Justia Public Benefits Opinion Summaries

The appellant, a military veteran, developed significant neck and back issues following his service, which worsened in May 2012. Medical imaging revealed cervical spondylosis with a herniated disk, leading to spinal fusion surgery in October 2012. He continued to suffer pain and functional limitations, including weakness in his left arm, and received limited disability benefits from the Department of Veterans Affairs. In 2021, he applied for Social Security disability benefits, claiming a disability onset date in 2012 and eligibility through the end of 2016.His application was denied by an Administrative Law Judge (ALJ) after a hearing, where both the appellant and a vocational expert testified. The ALJ found that, despite severe impairments, the appellant retained the residual functional capacity to perform light work, including his past relevant work as generally performed and other jobs available in the national economy. The ALJ discounted the only medical opinion addressing his functional ability—a 2016 evaluation by a physician’s associate—because it was inconsistent with other medical records. The Social Security Appeals Council denied review. The United States District Court for the Western District of Missouri affirmed the ALJ’s decision, holding that the ALJ’s findings were supported by substantial evidence.On appeal, the United States Court of Appeals for the Eighth Circuit reviewed whether the ALJ’s decision was supported by substantial evidence and free from legal error. The court held that the ALJ properly based the residual functional capacity determination on all relevant medical evidence, not just specific functional medical opinions. The court found that the ALJ thoroughly considered the record, including conflicting medical findings, and was not required to obtain additional functional evidence. The judgment of the district court, affirming the denial of disability benefits, was affirmed. View "Bonham v. Bisignano" on Justia Law

A legal advocacy organization petitioned for a writ of mandamus to compel the Department of Veterans Affairs (VA) to update its mailing addresses, alleging that the VA continued to send correspondence to incorrect addresses despite repeated notifications of changes. The petitioner requested court intervention to ensure the VA updated its address records, ceased sending correspondence to wrong addresses, and imposed financial penalties for future errors.The United States Court of Appeals for Veterans Claims dismissed the petition as moot after the VA voluntarily corrected the addresses and created a policy to guide attorneys on updating their addresses. The VA also provided affidavits and a fact sheet to confirm these corrections. The petitioner subsequently sought attorney fees under the Equal Access to Justice Act (EAJA), asserting that the Veterans Court’s order requiring affidavits constituted the necessary “judicial imprimatur” for prevailing-party status. The Veterans Court denied the application, relying on Cavaciuti v. McDonough, and found there was no court-mandated decision on the merits and no material alteration to the parties’ legal relationship.On appeal, the United States Court of Appeals for the Federal Circuit reviewed whether the Veterans Court erred in denying attorney fees under EAJA. The Federal Circuit held that a court order requiring a party only to confirm voluntary corrective actions for the purpose of assessing mootness does not constitute sufficient judicial imprimatur to confer prevailing-party status under EAJA. The court found that the Veterans Court’s order did not address the merits of the petition or alter the legal relationship between the parties. The Federal Circuit therefore affirmed the Veterans Court’s denial of the EAJA application. View "VETERANS LEGAL ADVOCACY GROUP v. COLLINS " on Justia Law

The petitioner began working as an Operational Support Technician with the Federal Bureau of Investigation in Miramar, Florida, in 1987. Her duties required her physical presence at the office, and she commuted daily from her home. In December 2016, she was found to have engaged in workplace misconduct—specifically, being under the influence while on duty—and was removed from her position in July 2018. In April 2019, she applied for Federal Employees’ Retirement System (FERS) disability retirement benefits, claiming that recurring seizures prevented her from commuting to work and performing the essential duties of her position.The Office of Personnel Management denied her application and subsequent request for reconsideration, determining that she had not established that her medical condition rendered her unable to provide “useful and efficient service” in her position. The petitioner appealed to the Merit Systems Protection Board. An administrative judge affirmed OPM’s determination, finding insufficient evidence that she was unable to perform the essential functions of her job. The judge also rejected her argument that her inability to commute, due to seizures and lack of transportation options, should be considered in assessing her disability status. The full Board adopted the administrative judge’s findings.The United States Court of Appeals for the Federal Circuit reviewed the Board’s final decision. The court held that, under 5 U.S.C. § 8451(a)(1)(B), the statutory definition of disability for FERS benefits does not include an employee’s ability to commute; only the refusal of reassignment to a position within the commuting area is governed by such considerations under § 8451(a)(2)(A). The court also ruled that it is statutorily barred from reviewing factual determinations underlying OPM’s disability findings. Accordingly, the Federal Circuit affirmed the Board’s decision. View "CHAFIN v. OPM " on Justia Law

