Justia Public Benefits Opinion Summaries

Sprinkle served in the U.S. Army, 1973-1974. While in the service, he was diagnosed with schizophrenia and prescribed a high dose of Thorazine®. In 1990, Sprinkle was diagnosed with mitral valve prolapse and chorea, a movement disorder similar to benign familial myoclonus. He succeeded in establishing entitlement to disability compensation before the Social Security Administration, the VA Regional Office awarded. Sprinkle a non-service-connected pension on effective 1990. In 2001, he sought a service connection for mitral valve prolapse and myoclonus, claiming that he was incorrectly diagnosed with schizophrenia and that the high doses of Thorazine® worsened his mitral valve prolapse and caused his myoclonus.The Regional Office denied the application. The Board of Veterans’ Appeals agreed and the Veterans’ Court affirmed. The Federal Circuit affirmed, holding that Sprinkle was not denied fair process as it related to responding to a medical exam ordered by the Board.View "Sprinkle v. Shinseki" on Justia Law

In 2001, Wagner, who served in the Navy for 23 years, sought disability compensation for a thyroid disorder that he claimed was contracted or aggravated in the line of duty. He finally prevailed in 2009, then timely filed an application for $11,710.57 in fees pursuant to the Equal Access to Justice Act (EAJA), 28 U.S.C. 2412.In October, 2009, the Veterans Court awarded $8,601.80, which gave the government all the reductions it sought except for 3.2 hours of work. Wagner filed his first supplemental application 12 days later, seeking $2,458.90 in fees for defending the original application against the government’s reasonableness challenges. The Veterans Court vacillated, then denied entry of judgment on the October 2009 fee award on the original fee application, and denied the first supplemental application. The Federal Circuit reversed in April 2011. On remand the Veterans Court granted Wagner’s first supplemental application for $2,458.90. The Federal Circuit vacated the denial of Wagner’s motion for the entry of a judgment and mandate regarding the 2009 and 2011 fee awards and affirmed the judgment regarding Wagner’s second supplemental application. View "Wagner v. Shinseki" on Justia Law

Williams had worked at Marathon’s Ashland, Kentucky, facility for 25 years, most recently as a senior barge welder. Williams alleged that he sustained a long thoracic nerve injury to his right shoulder while replacing parts of a barge in 2003. His injury was likely the result of the cumulative effect of his heavy lifting. Williams has not returned to work and has been seen by several physicians, but they do not agree on a common diagnosis. Following a remand the Benefits Review Board of the U.S. Department of Labor affirmed an administrative law judge’s award of permanent and total disability benefits under the Longshore and Harbor Workers’ Compensation Act, 33 U.S.C. 901. On a second appeal, the Sixth Circuit affirmed, finding that Williams is permanently and totally disabled and is unable to perform the alternative employment identified by Marathon’s vocational expert. The court granted Williams leave to seek attorney fees under 33 U.S.C. 928(a). View "Marathon Ashland Petroleum v. Williams" on Justia Law

Burris worked in coal mines for 23 years. He twice sought benefits under the Black Lung Benefits Act, 30 U.S.C. 901, abandoning his first claim in 2001, and pursuing a second claim in 2006. After a hearing on the second claim, an Administrative Law Judge determined that Burris was totally disabled by pneumoconiosis arising from his coal mining employment and that he qualified for benefits. The Benefits Review Board affirmed. The Seventh Circuit denied a petition for review, rejecting arguments that the ALJ erred in finding that Burris established a material change in condition following his first, abandoned claim; in concluding that Burris proved 15 years of surface mine employment in conditions substantially similar to those that exist in underground mines; and in rejecting evidence rebutting a presumption of pneumoconiosis. View "Consolidation Coal Co. v. Dir., Office of Workers' Comp. Programs" on Justia Law

Schomas, 54 years old, suffers from scoliosis and degenerative disc disease. Following a hearing, the Social Security Administration denied his application for Disability Insurance Benefits. The district court and the Seventh Circuit upheld the denial, rejecting a challenge to the ALJ’s credibility finding and assessment of his residual functional capacity. The court acknowledged that the ALJ’s decision was “problematic,” but concluded that Schomas waived most of his arguments, and that the rest were unfocused or undeveloped. View "Schomas v. Astrue" on Justia Law

