Justia Public Benefits Opinion Summaries

Sexton, a smoker, spent 25 years working in coal mines. He first applied for Black Lung Act (30 U.S.C. 901) benefits in 1973. The application was unsuccessful as were two other claims. In 2001, two years after the denial became final, Sexton filed a subsequent claim. The district director recommended an award of benefits. Buck Creek Coal requested a formal hearing. While his claim was pending Sexton died. His widow filed her own claim and the district director issued a proposed order awarding benefits in the survivor claim. Buck Creek requested a hearing. The administrative law judge considered four medical opinions, and based on that new evidence, determined that Sexton suffered a total disability from clinical and legal pneumoconiosis and that Sexton established a change in an applicable condition of entitlement pursuant to 20 C.F.R. 725.309 and awarded benefits. The Benefits Review Board affirmed with respect to Sexton’s claim and affirmed in part and vacated in part with respect to the survivor claim. The Sixth Circuit affirmed, holding that 20 C.F.R. 725.309 is valid and was correctly applied and that the Board’s decision did not violate principles of finality or res judicata. View "Buck Creek Coal Co. v. Sexton" on Justia Law

Plaintiff appealed the district court's decision affirming the Commissioner's denial of social security benefits. The court rejected plaintiff's contention to the extent that she alleged the ALJ failed to develop the record or make explicit findings regarding the mental and physical demands of her past relevant work as a factory packer and assembler. The court concluded that the ALJ had sufficient evidence on the record as a whole to reach his determination where the ALJ adequately compared the demands of plaintiff's past with her residual functioning capacity to perform light work, including with her manipulative limitations. Accordingly, the court affirmed the denial of benefits. View "Young v. Astrue" on Justia Law

Plaintiff-Appellant Pennie Keyes-Zachary appealed a district court order that affirmed the Commissioner's decision denying her applications for Social Security disability and Supplemental Security Income benefits. Plaintiff alleged disability based on, among other things, neck, back, shoulder, elbow, wrist, hand, and knee problems, accompanied by pain; hearing loss; urinary frequency; anger-management problems; depression; and anxiety. The ALJ upheld the denial of her application for benefits. The Appeals Council denied her request for review of the ALJ's decision, and she then appealed to the district court. The district court remanded the case to the ALJ for further consideration. After the second hearing, the ALJ determined that Plaintiff retained residual functional capacity to perform light work with certain restrictions, but that she was not disabled within the meaning of the Social Security Act. The Appeals Council declined jurisdiction, and the ALJ's decision was then deemed the Commissioner's final decision. On appeal Plaintiff raised two issues: (1) that the ALJ "failed to properly consider, evaluate and discuss the medical source evidence;" and (2) the ALJ "failed to perform a proper credibility determination." Upon review, the Tenth Circuit found no error in the ALJ's decision and affirmed the Commission's final determination in Plaintiff's case. View "Keyes-Zachary v. Astrue" on Justia Law

Adams worked in coal mines for 17 years, leaving A & E Coal in 1988, after 12 years, because he was having difficulty breathing. He has not worked since. Adams also smoked cigarettes for about 25 years, averaging a pack a day before quitting in 1998 or 1999. Adams filed his first claim for benefits under the Black Lung Benefits Act 30 U.S.C. 901 in 1988. His claim was denied: He did not prove that his pneumoconiosis was caused in part by his coal-mine work, or that his pneumoconiosis totally disabled him. In 2007, Adams filed a second claim. Two pulmonologists agreed that he was completely disabled, but disagreed on what lung diseases Adams had, and on what caused them. An Administrative Law Judge awarded benefits, finding that Adams had pneumoconiosis, that the disease was caused by Adams’s exposure to coal dust during his coal-mine employment, and that he was totally disabled because of the disease. The Benefits Review Board and the Third Circuit affirmed. Although the ALJ was not required to look at the preamble to the regulations to assess the doctors’ credibility, he was entitled to do so. View "A & E Coal Co. v. Adams" on Justia Law

Filus, a 50-year-old former truck driver, has twice applied for disability benefits under the Social Security Act, claiming that back problems have left him incapable of gainful employment. An administrative law judge concluded that Filus could perform some light work and denied his most recent application. The Seventh Circuit affirmed, holding that substantial evidence supports the denial. The ALJ adequately considered Filus’s testimony about the limiting effects of his pain along with his testimony that he regularly completed his daily household activities without any pain medication, not even over-the-counter products.View "Filus v. Astrue" on Justia Law