Several individuals applied for federal Supplemental Security Income (SSI) but experienced delays in receiving a determination of eligibility. While they waited, New York State provided them with interim public assistance through the Safety Net Assistance (SNA) program, which required participation in work experience programs (WEPs). The value of the assistance was tied to the minimum wage for the hours worked. Once petitioners were deemed eligible for SSI, the Social Security Administration issued retroactive SSI payments covering the period of delay, and New York was reimbursed from these payments for the interim assistance it had provided. Petitioners received the remainder of the retroactive SSI after reimbursement.Following an unsuccessful administrative challenge, petitioners commenced a combined CPLR article 78 proceeding and putative class action, contending that New York’s practice of recouping the full value of SNA from their retroactive SSI awards violated the Fair Labor Standards Act (FLSA) by effectively creating an unlawful “kick-back” of minimum wage earned through WEP participation. Supreme Court ruled in petitioners’ favor, holding that the reimbursement process was subject to the FLSA and must reflect the value of WEP labor. The Appellate Division, Third Department, unanimously reversed, determining that petitioners were not deprived of minimum wage compensation because they had already received the value of their work in interim assistance and that reimbursement merely prevented duplicate payments for the same period.The New York Court of Appeals affirmed the Appellate Division’s order. It held that reimbursement to New York from petitioners’ retroactive SSI awards for interim assistance, conditioned on WEP participation, does not violate the FLSA. The Court concluded that petitioners received all compensation to which they were entitled under federal law, including the minimum wage, and that federal law expressly authorizes such reimbursement to prevent windfalls. The holding applies regardless of whether interim assistance is conditioned on work activities. View "Andersen v Hein" on Justia Law

A Medicaid recipient in her late 80s, suffering from serious health conditions, applied in 2019 for 24-hour at-home personal care services through New York’s Medicaid program. The state, which provides varying levels of in-home care to eligible Medicaid recipients, partners with private managed long-term care plans (MLTCPs) to assess needs and offer care plans. The plaintiff was initially offered only eight hours of daily care by all MLTCPs she applied to, though she believed she required around-the-clock assistance. Under New York’s regulations, individuals cannot immediately appeal the initial level of care offered; they must first enroll in the plan, request an increase, and only appeal if that request is denied. The plaintiff followed this process and ultimately received 24-hour care after subsequent assessments, but with a delay and a gap in retroactive reimbursement for services.The United States District Court for the Southern District of New York granted summary judgment to the defendants—the State's Health Commissioner and the MLTCP—holding that the plaintiff did not have a cognizable property interest in a particular level of care, and therefore no due process rights were implicated. The court also denied class certification. The plaintiff appealed these decisions.The United States Court of Appeals for the Second Circuit reviewed the case de novo. The Second Circuit disagreed with the District Court’s conclusion regarding the existence of a property interest. It held that New York’s laws, regulations, and practices substantially restrict discretion in determining eligibility for 24-hour personal care services, thereby creating a property interest for qualifying Medicaid recipients and triggering due process protections. However, the court determined that New York’s current appeals procedures, though delayed, are constitutionally adequate because the delay is modest, expedited procedures exist for urgent cases, and the overall private interests at stake are sufficiently protected. On this alternative ground, the Second Circuit affirmed the District Court’s grant of summary judgment to the defendants. View "Bellin v. McDonald" on Justia Law

