department of Human Services' attempt to recover payments made to Dr. Frederick Nitta from its Medicaid Primary Care Physician Program the Supreme Court vacated the judgment of the intermediate court of appeals (ICA) to the extent it remanded the case and otherwise affirmed, holding that DHS's claims largely lacked merit.The Program at issue was established by 42 U.S.C. 1396a(a)(13)(C) of the Affordable Care Act (ACA) and enabled certain physicians to temporarily receive increased payments for primary care services provided in 2013 and 2014 to Medicaid patients. In this case, DHS demanded repayment of more than $200,000 in enhanced payments received by Nitta through the program after it determined that Nitta was ineligible for participation in the Program because he did not meet specialty requirements as set forth in a federal administrative rule. While Nitta's appeal was pending, the Court of Appeals for the Sixth Circuit invalidated the rule and remanded the case. The ICA adopted the Sixth's Circuit's analysis. The Supreme Court largely affirmed, (1) the rule is invalid because it contravenes the statute; and (2) Nitta was entitled to enhanced payments under the statute. View "Nitta v. Department of Human Services" on Justia Law

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The First Circuit affirmed the judgment of the district court denying Appellant's motion for attorneys' fees, which he filed more than two years after successfully representing Appellee before both the Social Security Administration (SSA) and the district court, holding that the district court properly denied the motion as untimely.In his motion requesting attorneys' fees under 42 U.S.C. 406(b), Appellant argued that the statute does not contain a fixed time for filing a section 406(b) petition. The district court denied the fee request as untimely, concluding that such a motion must be filed within a reasonable time of the SSA's decision awarding benefits. The First Circuit affirmed, holding that, given that Appellant failed to file his section 406(b) petition in a timely manner, the district court did not err in denying his request for attorneys' fees. View "Pais v. Kijakazi" on Justia Law