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Robinson served in the Marine Corps in the 1960s, with a deployment in Vietnam. He subsequently experienced heart problems. In 20016, Robinson saw his VA cardiologist, Dr. Sadoughian, who recommended diagnostic testing, but the testing was not performed. Nine months later, Robinson returned after a week in the hospital with blood clots in his leg. Dr. Sadoughian again recommended testing. Robinson received the prescribed testing in April 2007, 14 months after his initial recommendation. The results indicated “[c]oronary artery disease with prior inferior wall myocardial infarction.” In August 2010 the VA amended its regulations to add coronary artery disease to its list of conditions that are presumptively service-connected for veterans who were exposed to certain herbicides, 38 C.F.R. 3.309(e). In 2011, the VA retroactively granted disability benefits to Robinson for that disease following a “Nehmer” review. The Board of Veterans’ Appeals denied Robinson’s claim for an earlier effective date because the April 2007 test results were the earliest medical evidence demonstrating that he satisfied the criteria the disability rating. Robinson argued that he should not be penalized for the delay in scheduling tests and that he would have received an earlier effective date if the VA had provided him with prompt treatment as required by section 17.33(a)(2). The Board concluded that section 17.33 applies only to treatment and has no bearing on effective date criteria. The Veterans Court and Federal Circuit affirmed, noting that the record did not indicate what caused the testing delay or whether Robinson would have satisfied the disability rating requirements earlier. View "Robinson v. Wilkie" on Justia Law

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Plaintiff filed a civil rights action under 42 U.S.C. 1983, alleging that the termination of her housing voucher violated the Due Process Clause of the Fourteenth Amendment and regulations promulgated by the United States Department of Housing and Urban Development. The Eleventh Circuit vacated the district court's grant of summary judgment for the Authority, holding that indictments and evidence of an arrest did not constitute sufficient evidence to support the decision of a public housing authority to terminate housing subsidies provided under Section 8 of the Housing and Community Development Act of 1937. View "Yarbrough v. Decatur Housing Authority" on Justia Law

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Cousin served in the Army, 1951-1953. His entrance examination showed normal findings as to his back. In service, he injured his back while lifting cans; a month later, he complained of back pain. He was diagnosed with a mild back strain and placed on medically restricted duty. In 1952, his back condition was noted to have improved, and he was removed from restricted duty. Records from 1953 note back pain before service; an x-ray showed a “pedicle defect L5” and “spondylolysis.” He was placed on a permanent profile for a “weak back.” An examination report of his discharge noted his back had been taped in 1952 and that he was then asymptomatic. In 1954, Cousin unsuccessfully sought disability compensation for his back condition. Between 1979-2009, Cousin filed three unsuccessful applications to reopen that claim. In 2012, Cousin filed another application. In 2013, the regional office granted him service connection for a back disability effective January 2012. Cousin filed a Notice of Disagreement, arguing that an earlier effective date was warranted because there was clear and unmistakable error (CUE) in the prior denials. The Veterans Court upheld the denial, finding the Board “offered a plausible explanation for why the RO may have discounted the 1953 records.” The Federal Circuit reversed. Given the proper legal interpretation of defect in the regulation then in effect and the government’s factual concessions, the regional office could not, without error, have determined that spondylolysis was a “defect.” The 1954 decision contained CUE.VA View "Cousin v. Wilkie" on Justia Law

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Barrett applied for disability insurance benefits and supplemental security income based on limitations from bipolar disorder and alcohol addiction. If an administrative law judge (ALJ) had found him disabled, then Barrett would shoulder the burden of showing that his alcoholism was not material to his disability. An ALJ found that he was not disabled, however, even considering his alcohol addiction, and denied him benefits. The district court and Seventh Circuit affirmed, noting that the ALJ determined that Barrett’s impairments, including his alcoholism, taken together were at most moderately limiting, and that he could have sustained full-time employment. That conclusion is supported by substantial evidence: Barrett performed in workplace-like settings tasks such as summarizing depositions and medical records and maintaining attendance records of 100 people. He also sat for the LSAT—though the ALJ emphasized his “above-average” score when it was in fact below average, the fact that he sat for the test and achieved the score he did was consistent with someone capable of working. View "Barrett v. Berryhill" on Justia Law

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The Fifth Circuit affirmed the district court's denial of attorneys' fees for plaintiff under the Individuals with Disabilities Education Act (IDEA). The court held that the hearing officer's decision did not make plaintiff a prevailing party under the IDEA and thus she was not entitled to attorneys' fees. In this case, the officer's decision effected no change to plaintiff's educational plan, which the officer agreed was entirely appropriate despite lacking a prior autism diagnosis. Furthermore, the IDEA focuses, not on a student's diagnostic label, but on whether the student received appropriate education services, which the officer found plaintiff had received from the school district. View "Lauren C. v. Lewisville Independent School District" on Justia Law

