Justia Public Benefits Opinion Summaries

Several unemployed workers in Alabama applied for unemployment benefits and claimed that the Alabama Department of Labor unlawfully delayed processing their claims. They sued the Alabama Secretary of Labor in state court under 42 U.S.C. §1983, arguing that the delays violated their due process and federal statutory rights. They sought a court order to expedite the processing of their claims. The Secretary moved to dismiss the complaint, arguing that the claimants had not satisfied the administrative-exhaustion requirement under Alabama law. The state trial court granted the motion and dismissed the complaint.The claimants appealed to the Alabama Supreme Court, which affirmed the dismissal on the grounds of failure to exhaust administrative remedies. The court concluded that §1983 did not preempt the state's administrative-exhaustion requirement, effectively preventing the claimants from suing to expedite the administrative process until they had completed it.The Supreme Court of the United States reviewed the case and held that state courts may not deny §1983 claims on failure-to-exhaust grounds when the application of a state exhaustion requirement effectively immunizes state officials from such claims. The Court reasoned that Alabama's exhaustion requirement, as applied, prevented claimants from challenging delays in the administrative process, thus immunizing state officials from §1983 suits. The Court reversed the Alabama Supreme Court's decision and remanded the case for further proceedings consistent with its opinion. View "Williams v. Reed" on Justia Law

Ken Lick Coal Company employed Bob Reed from 1973 to 1986, during which he was exposed to coal dust. Reed later worked for Green Valley Hydro Seeding & Reclamation and JPR, where he continued to be exposed to coal dust. Reed developed breathing problems and filed three claims for black-lung benefits. His first claim in 1986 was denied. His second claim in 2007 was initially granted but later denied by an administrative law judge who found Reed did not have pneumoconiosis. Reed's third claim in 2018 was pursued by his widow after his death.The district director awarded benefits and designated Ken Lick as the responsible operator. An administrative law judge upheld this decision, finding Reed had over 15 years of coal-mine employment, including his work with Green Valley and JPR. The judge also found that Ken Lick had stipulated to being the responsible operator during Reed's second claim, which the judge deemed binding in the third claim.The United States Court of Appeals for the Sixth Circuit reviewed the case. The court held that the administrative law judge erred in treating Ken Lick's prior stipulation as binding. The court found that the stipulation was a legal conclusion rather than a factual one, and thus, the judge had the authority to disregard it. The court noted that the administrative law judge would not have required Ken Lick to pay the benefits but for the stipulation. Consequently, the Sixth Circuit granted Ken Lick's petition for review and transferred the liability for Reed's claim to the Black Lung Disability Trust Fund. View "Ken Lick Coal Co. v. OWCP" on Justia Law

Dale Staten, a coal miner for nearly thirty years, retired in 2000 and passed away in January 2017 from respiratory failure after a two-week hospitalization. His widow, Bernadette Staten, filed for survivor benefits under the Black Lung Benefits Act. A Department of Labor administrative law judge (ALJ) awarded benefits, concluding that Bernadette qualified for a statutory presumption that Dale died from black lung disease due to his extensive underground mining work and total disability at the time of his death. The Benefits Review Board affirmed the ALJ's decision in a divided ruling.Consolidation Coal Company (CONSOL), Dale's former employer, challenged the ALJ's award, arguing that the 15-year presumption should only apply to chronic pulmonary conditions, not acute illnesses like Dale's respiratory failure. CONSOL contended that Dale's total disability was due to an acute condition rather than a chronic one. The ALJ had credited Dr. Sanjay Chavda's opinion that Dale was totally disabled at the time of his death, while discounting the opinions of CONSOL's experts, Dr. James Castle and Dr. Robert Farney, who argued that Dale was not disabled based on his medical history before his hospitalization.The United States Court of Appeals for the Seventh Circuit reviewed the case and affirmed the ALJ's award of benefits. The court held that the Black Lung Benefits Act does not require a claimant to prove that a miner's total disability arose from a chronic pulmonary condition to invoke the 15-year presumption. The court found that the ALJ acted within its authority in crediting Dr. Chavda's opinion and concluding that CONSOL failed to rebut the presumption that Dale's death was due to pneumoconiosis. The court denied CONSOL's petition for review and affirmed the judgment of the Benefits Review Board. View "Consolidation Coal Company v OWCP" on Justia Law

