Justia Public Benefits Opinion Summaries

Deborah Dorr requested to reopen an unemployment appeal hearing that was to address Dorr’s appeal of the Idaho Department of Labor’s (“IDOL”) decision denying Dorr’s request to backdate her Pandemic Unemployment Assistance claim. After Dorr failed to appear at the hearing, IDOL dismissed her appeal and subsequently denied her request to reopen the hearing. Dorr appealed IDOL’s denial of her request to reopen, and the Idaho Industrial Commission (“the Commission”) affirmed. The Commission determined due process was satisfied and agreed with IDOL that Dorr’s own negligence was insufficient cause to reopen the hearing. Appealing pro se, Dorr petitioned the Idaho Supreme Court for relief. The Supreme Court concluded Dorr’s briefing did not meet the standard for an appeal under Idaho Appellate Rule 35(a)(6) and as such, her arguments were forfeited. The Commission’s decision upholding the Appeal Examiner’s denial of Dorr’s request to reopen her appeal hearing was affirmed. View "Dorr v. IDOL" on Justia Law

Milhem applied for Social Security disability insurance benefits, alleging that several conditions limited her ability to work. Milihem, age 38, had completed three years of college and had previously worked as a canvasser, receptionist, portrait photographer, and graphic designer. A vocational expert concluded that the evidence supported limiting Milhem’s work to that which can be learned in 30 days or less, that Milhem could stand or walk for at least two hours in an eight-hour workday, and that Milhem “could make judgments commensurate with functions of simple, repetitive tasks”; such an individual could not perform Milhem’s past work, but could work as a router, price marker, and cafeteria attendant, of which there were approximately 53,000, 307,000, and 63,000 jobs in the national economy, respectively. Changing the exertion level to sedentary, the expert testified, would include the work of an addresser, table worker, or document preparer, of which there were approximately 19,000, 23,000, and 47,000 jobs in the national economy, respectively.Based on this testimony, and “considering [Milhem’s] age, education, work experience, and residual functional capacity,” the ALJ found that there were a significant number of jobs that Milhem could perform, so Milhem was not under a qualifying disability. The district court upheld that determination. The Seventh Circuit affirmed. A reasonable person would accept 89,000 jobs in the national economy, a figure supported by substantial evidence, as a significant number. Other circuits have accepted similar numbers as significant. View "Milhem v. Kijakazi" on Justia Law

With the agreement of her supervisor, Johar, a salesperson, left work for about a week to care for a terminally ill relative. While she was away her employer (SWS) decided she had quit. Upon her return, SWS stated business was slow and gave her no new sales appointments. Johar sought unemployment benefits, citing a “temporary layoff.” SWS denied laying Johar off. While conceding that she left with her supervisor’s approval, SWS claimed that Johar’s failure to provide a return date or otherwise communicate with her supervisor while she was away amounted to a voluntary quit. The Employment Development Department agreed, found Johar ineligible for unemployment benefits, ordered reimbursement of benefits improperly paid, and imposed a penalty for willful misrepresentation. The California Unemployment Insurance Appeals Board (CUIAB) affirmed.After Johar sought judicial review, CUIAB confessed error for failing to consider new evidence discovered by Johar while the administrative appeal was pending. The court dismissed the case without reaching the merits. The court of appeal reversed. Johar was entitled to relief on the existing record. She left her job in emergency circumstances with the employer’s approval, thus for good cause; an employee who leaves work for good cause is presumed to have not voluntarily quit. SWS’ evidence did not establish that Johar positively repudiated her obligation to return in clear terms. View "Johar v. California Unemployment Insurance Appeals Board" on Justia Law

Clemons worked as a coal miner for 10 years and smoked two packs per day for 30 years. Clemons suffered and died from COPD. His claims for federal black-lung benefits (30 U.S.C. 901) were denied. An ALJ awarded Mrs. Clemons survivor’s benefits after considering three medical opinions. Dr. Sikder diagnosed Clemons with legal pneumoconiosis in the form of COPD that resulted from both cigarette smoking and from coal-mine dust exposure. Doctros Habre and Broudy attributed Clemons’s COPD solely to his cigarette smoking. The ALJ credited Sikder’s opinion as well-documented, well-reasoned, and supported by substantial evidence, irrespective of the length of coal mine employment she considered, so that opinion was accorded “probative weight” while the other opinions did not sufficiently explain why Clemons’s coal-mine dust exposure did not contribute “at least in part” to his COPD. The Benefits Review Board affirmed, concluding that the evidence was sufficient to establish the presence of legal pneumoconiosis.The Sixth Circuit denied a petition for review, finding that the ALJ took the coal mine employment discrepancy into account when he weighed Dr. Sikder’s opinion, and acted within his discretion in explaining that the discrepancy was not so great as to detract from the opinion’s probative value. View "Huscoal, Inc. v. Director, Office of Workers’ Compensation Programs, United States Department of Labor" on Justia Law

