Justia Public Benefits Opinion Summaries
Articles Posted in Government Law
Ennis v. N.D. Dep’t of Human Services
The North Dakota Department of Human Services ("the Department") appealed a district court judgment reversing the Department's order determining Edward Ennis was ineligible for continued Supplemental Nutrition Assistance Program ("SNAP") benefits. Ennis cross-appealed, challenging the district court's denial of his motion for costs. Ennis, self-employed, purchased a truck for $5,238 for use in his business. He paid for the truck in full and thus did not make ongoing payments. In March 2011, the County conducted a periodic recertification review to determine Ennis's continued eligibility for SNAP benefits. The County calculated his anticipated 2011 self-employment income based upon his actual 2010 self-employment income, without deducting the $5,238 expense for the truck. Based on this calculation, the County determined Ennis's anticipated 2011 income exceeded the income limit for SNAP benefits and issued a denial of benefits. Ennis appealed to the Department and requested a hearing. An administrative law judge ("ALJ") issued recommended findings of fact, conclusions of law and order determining that the purchase price of the truck should have been deducted from Ennis's anticipated 2011 self-employment income and recommending that the County's denial of further benefits be reversed. The executive director of the Department disagreed with the ALJ's recommendation and issued amended findings, conclusions and final order affirming the County's determination that Ennis was not entitled to further SNAP benefits. Ennis appealed to the district court, which reversed the Department's final order and reinstated the recommended findings of the ALJ. Upon review, the Supreme Court reversed the judgment and reinstated the Department's final order denying further benefits.
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Dahly v. Anderson
Wilfred Dahly appealed a district court judgment which affirmed a final order of the North Dakota Department of Human Services ("Department") which determined he was ineligible for Medicaid benefits. Upon review, the Supreme Court reversed and remanded, concluding the Department erred when it concluded the proceeds of the sale of Wilfred Dahly's home were an available asset which exceeded the asset limit for Medicaid eligibility.View "Dahly v. Anderson" on Justia Law
Posted in:
Government Law, Public Benefits
Id. Dept. of Health & Welfare v. McCormick
This appeal arose from a claim filed by the Idaho Department of Health and Welfare in the probate proceeding of George D. Perry, the deceased spouse of Medicaid recipient Martha J. Perry. The Department sought to recover funds under I.C. 56-218 from the sale of the couple’s home (their only significant asset) to recoup Medicaid benefits paid to Martha during her lifetime. The magistrate court disallowed the Department’s claim for recovery, finding that Martha had no interest in the real property because George, acting for Martha under a power of attorney, conveyed the property to himself before his death. That decision was upheld on appeal to the district court. The Department appealed to the Supreme Court. Upon review, the Court found that the district court erred in finding that federal law preempted the Department's ability to recover from George's estate what was once Martha's community property during the marriage. The Court reversed the district court and remanded the case for further proceedings.View "Id. Dept. of Health & Welfare v. McCormick" on Justia Law
Crawford v. Div. of Employment Sec.
Arnaz Crawford was fired from his job in January 2009. Crawford subsequently applied for Social Security disability benefits (SSDI benefits) due to a mental condition, but the social security administration (Administration) denied the claim. Meanwhile, Crawford applied for state unemployment benefits. The division of employment security (Division) awarded unemployment benefits to Crawford until March 20, 2010. On March 2, 2010, the Administration determined Crawford had been disabled and eligible for SSDI benefits since January 29, 2009. The Division subsequently determined (1) Crawford was unable to work from December 20, 2009 to March 20, 2010 and, therefore, was ineligible for unemployment compensation benefits; and (2) Crawford had received $3,080 in benefits that he was ineligible to receive. The labor and industrial relations commission (Commission) affirmed the determination that Crawford was ineligible for unemployment compensation benefits. The Supreme Court (1) reversed the Commission's decisions to the extent they authorized the Division to collect the overpayment from Crawford; but (2) otherwise affirmed the Commission's decision.View "Crawford v. Div. of Employment Sec." on Justia Law
Dilley v. City of Missoula
Plaintiff-Appellant John Dilley appealed the grant of summary judgment in favor of Defendant-Appellee City of Missoula. The district court concluded the City acted within its legal authority when it purchased the Missoula Civic Stadium with tax increment financing (TIF) funds designated for urban renewal. The stadium was originally planned and developed by Play Ball Missoula, Inc. (Play Ball), a volunteer, non-profit corporation organized for the purpose of bringing a minor league baseball team to Missoula. In 2000, Play Ball and the City entered a development agreement that permitted Play Ball to finance and construct a stadium on blighted City property and later convey the facility to the City. Plaintiff, acting pro se, filed suit prior to the City's acquisition of the stadium, alleging the planned purchase using TIF funds was an "illegal payoff of private enterprise debt." On appeal, Plaintiff argued that the district court erroneously failed to specify which provision under Title 7, Chapter 15, Part 42 of the Montana Code that permitted the "payoff." He also argued that the City could not make such an expenditure of TIF funds simply because the practice was not prohibited by statute. Finding that the City's use of TIF money to acquire the stadium was a proper exercise of its urban renewal posers, the Supreme Court affirmed the grant of summary judgment in the City's favor.
