Justia Public Benefits Opinion Summaries

Robinson worked for Concentra as a medical assistant from 2003 until she was terminated in 2010. Robinson applied for Social Security disability benefits four days after being terminated, claiming that she had multiple sclerosis that rendered her unable to work. The initial application was denied. An ALJ reversed, summarizing Robinson’s statements that: she must use a cane to walk because of leg numbness; she has poor vision; her hands frequently cramp and she has difficulty holding objects; and she needs help with all household chores. Robinson then filed suit against Concentra under Title VII, 42 U.S.C. 1981, and the Family and Medical Leave Act, claiming that she had been terminated on the basis of her race and color and in retaliation for filing a complaint with the EEOC and taking FMLA leave and that Concentra had interfered with her ability to take FMLA leave. The court entered summary judgment, finding that Robinson was estopped from showing that she was qualified for her position when she was terminated in September 2010, because she received disability benefits based on her statement that she was fully disabled as of June 2010. The Second Circuit affirmed, noting that Robinson failed to “proffer a sufficient explanation” for the contradictory statements. View "Robinson v. Concentra Health Servs.,Inc." on Justia Law

This action began in 1993 when Plaintiffs, representatives of a class of over 1.5 million Texas children eligible for Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment program ("EPSDT"), sued various Texas state officials under 42 U.S.C. 1983 for violations of federal Medicaid law in the state’s implementation of the Program. The parties concluded a consent decree in 1996 in which Defendants promised to implement a number of changes, among which was a training program for participating health care providers. A few years later, after little progress had been made, the district court found Defendants in violation of the Decree. The Fifth Circuit reversed solely on Defendants' challenge to the Decree's validity under the Eleventh Amendment. In 2007, the parties agreed on a corrective action order to resolve Plaintiffs’ concerns with one part of the Decree. Defendants, believing their obligations to be satisfied, moved to dissolve that order and the associated Decree provisions under Rule 60(b)(5). The district court granted their motion. Plaintiffs appealed the district court’s termination of several provisions of the Decree decree and the dissolution of a related corrective action order pursuant to the first clause of Federal Rule of Civil Procedure 60(b)(5), that the judgment has been “satisfied, released, or discharged.” Finding no reversible error, the Fifth Circuit affirmed. View "Frew v. Suehs" on Justia Law

Plaintiff-appellant Alphonso Myers was injured on the job. He received social security benefits due to his inability to work. While claiming benefits, he applied for a job as an armed guard with defendant-appellee Knight Protective Service. On his job application, plaintiff made no mention of his prior injury. Supervisors at Knight noticed that plaintiff appeared to be in pain. Plaintiff then admitted that he had undergone a series of surgeries from the prior workplace injury. Concerned that this pain might interfere with his duties as an armed guard, Knight required plaintiff to submit to a physical exam before resuming his duties as a guard. Plaintiff waited months for the exam - long enough that plaintiff considered the delay as an effective termination from his job. Plaintiff then filed suit, arguing that he had been discriminated against on the basis of his race and disability. The district court granted summary judgment to Knight, and plaintiff appealed. Finding no reversible error, the Tenth Circuit affirmed the district court's judgment. View "Myers v. Knight Protective Service" on Justia Law

The Board challenged the district court's decision to award O.L.'s parents reimbursement for one-on-one instruction outside the school setting as well as some of their attorney's fees. The parents cross-appealed the district court's decision not to award O.L. compensatory education. The court concluded that the parents were eligible for reimbursement; the district court was right to find that the alternative program was proper under the standard set forth in Bd. of Educ. of Hendrick Hudson Centr. Sch. Dist., Westchester Cnty. v. Rowley; even if the alternative program has its shortcomings, it was reasonably calculated to permit the child to obtain some educational benefit; the district court's reimbursement award was appropriate; the district court did not abuse its discretion when it took the quality of the chosen alternative into consideration; it was clear on the record that the district court properly weighed the evidence and did not abuse its considerable discretion when it denied the request for compensatory education; and there was no need to reverse the attorney's fee award since the court affirmed the district court's decision in all respects.View "R.L., et al. v. Miami-Dade Cty. Sch. Bd." on Justia Law