Robert Procive appealed when a district court dismissed his appeal of an Administrative Law Judge’s order that denied his claim for Workforce Safety and Insurance (“WSI”) benefits. Procive submitted his first claim in 2020, alleging he suffered carpal tunnel syndrome due to injuries to both wrists, elbows, and shoulders resulting from repetitive digging, hammering and driving stakes, steel posts, and iron rods into the ground. He claimed his original injury occurred in western North Dakota, and he notified his employer of his injury in November 2004 and October 2016. WSI accepted liability for Procive’s right carpal tunnel injury, but denied for the left. Later WSI issued its order reversing its acceptance of liability for the right carpal tunnel, finding Procive willfully made false statements about whether he had prior injuries or received treatment. WSI ordered Procive to repay past benefits he received. After a hearing the ALJ affirmed WSI’s decisions denying coverage. Procive appealed to the district court in Stutsman County. WSI moved to dismiss the appeal, arguing the district court lacked subject matter jurisdiction because Procive was required to file his appeal in the county where the injury occurred or the county where he resided. To this, the North Dakota Supreme Court affirmed, finding the district court did not have jurisdiction. View "Procive v. WSI" on Justia Law

Grant Bauserman, Karl Williams, and Teddy Broe, on behalf of themselves and all others similarly situated, brought a putative class action in the Michigan Court of Claims against the Unemployment Insurance Agency, alleging that the Agency violated their due-process rights, and that the Agency also engaged in unlawful collection practices. Plaintiffs, who were all recipients of unemployment compensation benefits, specifically alleged defendant had used an automated fraud-detection system, the Michigan Integrated Data Automated System (MiDAS), to determine that plaintiffs had received unemployment benefits for which they were not eligible and then garnished plaintiffs’ wages and tax refunds to recover the amount of the alleged overpayments, interest, and penalties that defendant had assessed without providing meaningful notice or an opportunity to be heard. Among other remedies for this constitutional violation, plaintiffs sought monetary damages. Although the Michigan Supreme Court had never specifically held that monetary damages were available to remedy constitutional torts, the Court now held that they were. “Inherent in the judiciary’s power is the ability to recognize remedies, including monetary damages, to compensate those aggrieved by the state, whether pursuant to an official policy or not, for violating the Michigan Constitution unless the Constitution has specifically delegated enforcement of the constitutional right at issue to the Legislature or the Legislature has enacted an adequate remedy for the constitutional violation. Because enforcement of Const 1963, art 1, § 17 has not been delegated to the Legislature and because no other adequate remedy exists to redress the alleged violations of plaintiffs’ rights, we agree that plaintiffs have alleged a cognizable constitutional-tort claim for which they may recover money damages and we agree with the lower courts that defendant was properly denied summary disposition.” View "Bauserman v. Unemployment Insurance Agency" on Justia Law

Patricia Allen appealed the Idaho Industrial Commission’s (the “Commission”) decision denying unemployment benefits. Allen was employed by Partners in Healthcare, Inc., doing business as North Canyon Medical Center (“NCMC”), between February 5, 1999, and May 8, 2020. On May 8, 2020, the CEO of NCMC and the HR director met with Allen to discuss her job performance. Allen was presented with a performance improvement plan (“PIP”), which outlined examples of Allen’s poor job performance and identified expectations for improving her performance. It was explained to Allen that if she wanted to forego the PIP, she could sign a severance agreement. Allen was then presented with a proposed severance agreement. Allen asked if she could discuss her options with her husband, but was pressed to make her decision then and there. The CEO told Allen that he thought it was in her best interest to take the severance package. Allen decided to forgo the PIP and took the severance agreement. After separating from NCMC, Allen filed an unemployment claim with the Idaho Department of Labor (“IDOL”). NCMC’s response to the Idaho Department of Labor was prepared by the Idaho Hospital Association (“IHA”), NCMC’s third-party administrator. IHA’s human resources director identified Allen’s reason for separation as “Fired/Discharged” and indicated Allen did not receive any compensation after her separation. IDOL determined Allen was eligible for unemployment benefits. NCMC’s HR director appealed the IDOL decision; IDOL sent NCMC and Allen a hearing notice on whether Allen quit voluntarily and, if so, whether she quit for good cause or was discharged for misconduct in connection with her employment. Following the hearing, the appeals examiner issued a written decision that denied Allen unemployment benefits. The examiner also found that Allen did not follow the grievance procedures to report her issues with her supervisor prior to quitting. In reversing the Commission’s decision, the Idaho Supreme Court concluded the Commission erred in failing to analyze whether the PIP was a viable option that would have allowed Allen to continue working. The matter was remanded for further proceedings. View "Allen v. Partners in Healthcare, Inc." on Justia Law