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Sheila Callahan & Friends, Inc. v. Montana
The State Department of Labor and Industry appealed a district court's order that reversed the Department's decision regarding Petitioner Sheila Callahan & Friends, Inc. (SC&F). SC&F, a radio broadcasting company entered into a one-year contract with Joni Mielke. During the term of employment, SC&F evaluated Mielke as being an excellent radio personality and announcer but as underperforming other responsibilities because she either did not want to do them or preferred announcing-related duties. Mielke elected not to renew her contract with SC&F, and on an exit interview form, Mielke indicated her reason for leaving was that she "quit." After Mielke left her employment with SC&F, she was hired by another radio station. After a brief employment with this subsequent employer, she was laid off and filed for unemployment benefits in October 2009. The Department of Labor sent a Notice of Chargeability Determination to SC&F assessing a pro rata share of the costs of Mielke’s unemployment insurance benefits to SC&F’s experience rating account. The Department administratively determined that Mielke was employed for SC&F on a contract basis during her base period of employment and that SC&F’s account was chargeable for a portion of benefits drawn by Mielke. SC&F requested a redetermination, arguing that Mielke had voluntarily left her employment. The Department issued a Redetermination affirming the initial Determination. An administrative hearing was then conducted by telephone; the hearing officer determined that Mielke neither voluntarily quit nor was discharged for misconduct and affirmed the decision to charge SC&F’s account. On appeal, the Department argued the District Court improperly failed to defer to the Board’s findings of facts. Upon review, the Supreme Court concluded that the error of the Board was primarily premised upon application of legal standards, in the nature of a conclusion of law. Given the inapplicability of the imputation rules to the situation here, the District Court properly concluded that the evidence did not support the Board’s determination that Mielke’s work separation was involuntary.
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In re E.B.
Infant was born with severe brain damage. Respondent, Infant's mother, on behalf of Infant, applied for and received Medicaid benefits from the West Virginia Department of Health and Human Resources (DHHR). Respondent later filed a medical malpractice lawsuit on behalf of Infant. Subsequently, Respondent petitioned the circuit court for approval of the settlement, requesting that Medicaid not be reimbursed. DHHR intervened. The court granted the motion of Respondent for allocation of the $3,600,000 settlement, holding that, pursuant to Arkansas Department of Health and Human Services v. Ahlborn, a proportional reduction of DHHR's recovery was required based on the ratio of the settlement to the "full value" of the case among the various damages categories. Using this allocation method, the court reduced DHHR's statutory reimbursement from the requested amount of $289,075 to $79,040 and directed that the net settlement proceeds be placed in a special needs trust for the benefit of Infant. The Supreme Court reversed in part and affirmed in part, holding (1) a $500,000 cap on noneconomic damages was applicable in this case; and (2) under the formula applied in Ahlborn, the DHHR was entitled to approximately $98,080, less its pro rata share of attorney's fees and costs. Remanded.View "In re E.B." on Justia Law
J.S. v. Hardy
Petitioner, J.S., was a thirteen-year-old boy who suffered from cerebral policy. Through his mother, J.S. submitted an authorization request for a power wheelchair with fifty-five accessories to the respondent, the state department of health and human resources (DHHR), which administers the Medicaid program in West Virginia. DHHR denied Petitioner's request on the basis that it exceeded the Medicaid policy of providing only the most economical equipment to meet a recipient's basic health care needs. The DHHR board of review upheld the denial. The circuit court upheld the decision. The Supreme Court reversed, holding that the circuit court applied an erroneous standard of review to the decision of the DHHR board of review. Remanded to the circuit court with direction to make an independent review of both the law and the facts of this case.View "J.S. v. Hardy" on Justia Law
Posted in:
Government Law, Public Benefits
Hall v. Employment Appeal Bd.
The Employment Appeal Board (Board) denied Willie Hall's application for unemployment insurance benefits. Hall filed a petition for judicial review. The district court affirmed the decision of the Board and assessed costs against Hall. The court of appeals affirmed. The Supreme Court reversed the portion of the judgment as it related to court costs, holding (1) pursuant to Iowa Code 96.15(2), any individual claiming benefits shall not be charged fees of any kind, including court costs, in a proceeding under the statute by a court or an officer of the court; and (2) therefore, the district court erred by requiring that Hall pay court costs.
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In re Pooled Advocate Trust
Pooled Advocate Trust, Inc. (PATI), the managing corporation for a Medicaid pooled trust, brought a declaratory judgment action on Medicaid eligibility issues associated with the trust and named the South Dakota Department of Social Services (DSS) as a necessary party. The circuit court granted declaratory judgment for PATI. Fred and Gladys Matthews transferred assets to the pooled trust. When the Matthews subsequently applied for Medicaid long-term care benefits, DSS imposed a penalty period because they were over age sixty-five at the time of the transfers. PATI petitioned for further relief, seeking a declaration that DSS could not impose penalty periods for transfers made by pooled trust beneficiaries age sixty-five or older. The circuit court granted PATI's petition. The Matthews also appealed DSS's application of a penalty period, but an ALJ upheld the decision and another circuit court affirmed. DSS appealed the circuit court's order granting PATI's petition and the Matthews appealed the other circuit court's affirmance of the ALJ's ruling. The Supreme Court affirmed the administrative appeal and reversed the declaratory judgment, holding that transfers of assets into pooled trusts by beneficiaries age sixty-five or older may be subject to a transfer penalty period for Medicaid eligibility purposes.View "In re Pooled Advocate Trust" on Justia Law