A former court reporter who worked for nearly four decades for a California county discovered, as she approached retirement, that the county had failed to enroll her in the state retirement system (CalPERS) for several years early in her employment. Upon learning this, she attempted to secure a complete employment record from the county, which CalPERS required to adjust her retirement benefits. The county failed to provide complete records, reportedly due to records being lost or destroyed, and provided only incomplete information to CalPERS. This left her unable to purchase prior service credit or receive full retirement benefits, causing her financial harm and forcing her to delay retirement.After filing a claim with the county and receiving no response, the plaintiff brought multiple causes of action in the Humboldt County Superior Court, including alleged violations of statutory duties and negligence against the county and individual employees. The trial court sustained the defendants’ demurrers, dismissing all statutory claims without leave to amend and granting leave to amend only the negligence claim. When the plaintiff submitted an amended complaint limited to negligence, the trial court again sustained the demurrer without leave to amend, finding no statutory duty supported the claim.The California Court of Appeal, First Appellate District, Division One, reviewed the case. It held that the plaintiff had stated valid causes of action against the county for violation of mandatory statutory duties to maintain personnel records and to enroll eligible employees in CalPERS under Government Code section 815.6. The court also held, in an unpublished portion, that the plaintiff stated a viable negligence claim against the individual defendants, with the county potentially vicariously liable. The appellate court reversed the trial court’s dismissal of these claims and remanded for further proceedings. View "Gibbs v. County of Humboldt" on Justia Law

A per diem judge had been credited with retirement service by the Employee Retirement System (ERS) for years under a 1990 memorandum that set eligibility criteria. In 2017, the ERS discovered that the Judiciary had not updated personnel forms as the memorandum appeared to require. Without notice or a hearing, ERS issued a new memorandum rescinding the 1990 policy and retroactively stripped the judge’s retirement credits for service after October 1, 2017. The ERS did not follow rulemaking procedures required by Hawaii’s Administrative Procedure Act.The judge administratively challenged the ERS decision. A hearing officer partially sided with her, but the Board of Trustees of the ERS overruled that recommendation and dismissed all claims. The judge appealed to the Circuit Court of the First Circuit, which reversed the ERS Board, finding that both the 1990 and 2017 memoranda were rules under HRS § 91-1 and invalid because they had not been properly promulgated. On appeal, the Intermediate Court of Appeals (ICA) reversed, agreeing that the memoranda were improperly issued but holding that the circuit court’s reasoning did not support the relief granted.The Supreme Court of the State of Hawai‘i reviewed the case. It held that both the 1990 and 2017 memoranda were rules affecting private rights, not mere internal management or intra-agency communications, and thus subject to statutory rulemaking procedures. The 2017 memorandum and its implementing letter were void as to the judge because they were not lawfully adopted and she had timely challenged them. However, because no timely challenge was made to the 1990 memorandum, it remained valid and controlled her eligibility. The Supreme Court vacated the ICA’s decision, reinstated the circuit court’s judgment, and ordered the ERS to credit the judge for eligible service. View "Martel v. Employee Retirement System" on Justia Law

