Justia Public Benefits Opinion Summaries

Plaintiff, a retired "dual status technician" with the National Guard, argues that the civil service pension he received in connection with his employment as a dual status technician – a civilian position that requires concurrent National Guard membership – is not subject to reduction under the Social Security Act's Windfall Elimination Provision because the pension falls within an exception applicable to payments based wholly on work performed as a member of a uniformed service. The district court granted summary judgment to plaintiff and the Administration appealed.The Second Circuit reversed the Administration's calculation of plaintiff's Social Security retirement benefits. The court read the plain language of the statute and used traditional tools of statutory interpretation, holding that a civil service pension based on federal civilian employment as a dual status technician does not fall within the uniformed service exception. Therefore, the court remanded for further proceedings consistent with the court's opinion. View "Linza v. Saul" on Justia Law

McAllister injured his knee while working as a sous chef for a restaurant. The injury occurred as he stood up from a kneeling position while attempting to retrieve food that had been misplaced in the cooler. He had previously had surgery on the knee and had received workers’ compensation benefits at that time. An arbitrator awarded him workers’ compensation benefits but the Illinois Workers’ Compensation Commission reversed, finding that the injury did not “arise out of” his employment. The circuit court and the Appellate Court, Workers’ Compensation Commission Division, affirmed.The Illinois Supreme Court reversed. The injury arose out of an employment-related risk; the acts that caused the injury were risks incident to his employment because these were acts his employer might reasonably expect him to perform in fulfilling his assigned job duties. McAllister was responsible for arranging the walk-in cooler and had a duty to find misplaced food. The court overruled certain cases to the extent that they held that injuries attributable to common bodily movements or routine everyday activities, such as bending, twisting, reaching, or standing up from a kneeling position, are not compensable unless a claimant can prove that he was exposed to a risk of injury from these common bodily movements or routine everyday activities to a greater extent than the general public. View "McAllister v. Illinois Workers' Compensation Commission" on Justia Law

In 1983, Rice sought benefits under the Black Lung Benefits Act (BLBA), 30 U.S.C. 901–45. The Department of Labor (DOL) looks to employers that employed the miner for at least one year and are capable of paying benefits. The miner’s most recent employer that meets these requirements is the “responsible operator.” Employers must either qualify as a self-insurer or purchase BLBA insurance. KRCC operated a coal mine where Rice worked in 1982-1983 but he was employed by a separate corporate entity, KRMS, which charged KRCC for the cost of Rice’s labor. The entities' ownership and management overlapped; KRMS had no assets and operated out of KRCC's offices. KRCC obtained BLBA coverage from Bituminous Casualty but only listed 10 employees. The other 150 were employed by KRMS. An ALJ identified KRMS as the responsible operator, then denied Rice’s claim on the merits. Rice appealed; KRCC and Bituminous successfully moved to be dismissed from the case, because the ALJ identified KRMS as the responsible operator.In 2002, Rice filed another BLBA claim. DOL again notified KRCC and Bituminous that KRCC might be the responsible operator. Bituminous claims it “denied coverage based on the fraudulent arrangements” between KRCC and KRMS. DOL refused to dismiss Bituminous.The Sixth Circuit affirmed, rejecting arguments that DOL was collaterally estopped from finding that KRCC was the responsible operator; that Bituminous was entitled to rescind its insurance agreement based on fraud by KRCC; and that delays in DOL administrative proceedings violated its right to due process. View "Karst Robbins Coal Co. v. Director, Office of Workers’ Compensation Programs" on Justia Law

The California State Teachers’ Retirement System (CalSTRS) determined that Ernest Moreno’s retirement benefits had been incorrectly calculated and initiated proceedings to adjust Moreno’s retirement benefits and collect the overpayment. The trial court denied Moreno’s petition for writ of administrative mandamus challenging the CalSTRS actions. Moreno appealed, contending: (1) CalSTRS’s adjustment of his retirement benefits and collection of the overpayment were barred by the statute of limitations found in Education Code section 22008 (c) because CalSTRS was on inquiry notice of the problem as early as 2008; and (2) CalSTRS should have been equitably estopped from adjusting his retirement benefits and collecting the overpayments. After review, the Court of Appeal concluded: (1) CalSTRS was not on inquiry notice of the reporting error that led to overpayment until December 2014 when it began an audit of Moreno’s retirement benefits, and, therefore, CalSTRS’s adjustments to Moreno’s retirement benefits and collection of overpayments were not barred by the statute of limitations; and (2) CalSTRS was not equitably estopped because CalSTRS was not apprised of (or on notice about) the overpayments until December 2014. View "Moreno v. Cal. State Teachers' Retirement System" on Justia Law