Donald Hunter, a former coal miner, applied for benefits under the Black Lung Benefits Act (BLBA) in 2019, claiming that he was totally disabled due to chronic obstructive pulmonary disease (COPD) caused by his coal mine employment. Southern Ohio Coal Company, his former employer, contested his claim, arguing that Hunter's COPD was caused by his significant history of smoking cigarettes rather than coal mine dust exposure.An Administrative Law Judge (ALJ) reviewed the case and awarded benefits to Hunter, finding that his COPD constituted legal pneumoconiosis and that it was a substantially contributing cause of his total disability. Southern Ohio Coal appealed to the Benefits Review Board (BRB), arguing that the ALJ erred in discrediting its evidence and in crediting Hunter's evidence. The BRB affirmed the ALJ's decision, holding that the ALJ had properly considered and weighed the evidence.The United States Court of Appeals for the Sixth Circuit reviewed the case. Southern Ohio Coal argued that the ALJ erred by relying on a pulmonary function test (PFT) that did not comply with regulatory quality standards and by relieving Hunter of his burden to establish entitlement to benefits. The court found that the ALJ acted within his discretion in determining that the PFT was compliant and supported Hunter's entitlement to benefits. The court also held that the ALJ did not improperly rely on regulatory guidance or flip the burden of proof to Southern Ohio Coal. The ALJ's decision was supported by substantial evidence, including expert opinions and Hunter's testimony.The Sixth Circuit denied the petition for review, affirming the ALJ's decision to award benefits to Hunter. The court held that the ALJ correctly applied the law and that his decision was supported by substantial evidence. View "Southern Ohio Coal Co. v. Office of Workers' Compensation Programs" on Justia Law

The plaintiff filed two successive applications for disability benefits under Title XVI of the Social Security Act. Her first application, alleging disability beginning June 24, 2017, was denied by an Administrative Law Judge (ALJ) on September 18, 2018. While appealing this denial to the district court, she filed a second application for benefits for a later period. Washington State Disability Determination Services (DDS) reviewed the second application and awarded benefits, determining she was disabled starting September 19, 2018, the day after the ALJ denied her first application.The district court partially ruled in her favor on the first application and remanded it for further proceedings. The Appeals Council remanded the case to the ALJ with instructions. On June 23, 2021, the ALJ reopened the second application and denied the benefits previously granted by DDS. The ALJ concluded that the plaintiff was disabled beginning July 14, 2020, on her first application. The district court held it lacked jurisdiction to review the ALJ’s reopening and denial of benefits on the second application.The United States Court of Appeals for the Ninth Circuit reversed the district court’s decision, holding that the district court had jurisdiction to review the ALJ’s reopening of the second application. The Appeals Council did not reopen the second application, and the ALJ’s reopening occurred more than two years after the award, which is only permissible in cases of fraud or similar fault. Finding no evidence of fraud or similar fault, the Ninth Circuit held that the ALJ erred in reopening and reversing the award of benefits on the second application. The court remanded for the district court to direct the agency to award benefits according to DDS’s decision. The Ninth Circuit affirmed the district court’s decision on the first application, concluding that the ALJ’s finding that the plaintiff was not disabled between June 24, 2017, and September 19, 2018, was supported by substantial evidence. View "NEVIN V. COLVIN" on Justia Law

Chesla A. Scott challenged the Idaho Department of Labor's service of three determination notices, claiming she did not receive them while temporarily working out-of-state. The Department mailed the notices to her last known address, and Scott missed the fourteen-day appeal period. When she attempted to appeal, the Department's Appeals Examiner dismissed her appeal as untimely. Scott argued that the Department's service by mail did not meet constitutional due process requirements.The Appeals Examiner conducted a hearing and concluded that Scott's appeal was untimely under Idaho Code section 72-1368(3) and (5). The Idaho Industrial Commission affirmed this decision, denying Scott's request for a new hearing and conducting a de novo review of the record. The Commission also concluded that Scott had not timely filed her appeal.Scott appealed to the Idaho Supreme Court, arguing that the Department's service by mail was constitutionally inadequate. The Court reviewed whether Scott exhausted her administrative remedies and preserved her constitutional challenge. The Court held that Scott had exhausted her administrative remedies and preserved her due process claim, allowing it to be reviewed.The Idaho Supreme Court affirmed the Commission's decision, holding that the Department's mailing of the determination notices was reasonable under all the circumstances and did not violate due process. The Court found that the Department's method of service was reasonably calculated to provide notice, and Scott's failure to receive the notices was not due to any fault of the Department. The Court did not award attorney fees to either party but awarded costs to the Department. View "Scott v. Home Depot USA, Inc." on Justia Law

S.S. was receiving temporary housing assistance through the Department for Children and Families (DCF) and staying at a shelter. After a confrontation with shelter staff over a mistakenly reassigned locker, S.S. was asked to vacate the shelter without prior warning. Consequently, DCF imposed a thirty-day period of ineligibility for further temporary housing assistance due to the shelter-rule violation. S.S. requested a fair hearing to challenge this decision, and a hearing officer recommended reversing the ineligibility period, which DCF subsequently did.S.S. then filed a motion with the Human Services Board to adopt the hearing officer’s findings and issue a final order. The hearing officer questioned the mootness of the case since DCF had already lifted the ineligibility period. The Board ultimately dismissed the case as moot, concluding there was no further relief it could provide since DCF had already granted S.S. the requested relief.The Vermont Supreme Court reviewed the case and affirmed the Board’s decision. The Court held that the Board lacked the statutory authority to provide the relief S.S. sought, as the Board can only affirm, modify, or reverse DCF decisions and provide appropriate relief. Since DCF had already reversed the ineligibility period, there was no live controversy for the Board to address. The Court also found that the capable-of-repetition-yet-evading-review exception to the mootness doctrine did not apply, as S.S. did not demonstrate a reasonable expectation of being subjected to the same action again. Consequently, the Board’s dismissal of the case was appropriate. View "In re appeal of S.S." on Justia Law