After separating from his employment with Walman Optical, the claimant created an optical consultation business. He designed a website, spent nearly $3,000 on advertising, and reported a net loss on his tax filings, but had not performed any services for clients or received earnings from the business. Shortly after these activities, he applied for unemployment compensation benefits.The Altoona UC Service Center determined that the claimant was ineligible for benefits, reasoning that his creation of a new business rendered him self-employed. Following a hearing, a referee affirmed this denial, and the Unemployment Compensation Board of Review adopted the referee’s findings and upheld the decision. Both the referee and the Board relied on the “positive steps” test, concluding that the claimant’s actions toward establishing a business meant he was customarily engaged in self-employment, even though he had not performed any services or received any wages.The claimant appealed to the Commonwealth Court of Pennsylvania, arguing that the “positive steps” test conflicted with the statutory requirements for self-employment. The Commonwealth Court, in a divided en banc opinion, affirmed the denial of benefits, holding that the positive steps test remained applicable in the context of a stand-alone business enterprise and that actual remuneration or performance of services was not necessary for a finding of self-employment.The Supreme Court of Pennsylvania reviewed the case and reversed the Commonwealth Court’s order. The Court held that Section 4(l)(2)(B) of the Unemployment Compensation Law sets forth the test for determining self-employment and that the positive steps test is contrary to the statute’s plain language. The Court concluded that self-employment requires the actual performance of services for wages and that merely taking steps to establish a business, without performing such services, does not disqualify a claimant from receiving benefits. View "Precht v. UCBR" on Justia Law

Arthur Miles was sentenced to a total of 300 months’ imprisonment following two separate federal convictions. After his first sentencing in October 2022, Miles was housed at the Marion County Jail in Indiana for fifteen months—some of this time was before and some after his second federal sentencing. During his time at the county jail, Miles worked as an orderly. He later argued that under the First Step Act of 2018 (“FSA”), he was entitled to earn time credits for this work, which could reduce his sentence, because his federal sentence had commenced and the work was equivalent to an evidence-based recidivism reduction (“EBRR”) program.The United States District Court for the District of Massachusetts reviewed Miles’s habeas petition after a magistrate judge recommended denying the Bureau of Prisons’ (BOP) motion to dismiss. The magistrate judge found that BOP regulations preventing prisoners from earning FSA credits until they arrived at a federal facility conflicted with the FSA’s language. The district court, however, rejected this recommendation and dismissed Miles’s petition, holding that the BOP’s rules did not violate the FSA.The United States Court of Appeals for the First Circuit held that the BOP’s regulation, which delayed the accrual of FSA time credits until a prisoner’s arrival at a federal facility, was invalid because it conflicted with the statutory definition of when a sentence commences. The court further held that a risk and needs assessment is not a prerequisite for earning FSA credits, and that prisoners may earn credits for qualifying programming—such as work as an orderly—performed after sentencing even while housed in non-federal facilities. The court vacated the dismissal of Miles’s habeas petition and remanded for further proceedings to determine his entitlement to credits for his time at the county jail. View "Miles v. Bowers" on Justia Law

The petitioner, a former Legal Administrative Specialist at the Office of Personnel Management (OPM), was diagnosed with major depressive disorder, generalized anxiety disorder, and insomnia. Her treating psychiatrist determined she was unable to work, and OPM subsequently removed her from federal service, citing her medical inability to perform essential job functions. The removal decision relied on medical documentation from her psychiatrist, which described her symptoms and limitations. Following her removal, the petitioner applied for disability retirement benefits through OPM, submitting the same medical documentation.OPM denied the disability retirement application, stating that while it acknowledged her diagnoses and symptoms, there was insufficient “objective” medical evidence to demonstrate the degree of her impairment and her inability to work. On reconsideration, OPM repeated that the documentation lacked details such as test results, psychotherapy notes, and treatment records. The petitioner appealed to the Merit Systems Protection Board (the Board), where OPM maintained its position that her evidence was inadequate. The Board’s administrative judge found that OPM had rebutted the presumption of disability—established when an employee is removed for medical inability—by asserting a lack of objective medical evidence. The Board weighed the evidence and affirmed OPM’s denial, making this its final decision.On review, the United States Court of Appeals for the Federal Circuit addressed whether OPM and the Board could overcome the presumption of disability (as set out in Bruner v. Office of Personnel Management) simply by asserting the absence of objective medical evidence. The court held that such an assertion alone is insufficient to rebut the presumption of disability. Because the Board relied solely on this rationale, the court concluded the presumption was not rebutted, reversed the Board’s final order, and found the petitioner entitled to disability retirement benefits. View "Garland v. Office of Personnel Management" on Justia Law