Justia Public Benefits Opinion Summaries

Rosa A. Camacho, a retired Class II member of the Northern Mariana Islands Retirement Fund, claimed that she was entitled to cost-of-living allowances (COLAs) as part of her retirement benefits. When Camacho entered the Retirement Fund in 1980, COLAs were not part of the retirement package. In 1989, the Commonwealth legislature amended the Retirement Fund Act to provide a two percent COLA. Over the years, this provision was repeatedly modified, suspended, and ultimately repealed in 2011. The Commonwealth’s financial difficulties led to a class action and a subsequent settlement agreement in 2013, which entitled participants to 75% of their “Full Benefits,” as defined by statute or guaranteed by the Commonwealth Constitution.The United States District Court for the Northern Mariana Islands held that Camacho was not entitled to COLAs under the settlement agreement, reasoning that COLAs were not constitutionally protected benefits at the time she joined the Retirement Fund and were discretionary by statute as of 2013. Camacho appealed, arguing that the statutory introduction of COLAs during her membership created a protected right under Article III, section 20(a) of the Commonwealth Constitution.The United States Court of Appeals for the Ninth Circuit certified to the Supreme Court of the Commonwealth of the Northern Mariana Islands the question of whether section 8334(e) of the Retirement Fund Act conferred a constitutionally protected accrued benefit in the form of COLAs for Class II members employed when the Act took effect. The Commonwealth Supreme Court answered in the negative, finding that COLAs were legislative policy adjustments and not protected contractual benefits. In accordance with this interpretation, the Ninth Circuit held that Camacho did not acquire a constitutionally protected right to COLAs under section 8334(e). The district court’s decision was affirmed. View "Camacho v. Northern Mariana Islands Settlement Fund" on Justia Law

Tamica Rainey, a Chicago police officer, was injured in duty-related car accidents in 2013 and 2015. She was awarded duty disability benefits in 2017 based on injuries to her neck and shoulder. As required by statute, Rainey’s disability status was periodically reviewed, and in 2022, after multiple hearings and submissions of medical records, the Retirement Board of the Policemen’s Annuity and Benefit Fund of the City of Chicago discontinued her duty disability benefits, concluding she was no longer disabled from her duty-related injuries. However, when Rainey attempted to return to work, the police department determined she could not perform her duties.Rainey sought administrative review in the Circuit Court of Cook County, which reversed the Board’s decision, relying on precedent that an officer remains disabled if the department cannot provide a position with needed accommodations. The circuit court also awarded Rainey attorney fees and costs under section 5-228(b) of the Illinois Pension Code. The Board appealed, and the Appellate Court of Illinois, First District, affirmed both the restoration of Rainey’s benefits and the award of attorney fees and costs.The Supreme Court of Illinois reviewed the Board’s challenge to the attorney fees and costs award. The court held that section 5-228(b) of the Illinois Pension Code authorizes an award of attorney fees and costs not only to police officers who successfully challenge the initial denial of duty or occupational disease disability benefits, but also to those who successfully challenge the discontinuation of such benefits. The court rejected the Board’s argument that statutory attorney fee awards are limited to initial applications, finding the statute’s plain language and legislative intent favor such awards for both denial and discontinuation challenges. The Supreme Court affirmed the judgments of the appellate and circuit courts and reversed the Board’s decision. View "Rainey v. Retirement Board of the Policemen & Annuity and Benefit Fund of the City of Chicago" on Justia Law

