Justia Public Benefits Opinion Summaries

Articles Posted in Kentucky Supreme Court
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In this interlocutory appeal from the circuit court’s review of an agency ruling, the Supreme Court adopted the United States Supreme Court’s test for standing as set forth in Lujan v. Defenders of Wildlife, 504 U.S. 555, 560-561 (1992) and held that the existence of a plaintiff’s standing is a constitutional requirement to prosecute any action in the courts of the Commonwealth, including seeking judicial review of an administrative agency’s final order.The putative petitioner in this case, a Medicaid beneficiary (the patient), sought judicial review of a final order of the Kentucky Cabinet for Health and Human Services ruling that the patient lacked standing to pursue an appeal of an insurer’s denial of reimbursement to a hospital for the patient’s services. The hospital, acting as the patient’s representative, sought judicial review of the Cabinet’s final order. The circuit court denied the Cabinet and the insurer’s motions to dismiss the petition. The Supreme Court remanded the case with instructions to dismiss the case, holding (1) Kentucky courts have the responsibility to ascertain whether a plaintiff has constitutional standing to pursue the case in court; and (2) under that test, the patient did not have the requisite constitutional standing to pursue her case in the courts of the Commonwealth. View "Commonwealth v. Sexton" on Justia Law

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Charles Wimberly filed an application for disability retirement benefits with the Kentucky Retirement Systems (KERS). A hearing officer recommended that Wimberly's application be denied and, before KERS could render a final decision, Wimberly filed a second application pursuant to Kentucky Revised Statute (KRS) 61.600(2). Following the recommendation of another hearing officer, KERS denied that application. Wimberly sought judicial review; the circuit court reversed KERS. KERS appealed to the Court of Appeals, which affirmed the circuit court. The Supreme Court granted discretionary review to address the parties' arguments regarding the application of the doctrine of res judicata and to determine whether the consumption of alcohol was or could be a pre-existing condition. Having reviewed the record and the arguments of the parties, the Supreme Court affirmed. View "Kentucky Retirement Systems v. Wimberly" on Justia Law

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Dianne Carson first filed an application for retirement disability benefits in November 2007. Based on the recommendation of a hearing officer, the Kentucky Retirement Systems (KERS) denied Carson's claim. Carson did not seek judicial review of KERS's order, choosing instead to file a second application in October 2009. Based on a recommendation of a different hearing officer, KERS again denied Carson's claim. Carson sought judicial review and the circuit reversed and remanded with instructions for KERS to consider all of the medical evidence Carson submitted. The Court of Appeals affirmed. KERS argued that Carson's second application should have been dismissed under the doctrine of res judicata. "If res judicata applied to this action, Carson would have been barred from filing a second application that was based on the same claim as her first application. However, KRS 61.600(2) requires KERS to accept an employee's timely filed "reapplication based on the same claim of incapacity" and to reconsider the claim 'for disability if accompanied by new objective medical evidence.'" This case was remanded for KERS to undertake the correct review of the evidence. The Supreme Court affirmed the Court of Appeals. View "Kentycky Retirement Systems v. Carson" on Justia Law

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The Cabinet for Health and Family Services filed a motion to hold Renee Ivy in contempt after Ivy fell behind in her child support payments. At the hearing on the motion, Ivy presented evidence that her sole source of income was a federal benefit under the Supplemental Security Income program (SSI). The trial court reduced Ivy's support obligation and held her in contempt for having failed to pay the past due amount. The court of appeals reversed, holding that the contempt finding and the order to pay even reduced child support could not stand because evidence showed Ivy did not have the ability to pay. The Supreme Court (1) reversed the court of appeals' decision to the extent that it suggested that a SSI recipient-parent's present inability to pay precludes even the assessment of child support; (2) vacated the existing order and remanded for the family court to determine if the guidelines-based amount would be unjust or inappropriate pursuant to Ky. Rev. Stat. 403.211(2); and (3) affirmed the holding that a contempt finding was inappropriate here where there was essentially uncontroverted evidence that Ivy's failure to provide child support stemmed only from her inability to do so. View "Cabinet for Health & Family Servs. v. Ivy" on Justia Law