Banks worked as a coal miner for 17 years and smoked about one pack of cigarettes per day for 38 years. His employment ended in 1991. After two unsuccessful attempts, in 2003, Banks filed a claim for benefits under the Black Lung Benefits Act, which provides benefits to coal miners who become disabled due to pneumoconiosis, 30 U.S.C. 901. An ALJ found that Banks had shown a change in his condition and that he suffered from legal pneumoconiosis which substantially contributed to his total disability. Banks was awarded benefits and the Benefits Review Board affirmed. The Sixth Circuit affirmed, adopting the regulatory interpretation urged by the Director of the Office of Workers’ Compensation Programs. The ALJ relied on reasoned medical opinions. View "Cumberland River Coal Co. v. Banks" on Justia Law

Palmquist, a veteran, injured in a helicopter crash that caused residual brain injury, was entitled to preference in federal employment, 5 U.S.C. 2108(3)(C), 3309(1), 3313(2)(A). The VA hired him as a medical support assistant. Aichner was his supervisor. Palmquist applied for promotion but did not receive an interview. He believed that the VA had not honored his preference, and told Aichner that he was going to complain to the equal employment opportunity specialist and his congressman. He did so. Aichner and Palmquist maintained a generally positive relationship for the next two years, but Palmquist was sometimes preoccupied, left the unit during working hours to do personal business, distracted other employees, and used his computer for personal purposes. Palmquist sought a new position. An interview went well. Interviewers warned Palmquist against unsolicited post-interview contact, but he e-mailed both to reiterate his qualifications. Aichner gave a generally favorable recommendation, but the recommendation was one factor in Palmquist not getting the job. The court rejected his claim under the Rehabilitation Act, 29 U.S.C. 701-796. The First Circuit affirmed. The Act does not entitle a plaintiff to relief when retaliation for complaints about disability discrimination is a motivating factor in, but not the “but-for” cause of, adverse employment action. View "Palmquist v. Shinseki" on Justia Law

Gallo served as an FAA air traffic control specialist from 1982 until 1995 when she experienced a job-related injury for which she received OWCP benefits. Gallo recovered enough to return to light duty. In 1996 she lost her medical certification to continue as an operational ATCS. Until 2000 she was assigned to a “non-operational” automation specialist position, which did not provide the same retirement credit or weekend pay. She received OWCP benefits for the differential. Gallo fully recovered in 2000 and received medical clearance; the Agency terminated OWCP benefit. She applied for restoration under 5 U.S.C. 8151(b)(2), which provides the right to priority consideration for restoration to federal employees who have overcome a compensable injury. The Agency assigned Gallo to a supervisory ATCS position. In setting her salary, the Agency did not take into account pay increases granted to operational ATCS employees during while Gallo was working as an automation specialist. The Merit Systems Protection Board denied her claim. The Federal Circuit reversed. The Board erred in interpreting “resumes employment with the Federal Government” under section 8151(a), and any pay increases that Gallo would have received based on her creditable service time with the federal government are “benefits based on length of service.” View "Gallo v. Dep't of Transp." on Justia Law

Plaintiff Rebecca Gonzalez (Relator) brought a qui tam action under the False Claims Act (FCA) against Defendants, Fresenius Medical Care N.A., Fresenius Medical Care Holdings, Inc., Bio-Medical Applications of Texas, Inc. (collectively, Fresenius), and Dr. Alfonzo Chavez. Relator also brought retaliation claims against Fresenius and her former supervisor Larry Ramirez. The district court granted in part and denied in part Defendants' motions for judgment as a matter of law, and the jury returned a verdict in favor of Defendants on the remaining claims. The district court then awarded Fresenius $15,360 in attorney's fees from Relator's counsel. The Fifth Circuit Court of Appeals affirmed the district court's judgment in all instances, holding (1) the district court correctly granted Defendants' motion for judgment as a matter of law on Relator's FCA claims, and the court's FCA jury instructions were not in error; (2) the district court did not err in granting Defendants' motion for judgment as a matter of law on Relator's retaliation claims; and (3) the district court did not abuse its discretion in awarding sanctions under 28 U.S.C. 1927. View "Gonzalez v. Fresenius Med. Care N.A." on Justia Law

Brault applied for Disability Insurance Benefits in 2007, claiming that he became disabled in 2006 because of nerve damage in his left arm and a cervical spine injury he sustained in a motor-vehicle accident. After his application was denied initially and on reconsideration, he requested an administrative hearing. Brault’s counsel asserted a Daubert-like objection to the vocational expert’s testimony, contending it was unreliable. The ALJ never directly responded to the objections, but issued a ruling which relied on the VE’s testimony, agreed that positions existed in the eight DOT positions the VE had identified at the numbers the VE had given, and denied Brault’s application for benefits. The district court affirmed the denial. The Second Circuit affirmed, finding that the denial was supported by substantial evidence. The administrative law judge was not required to state expressly his reasons for accepting a vocational expert’s challenged testimony.View "Brault v. Soc. Sec. Admin." on Justia Law