During a government shutdown that began on October 1, 2025, the United States Department of Agriculture (USDA) announced it would not provide November Supplemental Nutrition Assistance Program (SNAP) benefits, affecting millions of Americans who rely on these funds for food. Despite having approximately $6 billion in contingency funds appropriated by Congress for emergencies, USDA stated it would not use these funds, arguing they were unavailable once regular appropriations lapsed. Plaintiffs, including nonprofits, local governments, a union, and a food retailer, filed suit, alleging that USDA’s suspension of benefits was arbitrary, capricious, and contrary to law under the Administrative Procedure Act (APA).The United States District Court for the District of Rhode Island granted a temporary restraining order (TRO) requiring USDA to provide either full or partial November SNAP payments by specified dates. The government chose to provide partial payments but failed to do so in a timely manner, as many recipients would not receive benefits by the court’s deadline. The district court found the government had not complied with its order, both by failing to resolve administrative burdens and by not ensuring timely disbursement. As a result, the court ordered USDA to make full November SNAP payments, including by using funds from the Section 32 fund in combination with contingency funds. The government appealed and sought a stay of the district court’s order.The United States Court of Appeals for the First Circuit reviewed the government’s request for a stay pending appeal. The court held that the government had not met its burden to justify a stay, finding it had failed to show a likelihood of success on the merits or that irreparable harm would result from compliance. The court emphasized the immediate and substantial harm to SNAP recipients if benefits were withheld and denied the government’s motion for a stay. View "Rhode Island State Council of Churches v. Rollins" on Justia Law

A personal care assistance provider agency in Minnesota was audited by the Department of Human Services (DHS) for recordkeeping deficiencies related to its provision of services under the state’s Medicaid program. The agency, which served both traditional and PCA Choice recipients, was found to have various documentation errors, including missing or incomplete care plans and timesheets, as well as timesheets lacking required elements. DHS did not allege fraud or that services were not provided, but sought to recover over $420,000 in payments, arguing that these deficiencies constituted “abuse” under state law and justified monetary recovery.After an evidentiary hearing, an administrative law judge (ALJ) recommended limited recovery for some missing documentation but rejected most of DHS’s claims, finding that DHS had not shown the deficiencies resulted in improper payments. The DHS Commissioner disagreed, ordering full repayment. The Minnesota Court of Appeals reversed the Commissioner’s decision, holding that DHS must prove not only that the provider engaged in “abuse” but also that the abuse resulted in the provider being paid more than it was entitled to receive. The court also determined that provider agencies must maintain care plans for both traditional and PCA Choice recipients in their files.The Minnesota Supreme Court affirmed in part, reversed in part, and remanded. It held that, to obtain monetary recovery under Minn. Stat. § 256B.064, subd. 1c(a), DHS must prove either: (1) the provider engaged in conduct described in subdivision 1a and, had DHS known of the conduct before payment, it would have been legally prohibited from paying under a statute or regulation independent of subdivision 1a; or (2) the payment resulted from an error such that the provider received more than authorized by law. The Court also held that provider agencies must keep care plans for all PCA services, including PCA Choice, in their files. View "In the Matter of the SIRS Appeal by Best Care, LLC" on Justia Law

A firefighter with fifteen years of service applied for disability pension benefits from a municipal pension fund, claiming he was permanently disabled due to post-traumatic stress disorder (PTSD) resulting from several traumatic events encountered during his career. The pension fund’s Board of Trustees denied his application after a hearing, finding he did not meet the policy’s requirements for a mental health disability benefit, specifically the requirement that the traumatic events causing the disability be “unexpected” within the context of his regular duties.The applicant sought judicial review in the Chancery Court for Hamilton County, which reviewed the Board’s decision under Tennessee’s Uniform Administrative Procedures Act (UAPA). The trial court found the Board’s interpretation of the policy arbitrary and capricious, holding that the events were unexpected to the applicant and that the policy should be construed in favor of the employee. The trial court reversed the Board’s denial and awarded benefits. The Tennessee Court of Appeals affirmed, finding the policy ambiguous and applying a liberal construction doctrine to interpret the policy in favor of the applicant.On further appeal, the Supreme Court of Tennessee held that the term “unexpected” in the policy was not ambiguous and should be given its plain meaning. The Court concluded that the Board’s decision was supported by substantial and material evidence and was not arbitrary or capricious. The Court also held that the liberal construction doctrine did not apply because the policy was unambiguous. Accordingly, the Supreme Court of Tennessee reversed the judgments of the Court of Appeals and the trial court, reinstating the Board’s denial of disability benefits, and remanded the case for further proceedings consistent with its opinion. View "Long v. Chattanooga Fire and Police Pension Fund" on Justia Law