Veterans sought disability compensation for post-traumatic stress disorder (PTSD) allegedly caused by sexual assaults that occurred during service. Their service records do not reflect any reports of the alleged sexual assaults. The VA Regional Office, Board of Veterans’ Claims, and the Court of Appeals for Veterans Claims rejected the claims in part on the ground that the service records did not include reports of the alleged assaults, and because the veterans stated that the assaults were never reported to military authorities. The Federal Circuit vacated and remanded, holding that the absence of a service record documenting an unreported sexual assault is not pertinent evidence that the sexual assault did not occur; the Board and Veterans Court may not rely on failure to report an in-service sexual assault to military authorities as pertinent evidence that the sexual assault did not occur. View "AZ v. Shinseki" on Justia Law

Plaintiffs, employees of Coca-Cola, suffered work-related injuries and applied for workers’ compensation benefits through Sedgwick, Coca-Cola’s third-party benefit claims administrator. Sedgwick disputed the claims. Plaintiffs claim that Coca-Cola and Sedgwick “engaged in a fraudulent scheme involving the mail . . . to avoid paying benefits to injured employees,” and filed suit under the civil remedies provision of the Racketeer Influenced and Corrupt Organizations Act (RICO), 18 U.S.C. 1962(c). The district court dismissed. On rehearing, en banc, the Sixth Circuit affirmed, holding that the plaintiffs did not plead an injury to their “business or property” that is compensable under RICO. The RICO theory advanced in this case would throw the viability of workers’ compensation schemes into doubt; RICO “does not purport to afford remedies for all torts committed by or against persons engaged in interstate commerce.” The Michigan workers’ compensation scheme provides ample mechanisms by which the employee can contest denials. View "Jackson. Segwick Claims Mgmt. Servs." on Justia Law

Kit Carson was born in May 1996, and received numerous vaccinations during his first year of life. At his 18-month and 24-month check-ups, Kit’s pediatricians noted that his speech was delayed. Following his three-year check-up, Kit was referred for evaluation and diagnosed with autism spectrum disorder in 2001. His parents sought compensation under the National Childhood Vaccine Injury Act, 42 U.S.C. 300aa, in 2002. A Special Master concluded that the first symptoms of Kit’s disorder were recorded in May 1999 and that the claim was not filed within the 36-month limitations period. The Federal Circuit affirmed, rejecting an argument that speech delay cannot be a “first symptom” because it is an insufficient basis for a diagnosis of autism. View "Carson v. Sec'y, Health & Human Servs." on Justia Law

A 2010 fire at an apartment in Erie, Pennsylvania took the lives of a tenant and her guest. The third-floor bedroom purportedly lacked a smoke detector and an alternate means of egress, both of which are required under the Section 8 housing choice voucher program (42 U.S.C. 1437f) in which Richardson participated. The district court rejected a defense of qualified immunity in a suit under 42 U.S.C. 1983 by the estates of the deceased. The Third Circuit reversed. State officials’ approval and subsidization of the apartment for the Section 8 program, even though the apartment allegedly failed to comply with Section 8’s standards, did not constitute a state-created danger toward the apartment’s tenant and her guest in violation of their constitutional substantive due process rights. View "Henry v. City of Erie" on Justia Law

In a social security disability or Supplemental Security Income (SSI) case, an administrative law judge (ALJ) must evaluate the effect of a claimant's mental impairments on her ability to work using a "special technique" prescribed by the Commissioner's regulations. At the second step of a five-step analysis, the ALJ must determine whether the mental impairment is "severe" or "not severe." If "not," then the ALJ must determine and discuss them as part of his residual functional capacity (RFC) analysis at step four. A question that is frequently encountered in social security disability appeals cases is how much further discussion of a non-severe impairment is required at step four? The Tenth Circuit found that in assessing the claimant's RFC, the ALJ must consider the combined effect of all of the claimant's medically determinable impairments; the Commissioner's procedures do not permit the ALJ to simply rely on his finding of non-severity as a substitute for a proper RFC analysis. In this case, the ALJ found that Petitioner's alleged mental impairments were medically determinable but non-severe. He then used language suggesting he had excluded them from consideration as part of his RFC assessment, based on his determination of non-severity. Under the regulations, however, a finding of non-severity alone would not support a decision to prepare an RFC assessment omitting any mental restriction. The ALJ's specific conclusions he reached in this portion of his analysis were unsupported by substantial evidence. Accordingly, the Tenth Circuit reversed the district court's affirmance of the ALJ's decision and remand to the district court with instructions to remand to the Commissioner for further proceedings at step four. View "Wells v. Colvin" on Justia Law