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The Second Circuit granted a petition for review of the Commissioner's decision adopting the Department of Appeals Board's (DAB) decision and imposition of an assessment and penalty for petitioner's failure to report work activity while receiving Social Security disability insurance (SSDI) benefits. Although the court agreed that petitioner's failure to report work activity was "material" and thus authorized the Commissioner to impose an assessment and penalty, the court held that the DAB lacked substantial evidence to support the amounts of the assessment and penalty it imposed. In this case, petitioner's earnings from work activity did not amount to "substantial gainful activity," he remained disabled while failing to report work activity, and the findings of fact on which the DAB relied established only that petitioner's work was "sporadic." Therefore, the court vacated the DAB's decision and remanded for further proceedings. View "Cappetta v. Commissioner of Social Security Administration" on Justia Law

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In this challenge to an initiative petition seeking to expand Medicaid coverage the Supreme Court affirmed the judgment of the district court granting summary judgment in favor of Defendants, the named sponsors of the petition and the Secretary of State, holding that Appellants’ statutory and constitutional arguments were unavailing. Appellants sought to invalidate an initiative petition that received enough signatures to be placed on the November 2018 ballot. The district dismissed the complaint with prejudice. The Supreme Court affirmed, holding that the district court did not err by (1) dismissing as unripe and failing to find merit to Appellant’s claims that the ballot measure was an unconstitutional delegation of legislative authority and did not meet the statutory criteria for appropriations; (2) finding that the initiative did not violate the single subject rule; and (3) excluding a challenged exhibit from the evidence. View "Christensen v. Gale" on Justia Law

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The SSA determined that because plaintiff was also receiving civil service disability retirement payments, his Social Security benefits should be reduced under the windfall elimination provision. At issue was the boundaries of "payment based wholly on service as a member of a uniformed service" for the purpose of social security benefit calculations. The Eleventh Circuit, accounting for the unique nature of the dual status technician position and applying Skidmore deference, held that plaintiff did not perform his dual status technician employment wholly as a member of a uniformed service. Consequently, payments based on that employment did not qualify for the exception. The court did not think the requirements of the dual status technician position were sufficient to place dual status technicians within the sweep of the exception—especially given the provision's use of the word "wholly." Therefore, the uniformed services exception did not apply in plaintiff's case. View "Martin v. Social Security Administration" on Justia Law

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Silver’s qui tam action, filed under the False Claims Act (FCA), 31 U.S.C. 3729–33, alleged that PharMerica, which owns and operates institutional pharmacies serving nursing homes, unlawfully discounted prices for nursing homes’ Medicare Part A patients (reimbursed by the federal government to the nursing home on a flat per-diem basis) in order to secure contracts to supply services to patients covered by Medicare Part D and Medicaid (reimbursed directly to the pharmacy by the government on a cost basis) in the same nursing homes--a practice called swapping. The district court dismissed, based on the FCA’s public disclosure bar. The Third Circuit reversed. The district court improperly determined that documents publicly describing the generalized risk of swapping in the nursing home industry served to bar his specific claim, which depended on non-public information that PharMerica was actually engaging in swapping in specific contracts. The district court also erred in concluding, on the basis of Silver’s testimony, that he relied upon certain publicly available information to reach his conclusion and that the information itself disclosed the fraud, without independently determining that the relevant public document did, in fact, effectuate such a disclosure. View "Silver v. Omnicare Inc" on Justia Law

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The Hayes family is a low-income family whose rent is subsidized by enhanced voucher assistance under the Housing Act, 42 U.S.C. 1437f(t) (Section 8). Enhanced vouchers exist to enable residents to “choose” to continue renting the “dwelling unit in which they currently reside.”because an ordinary voucher does not cover a tenant’s rent to the extent that it exceeds the applicable payment standard, and, following a valid opt-out, property owners are no longer subject to limitations on what they may charge for rent. The Hayes family's eligibility to receive enhanced vouchers is contingent upon their continued tenancy in a unit currently owned by Harvey. Harvey notified the Hayes family that he would not renew their lease. The Hayes family refused to vacate, arguing that as enhanced-voucher tenants, they have an enforceable “right to remain” in their unit as long as it is offered for rental housing. The district court granted Harvey summary judgment. The Third Circuit initially affirmed. On rehearing, the Third Circuit reversed. The statute’s plain language and history indicate that enhanced voucher holders may not be evicted absent good cause, even at the end of a lease term. The court remanded so that the district court may consider whether Harvey has good cause to evict. View "Hayes v. Harvey" on Justia Law