A firefighter employed by the City of Birmingham developed hypertension during his employment and applied to the City of Birmingham Retirement and Relief System for both extraordinary and ordinary disability benefits, arguing that his condition and the medications required to control it prevented him from safely performing his job. He detailed unsuccessful attempts to manage his hypertension with various medications and provided medical opinions supporting his claim that only beta-blockers, which are not recommended for firefighters, could control his blood pressure. The Board, after considering the opinion of its medical expert, denied both applications, concluding that he had not exhausted all other antihypertensive regimens.The firefighter sought review of the Board’s decisions by filing a petition for a writ of mandamus in the Jefferson Circuit Court, as permitted by statute. Initially, the circuit court dismissed the action for lack of service, but the Supreme Court of Alabama reversed that dismissal and remanded the case. After service was obtained, the respondents argued that the claim for extraordinary disability benefits failed as a matter of law because the hypertension was not caused by a specific workplace accident, and that the Board’s denial of ordinary disability benefits was not manifestly wrong. The circuit court denied the mandamus petition without a hearing or consideration of evidence beyond the pleadings.The Supreme Court of Alabama affirmed the circuit court’s denial of extraordinary disability benefits, holding that the statutory requirements were not met because the disability did not result from an accident at a definite time and place. However, the Supreme Court reversed the denial of ordinary disability benefits, finding that the circuit court erred by not allowing the petitioner to present evidence or reviewing the evidence considered by the Board. The case was remanded for further proceedings on the ordinary disability claim. View "Hoffman v. City of Birmingham Retirement and Relief System" on Justia Law

A group of Black farmers and their association, along with several individual members, sought to file claims with the U.S. Department of Agriculture (USDA) for financial assistance under a program created by the Inflation Reduction Act of 2022. They wished to submit applications on behalf of deceased relatives who had allegedly experienced discrimination in USDA farm lending programs. The USDA, however, had a policy that excluded applications reporting only discrimination against individuals who were deceased at the time of application, making such claims ineligible for the program.The plaintiffs filed suit in the United States District Court for the Western District of Tennessee, seeking an injunction to require the USDA to accept these “legacy claims.” The district court denied their motion for a preliminary injunction and granted the government’s motion to dismiss under Rule 12(b)(6), holding that the relevant statute only authorized financial assistance to living farmers. The plaintiffs appealed this decision to the United States Court of Appeals for the Sixth Circuit and also sought an emergency injunction pending appeal, which was denied.The United States Court of Appeals for the Sixth Circuit reviewed the district court’s dismissal de novo. The appellate court held that the statutory language of § 22007(e) of the Inflation Reduction Act required the USDA to provide “assistance” to farmers who experienced discrimination, and that “assistance” was forward-looking and could not be provided to deceased individuals. The court found that the statute did not authorize compensation for past harm to deceased farmers, distinguishing “assistance” from “compensation.” The court affirmed the district court’s judgment and denied the motion for an injunction pending appeal as moot, holding that the USDA was required to reject applications filed on behalf of deceased farmers. View "Black Farmers & Agriculturalists Ass'n v. Rollins" on Justia Law

