Justia Public Benefits Opinion Summaries
Articles Posted in Alaska Supreme Court
A husband and wife appealed denials of their Permanent Fund Dividends (PFDs) for 2014 and 2015. The husband’s 2014 PFD application was denied because he had been absent from the state for more than five years, creating a presumption of nonresidence that he was unable to rebut. The wife’s application was denied because her PFD eligibility as an accompanying military spouse depended on her husband’s. After the denials were affirmed by an Administrative Law Judge (ALJ), the couple appealed to the superior court. While this appeal was pending they both applied for 2015 PFDs and were again denied. The husband’s 2015 application was denied because his residency for PFD purposes was severed in the 2014 PFD proceedings and he had not reestablished it. The wife’s application was again denied because of her accompanying-spouse status. They appealed the 2015 denials too; the superior court consolidated the 2014 and 2015 cases and affirmed both denials. The Alaska Supreme Court determined neither spouse met the residency requirements to qualify for either a 2014 or a 2015 PFD under the plain language of the applicable statute. The Court therefore affirmed the ALJs’ decisions. View "Jones v. Alaska, Department of Revenue" on Justia Law
Posted in: Alaska Supreme Court, Civil Procedure, Constitutional Law, Government & Administrative Law, Public Benefits
A 2014 statute and 2013 regulation re-defined which abortions qualified as “medically necessary” for the purposes of Medicaid funding. The statute defined medically necessary abortions as those that “must be performed to avoid a threat of serious risk to the life or physical health of a woman from continuation of the woman’s pregnancy” as a result of a number of listed medical conditions; the regulation was similarly restrictive. Planned Parenthood of the Great Northwest challenged both the statute and regulation as unconstitutional, and the superior court held that both measures violated the equal protection clause of the Alaska Constitution. The court reasoned that these measures imposed a “high-risk, high- hazard” standard on abortion funding unique among Medicaid services, and held that our 2001 decision striking down an earlier abortion funding restriction on equal protection grounds compelled the same result. The State appealed, arguing that the statute and regulation should be interpreted more leniently and therefore do not violate the Alaska Constitution’s equal protection clause. The Alaska Supreme Court affirmed the superior court’s decision: the statute’s and the regulation’s facially different treatment of pregnant women based upon their exercise of reproductive choice required the Court to apply strict scrutiny, and the proposed justifications for the funding restrictions "did not withstand such exacting examination." View "Alaska v. Planned Parenthood of the Great Northwest" on Justia Law
Posted in: Alaska Supreme Court, Civil Procedure, Constitutional Law, Government & Administrative Law, Health Law, Public Benefits
An employee continued to work for over ten years after a job-related knee injury but had multiple surgeries on her injured knee. Over time, her employer made several permanent partial impairment payments, and she was eventually determined to be permanently and totally disabled because of the work injury. She began to receive Social Security disability at about the same time she was classified as permanently and totally disabled for workers’ compensation. Her employer asked the Alaska Workers’ Compensation Board to allow two offsets to its payment of permanent total disability (PTD) compensation: one related to Social Security disability benefits and one related to the earlier permanent partial impairment (PPI) payments. The Board established a Social Security offset and permitted the employer to deduct the amount of previously paid PPI. The employee appealed to the Alaska Workers’ Compensation Appeals Commission, arguing that the Board had improperly applied one of its regulations in allowing the PPI offset and had incorrectly calculated the amount of the Social Security offset. She also brought a civil suit against the State challenging the validity of the regulation. The State intervened in the Commission appeal; the lawsuit was dismissed. The Commission reversed the Board’s calculation of the Social Security offset and affirmed the Board’s order permitting the PPI offset. The employer appealed the Commission’s Social Security offset decision to the Alaska Supreme Court, and the employee cross- appealed the PPI offset. The Court affirmed that part of the Commission’s decision reversing the Board’s calculation of the Social Security disability offset and reversed that part of the Commission’s decision permitting an offset for permanent partial impairment benefits. The case was remanded back to the Commission for further proceedings. View "Alaska Airlines, Inc. v. Darrow" on Justia Law
Posted in: Alaska Supreme Court, Government & Administrative Law, Insurance Law, Labor & Employment Law, Personal Injury, Public Benefits