Jerry L. Blankenship applied for living miner benefits under the Black Lung Benefits Act, claiming he suffered from coal dust-induced pneumoconiosis and was totally disabled. An Administrative Law Judge (ALJ) found Blankenship entitled to a rebuttable presumption of total disability due to pneumoconiosis under 30 U.S.C. § 921(c)(4) and determined that his former employer, Island Creek Coal Company, failed to rebut this presumption. Consequently, Blankenship was awarded benefits. The Benefits Review Board affirmed the ALJ’s decision.Island Creek petitioned for review, arguing that the ALJ improperly conflated the presence of pneumoconiosis and disability causation with the separate total disability analysis. Additionally, Island Creek contended that the ALJ failed to adequately explain his decision to credit the opinions of Blankenship’s medical experts over those of Island Creek’s experts.The United States Court of Appeals for the Fourth Circuit reviewed the case and agreed with Island Creek. The court found that the ALJ improperly relied on the presence of pneumoconiosis and the causation of Blankenship’s impairment in concluding that he was totally disabled. The court also determined that the ALJ failed to provide a sufficient explanation for crediting the medical opinions of Drs. Nader and Green over those of Drs. McSharry and Sargent, violating the duty of explanation under the Administrative Procedure Act.The Fourth Circuit granted Island Creek’s petition for review, vacated the decision of the Benefits Review Board, and remanded the case with instructions for the Board to return Blankenship’s case to the ALJ for reconsideration consistent with the court’s opinion. View "Island Creek Coal Co. v. Blankenship" on Justia Law

Consuelo Griselda Nerio Mejia challenged the denial of her disability benefits by the Social Security Administration (SSA). After an administrative law judge (ALJ) denied her application, concluding that despite her severe impairments, she could perform other jobs available in the national economy, Nerio Mejia filed a civil suit. She raised three objections to the ALJ's decision, but the district court only addressed her claim that the ALJ improperly rejected her symptomology testimony, finding that the ALJ failed to provide clear and convincing reasons for doing so. The court reversed the ALJ's decision and remanded the case to the SSA for further proceedings.The United States District Court for the Central District of California found that the SSA's position was not substantially justified, making Nerio Mejia eligible for attorneys' fees under the Equal Access to Justice Act (EAJA). However, the district court reduced the fee award, excluding time spent on two additional issues that the court did not address, citing the Ninth Circuit's decision in Hardisty v. Astrue. The court concluded that fees for work on issues not decided by the court were not compensable under the EAJA.The United States Court of Appeals for the Ninth Circuit reviewed the case and reversed the district court's order reducing the fee award. The Ninth Circuit held that the district court misapplied Hardisty, which did not address the compensability of fees for undecided issues. The appellate court found that the district court's ruling was contrary to the Supreme Court's decision in Hensley v. Eckerhart and the Ninth Circuit's en banc decision in Ibrahim v. United States Department of Homeland Security. These cases establish that a fully compensatory fee should be awarded when a plaintiff achieves excellent results, even if some issues were not decided. The Ninth Circuit remanded the case with instructions to award the full amount of fees requested by Nerio Mejia. View "MEJIA V. O'MALLEY" on Justia Law

K.M., an adult with multiple disabilities, including autism and a seizure disorder, has been receiving Medicaid-funded developmental disabilities services for over twenty years. These services, provided by Washington County Mental Health Services (WCMHS), were supposed to include more than thirty hours of community support each week. However, since March 2020, K.M. has only received two to five hours of support weekly, leading to negative health effects.K.M. petitioned the Human Services Board to order the Department of Disabilities, Aging, and Independent Living (DAIL) to provide the full services he is entitled to. The Board dismissed his petition, stating it failed to specify the action required for compliance and that an order to provide services without available staff was too vague. The Board also interpreted K.M.'s request as seeking a broader policy change, which it deemed outside its authority, citing Husrefovich v. Department of Aging & Independent Living.The Vermont Supreme Court reviewed the case and reversed the Board's dismissal. The Court held that the Board has the statutory authority to order DAIL to provide the services K.M. is entitled to under federal and state law. The Court clarified that while the Board cannot issue broad policy injunctions, it can provide specific relief to individuals. The Court found K.M.'s request for services clear and specific enough to inform DAIL of the required action. The case was remanded to the Board for further proceedings consistent with this opinion. View "In re Appeal of K.M." on Justia Law