Justia Public Benefits Opinion Summaries

by
The case involves Melissa Palmer, who applied for Pandemic Unemployment Assistance (PUA) benefits due to loss of income from her self-employment as a sign-language interpreter during the COVID-19 pandemic. Despite continuing to work her second job at Woofs and Waves, she did not report this income in her weekly requests for benefits. The South Dakota Department of Labor and Regulation, Reemployment Assistance Division (Department) determined that she had misrepresented her income and was therefore ineligible for the benefits she had received. The Department ordered her to repay the benefits and assessed a mandatory penalty.The administrative law judge (ALJ) upheld the Department's decision, finding that Palmer had willfully misrepresented her income. The circuit court affirmed the ALJ’s decision. Palmer appealed, arguing that she had not willfully misrepresented her income because she believed she only needed to report her self-employment income.The Supreme Court of the State of South Dakota reversed the lower courts' decisions. The Court found that the ALJ's finding that Palmer believed she only needed to report her self-employment income was inconsistent with the conclusion that she had willfully misrepresented her income. The Court held that a willful misrepresentation requires evidence of intentional misrepresentation, not merely knowledge of the falsity of the representation. The Court remanded the case for the ALJ to reconsider whether Palmer was at fault for the overpayment and whether she was eligible for a waiver. View "Palmer V. Dep’t Of Labor & Regulation" on Justia Law

by
The case involves Lorain Ann Stiffler, who applied for disability insurance benefits under the Social Security Act, claiming disability due to attention deficit hyperactivity disorder, depression, a mood disorder, right knee problems, and a processing disorder. Her application was initially denied and denied again upon reconsideration. Dr. Khosh-Chashm, who diagnosed Stiffler with major depressive disorder, concluded that she had extreme mental functioning limitations and lacked the cognitive and communicative skills required for gainful employment. However, state agency medical consultants Dr. Goldberg and Dr. Bilik disagreed, concluding that Stiffler was not disabled but had moderate limitations on her ability to carry out detailed instructions, maintain concentration, work with others, make simple work-related decisions, and complete a normal workday and workweek.The Administrative Law Judge (ALJ) affirmed the denial of Stiffler's application for disability benefits. The ALJ rejected Dr. Khosh-Chashm's opinion, finding it unsupported by and inconsistent with the medical evidence and Stiffler's significant daily activities. The ALJ also found no conflict between the testimony of the vocational expert and the Dictionary of Occupational Titles (DOT), concluding that Stiffler could work as a marking clerk, mail clerk, or laundry worker.The United States Court of Appeals for the Ninth Circuit affirmed the district court's judgment, which had upheld the ALJ's decision. The court found substantial evidence supporting the ALJ's evaluation of Dr. Khosh-Chashm's medical opinion and concluded that there was no conflict between Stiffler's limitation to "an environment with few workplace changes" and the DOT's Reasoning Level 2. View "STIFFLER V. O'MALLEY" on Justia Law

by
The case involves Dennis G. Crosen, a former employee of Blouin Motors, Inc., who suffered two work-related injuries in 1984 and 2002, respectively. The 1984 injury occurred while Crosen was working for Rockingham Electric, Inc., and the 2002 injury occurred while he was working for Blouin Motors, Inc. The two injuries combined to render Crosen totally incapacitated. A hearing officer apportioned 40% of the responsibility for Crosen's incapacity to Rockingham and 60% to Blouin. In 2014, Crosen began collecting old-age insurance benefits under the United States Social Security Act. By statute, Blouin's obligation to pay weekly incapacity benefits based on the 2002 injury was to be reduced by half of the amount of Social Security benefits that Crosen receives. No Social Security offset applies to the compensation that Rockingham owes for the 1984 injury.The Administrative Law Judge (ALJ) and the Workers’ Compensation Board Appellate Division denied Blouin's petition to apply the entire Social Security offset to its compensation payments to Crosen. The ALJ and the Appellate Division interpreted the relevant statute to mean that Blouin could only apply the offset to the portion of the benefits for which it was responsible (60%), not the entire amount.The Maine Supreme Judicial Court disagreed with the lower courts' interpretation of the statute. The court held that Blouin was entitled to take the full offset provided by the statute, not just the portion corresponding to its share of responsibility for Crosen's incapacity. The court vacated the decision of the Appellate Division and remanded the case for further proceedings. The court also noted that Blouin may be entitled to a credit for the portion of the offset that it did not take prior to this case, but left this issue to be resolved on remand. View "Crosen v. Blouin Motors., Inc." on Justia Law