Sunny Radebaugh contested both her inability to cross-examine the nurse who performed an annual assessment and the Department of Health and Social Services' reversal of an administrative law judge’s determination. Radebaugh was a Medicaid in-home nursing care benefits recipient, who had her benefits terminated by the Department after an annual assessment. The assessment concluded that Radebaugh’s physical condition had materially improved to the point where she no longer required the benefits. She challenged the termination of her benefits at an administrative hearing, and the nurse who performed the assessment did not testify. Following the hearing, the administrative law judge determined that the Department erroneously terminated her benefits. The Department, as final decision maker, reversed the administrative law judge’s determination and reinstated the decision to terminate Radebaugh’s benefits. Radebaugh appealed to the superior court, which first determined that the Department had violated her due process rights but then reversed itself and upheld the Department’s decision. After review, the Alaska Supreme Court concluded Radebaugh waived the right to challenge her inability to cross-examine the nurse who performed the assessment. The Court held that the agency sufficiently supported its final decision. The Court therefore affirmed the superior court’s affirmance of the Department’s final decision. View "Radebaugh v. Dept. of Health & Social Services" on Justia Law
A worker was involved in a fight in a logging camp bunkhouse. He did not file a report of injury related to the fight for over a year. When he finally filed a report of injury, he alleged that he had injured his hip, lower back, and ear in the fight. His employer denied the worker benefits because he did not give timely notice of the injury. The worker then alleged that he had verbally informed his supervisor of the injuries. After a hearing, the Alaska Workers’ Compensation Board determined that the worker’s claim was barred because he did not give his employer timely notice of the injury. The Board performed an alternative analysis assuming the worker had given timely notice and decided that the claim was not compensable. The Alaska Workers’ Compensation Appeals Commission affirmed the Board’s decision. Because the Commission correctly determined that substantial evidence in the record supports the Board’s decision on the compensability of the claim, the Supreme Court affirmed the Commission’s decision.
An elderly woman requiring long-term medical care gave $120,000 to her son in February 2007. The mother believed that the gift would not prevent her from receiving Medicaid coverage if she lived long enough to exhaust her remaining assets. She relied on a provision in Alaska's Medicaid eligibility manual that suggested prospective Medicaid beneficiaries could give away a portion of their assets while retaining sufficient assets to pay for their medical care during the period of ineligibility that Medicaid imposes as a penalty for such gifts. But by the time the mother applied for Medicaid in September 2008, the Alaska legislature had enacted legislation with the retroactive effect of preventing the kind of estate planning the mother had attempted through her gift. The State temporarily denied the mother's application. The son appealed pro se on behalf of his mother, who died in 2009. Upon review, the Supreme Court found that the Alaska legislature's retroactive change to the Medicaid eligibility rules was valid. The Court thus affirmed the State's temporary denial of the mother's application.
Posted in: Alaska Supreme Court, Government & Administrative Law, Insurance Law, Public Benefits, Trusts & Estates
Parents requested that the Anchorage School District evaluate their child for eligibility for special education services. While awaiting the results of the eligibility assessment, the parents arranged for private tutoring. The school district did not assess the child’s eligibility within the statutorily-required time, and the parents requested a due process hearing. They also arranged for their child to be privately evaluated to determine whether he was eligible for special education services. The school district subsequently completed its evaluation and determined the child to be ineligible for services. At the due process hearing, the parents alleged that the school district committed procedural violations under the federal Individuals with Disabilities Education Act (IDEA), including impermissibly delaying the evaluation. They sought reimbursement for the cost of their child’s private evaluation and tutoring. An independent hearing officer presided over the due process hearing and ultimately agreed with the district that the child was ineligible for services. The hearing officer ordered the school district to pay the cost of the private eligibility assessment and to partially pay the cost of the tutoring. The superior court upheld the award of the private eligibility assessment, but reversed the award of the private tutoring cost. On appeal to the Supreme Court, the school district argued that the parents should not be reimbursed for the evaluation or the tutoring; the parents argued they are entitled to full reimbursement for both expenses. The central question the Court addressed was: where a child is ultimately determined to be ineligible for special education services, does the IDEA provide relief for procedural violations that occur during the process of evaluating the child’s eligibility for services? The Court affirmed the superior court’s decision, upholding the independent hearing officer’s award of the private assessment cost, but reversing the hearing officer’s award of the private tutoring expenses.
Posted in: Alaska Supreme Court, Civil Rights, Education Law, Government & Administrative Law, Juvenile Law, Public Benefits