In 1997, in response to Congress’s enactment of the Personal Responsibility and Work Opportunity Reconciliation Act, which narrowed the eligibility of non-citizens for Medicaid and other federal benefits, the state of Maine extended state-funded medical assistance benefits to certain legal aliens rendered ineligible for Medicaid. In 2011, the Maine Legislature terminated these benefits. Appellants moved for a preliminary injunction against enforcement of the 2011 legislation, alleging that the state violated their equal protection rights by providing state-funded medical assistance benefits to United States citizens while denying those benefits to similarly situated non-citizens due solely to their alienage. The district court denied Appellants’ motion for a preliminary injunction. The First Circuit Court of Appeals affirmed the district court’s denial of a preliminary injunction, holding that Appellants’ equal protection claim failed on the merits because the state of Maine was not obligated to extend equivalent state-funded benefits to Appellants in the first place, and therefore, the termination of those benefits did not violate the Equal Protection Clause.View "Bruns v. Mayhew" on Justia Law

After his employment with the town was terminated, the plaintiff sought benefits under the Illinois Unemployment Insurance Act. The town opposed his claim, arguing that he was ineligible for unemployment benefits because he had constructively resigned “without good cause” by failing to obtain a commercial driver’s license within one year of starting work, a condition of his employment. The department agreed with the town. The plaintiff unsuccessfully appealed. He then sued in federal court under 42 U.S.C. 1983, claiming that he was fired in violation of his rights to due process of law and freedom of speech. The district court dismissed the claim as barred by collateral estoppel. The Seventh Circuit reversed, reasoning that the Illinois statute, 820 ILCS 405/1900(B), denies collateral estoppel effect to rulings in unemployment insurance proceedings. View "Council v. Village of Dolton" on Justia Law

After Defendants were charged with Medicaid fraud, the Commonwealth obtained search warrants to obtain and search designated e-mail accounts of Defendants' former billing director. Defendants moved for a protective order, claiming that the attorney-client privilege protected many of the e-mails. A motion judge amended the order to permit the Commonwealth to search the e-mails by using a "taint team," assistant attorneys general not involved in the investigation or prosecution of Defendants. Defendants filed a petition seeking relief from the order. The Supreme Court answered reported questions from the county court by holding (1) the Commonwealth may, by means of an ex parte search warrant, search the post-indictment emails of a criminal defendant; and (2) the "taint team" procedure was permissible under the Massachusetts Constitution. View "Preventive Med. Assocs. v. Commonwealth" on Justia Law

Three corporations, each of which owned a nursing home facility, requested a hearing with the Kansas Department on Aging, challenging new reimbursement rates for each facility, arguing that because the facilities underwent a change of ownership, the rates should be recalculated. The hearing officer rejected the corporations' arguments, finding that, by operation of law for Medicaid reimbursement purposes, there was no change of ownership. The Kansas Health Policy Authority upheld the ruling, and the district court affirmed. The Supreme Court affirmed, holding that the agency orders were valid, did not violate equal protection or due process, and were not vague. View "Village Villa v. Kan. Health Policy Auth." on Justia Law

Applicant Marilyn Clifford appealed the denial of long-term home-care benefits under the Medicaid-funded Choices for Care program, arguing that a second home on an adjacent piece of property should have been excluded from the financial-eligibility calculation. Given the language of the regulation, the legislative history that led to its promulgation, and the policy considerations attending the Medicaid program, the Supreme Court concluded that the Secretary correctly interpreted the home-exclusion rule when he reinstated the determination of the Department of Children and Families denying the benefits. Thus, the Court found no compelling indication of error in the Secretary’s determination and affirmed. View "In re Marilyn Clifford" on Justia Law

Appellant was a personal care attendant for a Medicaid beneficiary. Appellant was later charged with Medicaid fraud for submitting a false claim for his services. After a bench trial Appellant was convicted under Kan. Stat. Ann. 21-3846(a)(1) for defrauding the Medicaid program. The court of appeals reversed Appellant's conviction, holding that the complaint charged that Appellant submitted statements for services he did not provide while the evidence at trial established that Appellant actually did provide the services for which he submitted statements. The Supreme Court reversed the court of appeals and affirmed the district court, holding that sufficient evidence supported Appellant's conviction for Medicaid fraud.View "State v. McWilliams" on Justia Law