by
The case revolves around a group of Texans who were receiving Pandemic Unemployment Assistance (PUA) until the Texas governor informed the Department of Labor that Texas would withdraw from its agreement with the Secretary of Labor to participate in the PUA program. The plaintiffs argued that the Federal Government violated the mandate in PUA that the Secretary of Labor “shall provide . . . assistance” to “any covered individual.”The United States District Court for the Western District of Texas dismissed the case, agreeing with the magistrate judge's recommendation. The judge reasoned that the CARES Act, which established the PUA, required the existence of an agreement with a state for the payment of benefits. The judge also noted that the Act did not provide a mechanism for the Secretary to pay out benefits in the absence of an agreement with the relevant state. The judge concluded that Congress intended for the funds to be administered solely by the states.The plaintiffs appealed to the United States Court of Appeals for the Federal Circuit. The court affirmed the lower court's decision, stating that the PUA does not require the Secretary to pay PUA benefits to individual citizens; rather, the Secretary must provide assistance through agreements with the states. The court concluded that the plaintiffs failed to state a claim under the Little Tucker Act. View "CREAGER IRELAND v. US " on Justia Law

by
The case involves Keeley Hamilton, who applied for disability insurance benefits and supplemental security income from the Social Security Administration (SSA) due to her physical impairments. An administrative law judge (ALJ) within the SSA denied her applications, concluding that despite her physical impairments, she could still work in two occupations. Hamilton appealed, arguing that she should be considered disabled unless she could work in at least three occupations, a rule she derived from Ninth Circuit caselaw.Hamilton's applications were initially denied by an ALJ, who found that she could still work in two occupations despite her physical impairments. The district court remanded the case back to the SSA for further proceedings, citing a failure to ask the vocational expert about potential conflicts between his testimony and the occupational information in the Dictionary of Occupational Titles. On remand, the ALJ held another hearing and again denied Hamilton's applications, concluding that Hamilton's skills permitted her to perform two semi-skilled sedentary occupations: food checker and auction clerk.In the United States Court of Appeals for the Sixth Circuit, Hamilton argued that the ALJ should have found her disabled because his findings showed that her skills did not transfer to at least three occupations. The court disagreed with Hamilton's interpretation of the rule, stating that the ALJ did not err by ruling that Hamilton was not disabled under the regulations because she had skills that transferred to a significant range of work. The court affirmed the district court's decision upholding the Social Security Administration's denial of benefits to Hamilton. View "Hamilton v. Comm'r of Soc. Sec." on Justia Law

by
Lonnie Reidburn, a self-employed insurance agent, appealed a decision by the South Dakota Department of Labor, Reemployment Assistance Division (Department) that he must repay $24,690 in pandemic unemployment benefits he received. Reidburn's income was based on commissions he received for new policies and renewals, which required in-person visits to clients' homes or businesses. During the COVID-19 pandemic, Reidburn experienced a significant reduction in his ability to procure new policies and renewals because clients did not want him to make in-person visits. As a result, Reidburn's income decreased. He applied for Pandemic Unemployment Assistance (PUA) through the Department and received benefits for 39 weeks. However, the Department later determined that Reidburn's loss of income was not the direct result of the pandemic and issued a determination of ineligibility.The administrative law judge (ALJ) upheld the Department's determination of ineligibility, reasoning that the individual decisions of Reidburn's clients to preclude him from entering their homes or places of business were not a direct result of the pandemic. However, the ALJ rejected the Department's at-fault determination and found that Reidburn was not at fault for the overpayment. The ALJ also concluded that Reidburn's request for a waiver was untimely. Reidburn appealed the ALJ's decision to the circuit court, which affirmed the ALJ's decision.The Supreme Court of the State of South Dakota reversed the ALJ's determination that Reidburn was ineligible to receive PUA benefits for 35 of the 39 weeks at issue, based on its recent decision in Bracken v. South Dakota Department of Labor and Regulation, Reemployment Assistance Division. The court declined to address the Department's argument that Reidburn failed to present sufficient evidence to support his testimony that he experienced a significant reduction in services, as the Department did not raise this argument at Reidburn's administrative hearing. The court affirmed the circuit court's denial of Reidburn's motion for attorney fees. View "Reidburn v. Department of Labor & Regulation" on Justia Law