Horace Meredith worked as a coal miner for several decades, with his last employment at Hobet Mining, Inc. During Meredith’s tenure at Hobet, Arch Coal Company, Inc. was Hobet’s parent company and provided self-insurance for black lung liabilities. Years after Meredith left Hobet and after Arch had sold Hobet to Magnum Coal (which was later acquired by Patriot Coal Company), Meredith filed a claim for black lung benefits. By the time of his claim, both Patriot and Hobet were defunct, and the Department of Labor sought to hold Arch liable for Meredith’s benefits, despite Arch no longer owning or insuring Hobet.After Meredith filed his claim, the district director designated Hobet as the responsible operator and Arch as the insurance carrier. Arch and Hobet contested this designation, arguing that Arch was no longer responsible for Hobet’s liabilities and that the Black Lung Disability Trust Fund should cover the claim. The Administrative Law Judge (ALJ) found Hobet to be the responsible operator and Arch liable as its self-insurer at the time of Meredith’s last employment. The Department of Labor’s Benefits Review Board affirmed the ALJ’s decision, holding Hobet and Arch liable for the claim.The United States Court of Appeals for the Fourth Circuit reviewed the Board’s decision. The court held that neither the Black Lung Benefits Act nor its regulations imposed liability on Arch under these circumstances. Specifically, the court found that Hobet did not meet the regulatory requirements to be a financially capable responsible operator, and Arch could not be held liable as a self-insurer for claims filed long after it ceased to own or insure Hobet. The Fourth Circuit granted the petition for review, vacated the Board’s decision, and remanded for further proceedings consistent with its opinion. View "Hobet Mining, Inc. v. Director, Office of Workers' Compensation Programs" on Justia Law

Catherine Baker was employed by San Mateo County as a Social Worker III but went on medical leave in 2009 due to back pain. In 2015, she returned to work in a different position as a screener trainee, which involved different duties but was compensated at the same pay rate as her original position. Her last paycheck was issued in January 2016. In 2017, Baker applied for a service-connected disability retirement, and the San Mateo County Employees Retirement Association (SamCERA) determined that the effective date for her retirement benefits should be January 22, 2016, the day after her last receipt of “regular compensation.”After SamCERA’s Board approved her application and set the effective date, Baker sought administrative review, arguing that her compensation as a screener trainee did not qualify as “regular compensation” under Government Code section 31724 because she had not returned to her original job. An administrative law judge recommended denial of her request to change the effective date, and the Board adopted this recommendation. Baker then filed a petition for writ of administrative mandamus in the Superior Court of San Mateo County, which denied the petition and confirmed the January 22, 2016 effective date.On appeal, the California Court of Appeal, First Appellate District, Division One, reviewed whether “regular compensation” under section 31724 included Baker’s pay as a screener trainee. Exercising independent judgment on statutory interpretation, the court held that “regular compensation” refers to regular salary or full wages, regardless of whether the position is the employee’s original job. Because Baker’s screener trainee pay matched her original position’s rate, it qualified as “regular compensation.” The court affirmed the trial court’s judgment, upholding the effective date set by SamCERA. View "Baker v. San Mateo County Employees Retirement Assn." on Justia Law

The plaintiff, a Nebraska resident, received Medicaid benefits administered by the Nebraska Department of Health and Human Services (NDHHS). In April 2024, she was sent a notice stating her Medicaid eligibility was ending due to income exceeding program standards. The notice informed her of her rights to request a conference or appeal and outlined the process for a fair hearing. She did not appeal the termination, and her coverage ended on May 1, 2024. Subsequently, she filed a federal lawsuit on behalf of herself and similarly situated individuals, alleging that the termination notices failed to meet due process requirements and seeking class certification, declaratory and injunctive relief, including reinstatement of benefits until proper notice was provided.The United States District Court for the District of Nebraska considered only her individual claims, as she did not challenge the court’s decision to exclude class claims on appeal. The district court denied her request for a temporary restraining order, finding she was unlikely to succeed because her claims sought retroactive relief barred by sovereign immunity and because the notices likely satisfied due process. The court then dismissed her complaint for lack of subject matter jurisdiction, concluding she had not alleged an ongoing violation of federal law and was not seeking prospective relief, as required to invoke the Ex parte Young exception to Eleventh Amendment immunity.The United States Court of Appeals for the Eighth Circuit reviewed the case and affirmed the district court’s dismissal. The Eighth Circuit held that the plaintiff’s alleged due process violation was a discrete past event—the issuance of the notice and termination of benefits—not an ongoing violation. The court further held that the relief sought was retrospective, not prospective, and thus barred by the Eleventh Amendment. The court concluded that the Ex parte Young exception did not apply, and affirmed the dismissal. View "Filyaw v. Corsi" on Justia Law