The State redesigned the dental insurance plan offered to public retirees in 2014, narrowing coverage but also decreasing premiums paid by retirees. The Retired Public Employees of Alaska challenged the redesign. After a bench trial the superior court concluded that the new plan unconstitutionally diminished retirees’ accrued benefits. The State appealed, arguing that the superior court erred by determining the dental plan was a constitutionally protected “accrued benefit” and by refusing to consider premium rates for retirees as relevant to the diminishment analysis. The Alaska Supreme Court agreed with the State on the second point only: "The Alaska Constitution does protect public retirees’ option to purchase dental insurance as an accrued benefit, but both coverage for retirees and price to retirees influence the value of this option." The Court therefore vacated and remanded for the superior court to reevaluate the plan changes and incorporate premium pricing into its analysis. View "Tshibaka v. Retired Public Employees of Alaska, Inc." on Justia Law

For almost 30 years, Prill worked for the Eau Claire, Wisconsin County Highway Department performing physically demanding work, including driving a dump truck and maintaining roads. She suffered from pain in her lower back and knees, which was exacerbated by a car accident and multiple work injuries. Prill retired in 2014 and later filed for Social Security disability benefits alleging she could no longer perform heavy or medium work. Several doctors examined Prill or reviewed her medical records but reached different conclusions about her physical limitations.An ALJ found Prill’s testimony only partially credible, concluding that her report about the severity of her symptoms and the extent of her limitations was inconsistent with other record evidence. The ALJ also weighed the competing medical evidence and gave greater weight to the opinions of consulting physicians who reviewed Prill’s medical records than to the opinion of Prill’s treating physician. The ALJ concluded that Prill had not been disabled since August 2014. The Appeals Council of the Social Security Administration denied her request for review. The district court and Seventh Circuit affirmed. Substantial evidence supported the ALJ’s decision. The court rejected arguments the ALJ wrongly discounted Prill’s subjective allegations and improperly weighed the differing medical opinions. View "Prill v. Kijakazi" on Justia Law

Social Security retirement benefits are calculated using a formula based on past earnings, 42 U.S.C. 415(a)(1)(A). Under the “windfall elimination” provision, benefits are reduced when a retiree receives a separate pension payment based on employment not subject to Social Security taxes. Pension payments exempt from the windfall reduction include those "based wholly on service as a member of a uniformed service.”A “military technician (dual status),” 10 U.S.C. 10216, is a “civilian employee” assisting the National Guard. Such technicians are required to maintain National Guard membership and must wear uniforms while working. For their work as full-time civilian technicians, they receive civil-service pay. If hired before 1984, they receive Civil Service Retirement System pension payments. As part-time National Guard members, they receive military pay and pension payments from a different arm of the government.The SSA applied the windfall elimination provision to the benefits calculation for Babcock, a dual-status technician. The district court and Sixth Circuit upheld that decision, declining to apply the uniformed-services exception.The Supreme Court affirmed. Civil Service Retirement System pensions generally trigger the windfall provision. Babcock’s technician work was not service “as” a National Guard member. A condition of employment is not the same as the capacity in which one serves. The statute states: “For purposes of this section and any other provision of law,” a technician “is” a “civilian employee,” “authorized and accounted for as” a “civilian.” While working in a civilian capacity, technicians are not subject to the Uniform Code of Military Justice. They possess characteristically civilian rights concerning employment discrimination, workers’ compensation, disability benefits, and overtime work; technicians hired before 1984 are “civil service” members, entitled to pensions as civil servants. Babcock’s civil-service pension payments are not based on his National Guard service, for which he received separate military pension payments. View "Babcock v. Kijakazi" on Justia Law