by
The case revolves around Brenda Warnell, who applied for disability insurance benefits and supplemental security income under the Social Security Act in 2019. Warnell claimed she was unable to work due to debilitating migraines and chronic pain in her back, shoulders, and neck. Her medical record was mixed, with some physicians assessing her as having severely limited functional capacity, while others found her capable of limited physical exertion.The Administrative Law Judge (ALJ) denied Warnell's claim, finding that the medical evidence did not substantiate the severity of her alleged functional limitations. The ALJ concluded that Warnell's pain symptoms did not prevent her from performing light work with moderate noise and limited physical requirements. The ALJ's decision was affirmed by the district court.In the United States Court of Appeals for the Seventh Circuit, Warnell challenged the ALJ's decision, arguing that the ALJ needed to provide more detailed accounts of the medical evidence. The court rejected this argument, stating that the ALJ's decision was supported by substantial evidence and met the light standard set by the Supreme Court. The court found that the ALJ had provided a sufficient explanation for her decision, highlighting specific evidence that contradicted Warnell's claims and addressing conflicting evidence. The court affirmed the ALJ's decision, rejecting Warnell's claim that the ALJ needed to provide more detailed accounts of the medical evidence. View "Warnell v. O'Malley" on Justia Law

by
The case involves a claimant, Isaac Flowers, who applied for Social Security Disability benefits due to various health issues including back, neck, shoulder, and joint problems, obesity, vision loss in one eye, and depression and opioid dependence. The Administrative Law Judge (ALJ) initially denied his claim, deeming that he could perform "sedentary work". Later, Flowers applied for benefits again, and the ALJ denied his claim again, this time finding that he could perform "light work", a classification slightly more intensive than "sedentary work".Flowers appealed this decision, arguing that the ALJ's finding that he could perform "light work" wasn't supported by substantial evidence as there was no proof of his condition improving. He also suggested that the ALJ should have considered the previous finding of him only being able to perform "sedentary work".The United States Court of Appeals for the Eleventh Circuit rejected Flowers' argument. Firstly, the court found that Flowers hadn't raised this legal issue in the lower courts and they declined to consider it for the first time on appeal. Secondly, the court concluded that even if Flowers had raised the issue in the lower courts, any error would have been harmless because Flowers hadn't shown that he would be entitled to disability benefits even if he was limited to "sedentary work". Lastly, the court found that the ALJ's decision was supported by substantial evidence. Consequently, the court affirmed the ALJ's decision. View "Flowers v. Commissioner, Social Security Administration" on Justia Law

by
The plaintiff, Robert Conway, appealed a decision by the district court that upheld the denial of his social security benefits by an administrative law judge (ALJ). The ALJ had found that Conway could perform "medium work" based on the testimony of a vocational expert. Under Terry v. Saul, the term "medium work" was presumed to imply a six-hour standing and walking limitation.However, Conway argued that this presumption was rebutted during the cross-examination of the vocational expert. When asked if someone could perform medium work if they were only able to be on their feet for six hours maximum, the expert responded that the three sample occupations provided would not be possible and it would be difficult to provide substitute unskilled, medium occupations.The United States Court of Appeals for the Ninth Circuit agreed with Conway, finding that the vocational expert's significantly different responses revealed that the expert did not understand the ALJ’s hypothetical to impliedly include a six-hour standing and walking limitation. As such, the expert’s response to the ALJ’s question had no evidentiary value to support the ALJ’s finding that Conway could perform jobs in the national economy. The court concluded that the error was not harmless and reversed the district court’s judgment, remanding the case to the Commissioner of Social Security for further proceedings. View "CONWAY V. O'MALLEY" on Justia Law

by
In this appeal before the United States Court of Appeals for the Seventh Circuit, the plaintiff, Kelly Chavez, had been denied supplemental security income due to her various mental and physical impairments. The administrative law judge (ALJ) at a hearing found that Chavez could perform jobs that existed in significant numbers in the economy. This decision was affirmed by the district court, leading to this appeal. Chavez contended that the vocational expert's testimony, which the ALJ relied on, did not provide substantial evidence supporting the ALJ's decision.The vocational expert, Sarah Holmes, testified that a person with Chavez's age, background, and ability could perform several light exertion jobs, such as cleaner, office helper, and storage rental clerk. She used a software program, Job Browser Pro, to estimate the number of jobs, which uses data from the Bureau of Labor Statistics.Chavez's main argument was that Holmes did not explain Job Browser Pro's underlying formula, thereby rendering her testimony unreliable. However, the court held that Holmes's testimony provided substantial evidence for the ALJ's finding. The court highlighted that Holmes used a generally accepted source of job numbers, provided a straightforward overview of how the source worked, offered to provide additional information about the source's underlying formula, and identified jobs commonly found in the national economy. Therefore, the court affirmed the district court's judgment. View "Chavez v. O'Malley" on Justia Law