At issue in this case was the correct interpretation of Ariz. Rev. Stat. 23-750(E)(5), which provides that income earned by any individual who performed certain services while employed by an entity that provides such services to or on behalf of an "educational institution" cannot be used to qualify for unemployment during breaks between academic terms if that person is guaranteed reemployment.Plaintiffs were employees of Chicanos For La Cause (CPLC), a nonprofit corporation that administered federally funded Early Head Start and Migrant Seasonal Head Start programs and provided services to help school districts comply with their obligations under the Individuals with Disabilities Education Act (IDEA), 20 U.S.C. 1400 et seq. When the summer break began, Plaintiffs applied for unemployment insurance benefits from Arizona Department of Economic Security (ADES), which granted benefits. The ADES Appeals Board reversed. The Supreme Court remanded the case to ADES to award unemployment benefits to two plaintiffs and for further proceedings to resolve the claims of the remaining plaintiffs, holding that section 23-750(E)(5) applies to plaintiffs only if they performed services for CPLC that CPLC supplied to the school districts. View "Rosas v. Arizona Department of Economic Security" on Justia Law

Ehnert was placed at WPP by Staffmark as a temporary general laborer. It was understood that Ehnert would be considered for hire as a WPP employee. Ehnert suffered from various medical conditions but never requested accommodations. On May 23, 2012—the last day of his work placement—Ehnert was informed that he would not be hired by WPP. Ehnert completed applied for social security disability insurance (SSDI) benefits, representing that he had been unable to work due to a “disabling condition” since May 21, 2012. An ALJ granted Ehnert benefits. Ehnert then sued WPP and Staffmark, alleging discrimination on the basis of disability and age, under the Americans with Disabilities Act, the Pennsylvania Human Relations Act, and the Age Discrimination in Employment Act.The Third Circuit affirmed summary judgment for the defendants. Ehnert was unable to establish a prima facie case of discrimination because a necessary element was lacking for his ADA and PHRA claims--that he was otherwise qualified to perform the essential functions of the job as of the date WPP informed him that he would not be hired. Ehnert’s statements regarding his disability for SSDI purposes preclude his subsequent claim that, for the purposes of the ADA and the PHRA, he was “qualified” for the position; Ehnert failed to advance a reasonable explanation that reconciles those positions. View "Ehnert v. Washington Penn Plastic Co Inc." on Justia Law

Justice, employed as a workers’ compensation claims adjuster since 1991, fell at work in 2011 and injured her left knee. She later developed problems in her right knee, which was found to be a compensable consequence of the first injury. In 2012-2013 Justice had total bilateral knee replacement. Dr. Anderson, an orthopedic surgeon, testified that there was significant preinjury degeneration in both knees, that knee replacement was not required because of the meniscus tear, and that the fall “hasten[ed]” the need for knee replacement by “lighting up the underlying pathology.” Anderson apportioned 50 percent of the bilateral knee disability to the nonindustrial, preexisting degeneration. The workers’ compensation judge determined that Justice had sustained permanent partial disability of 48 percent, worth $59,110.00, stating that “the need for these surgeries was at least partially non-industrial. … the surgeries appear to have significantly increased [Justice’s] ability to walk and engage in weight-bearing activities. The judge stated that before the 2017 Hikida decision, he would have awarded permanent disability with 50% apportionment but that Hikida precluded apportionment. The Appeals Board affirmed.The court of appeal annulled the decision. Justice's permanent disability should have been apportioned between industrial and nonindustrial causes. Hikida, in which a medical treatment resulted in a new compensable consequential injury, is distinguishable. Here, there was unrebutted substantial medical evidence that Justice’s permanent disability was caused, in part, by preexisting pathology. Apportionment was required. Whether or not the workplace injury “directly caused” the need for surgery, the apportionment statutes demand that the disability be sorted among direct and indirect causal factors. View "County of Santa Clara v. Workers' Compensation Appeals Board" on Justia Law

The First Circuit affirmed the order of the district court finding that Plaintiff was disabled as defined under 20 C.F.R. 404.1520 and awarding her benefits, holding that there was very strong evidence of Plaintiff's disability, without any contrary evidence, to justify an award of benefits.At age thirty-four, Plaintiff filed applications for Social Security Disability Benefits and Supplemental Security Income. The Commissioner of Social Security denied Plaintiff's applications. In an independent assessment of her claim, an ALJ agreed with the Commissioner's decision, finding that Plaintiff was not disabled as defined under the Social Security Act. A federal magistrate judge found that substantial evidence did not support the ALJ's denial of benefits and recommended reversing the Commissioner's decision and remanding the case for further development of the facts. The district court agreed with the magistrate judge's findings but bypassed the need for further fact-finding and awarded benefits. The First Circuit affirmed, holding that there was overwhelming evidence to support a finding of disability and an award of benefits and that a remand for further proceedings was unnecessary. View "Sacilowski v. Saul" on Justia Law

Babcock joined the Michigan National Guard in 1970 and became a dual-status technician “a Federal civilian employee” who “is assigned to a civilian position as a technician” while maintaining membership in the National Guard, 10 U.S.C. 10216(a)(1); 32 U.S.C. 709(e). Babcock served as a National Guard pilot, held the appropriate military grade, wore a uniform that displayed his rank while working, and attended weekend drills. In 2004-2005, Babcock was deployed to Iraq on active duty. Babcock received military pay for his active-duty service and his inactive-duty training, including weekend drills. Otherwise, he received civil pay and participated in the Civil Service Retirement System (CSRS), 5 U.S.C. 5301. Babcock paid Social Security taxes on the wages for his active-duty service and his inactive-duty training from 1988 onwards, 42 U.S.C. 410(l)(1). He did not pay Social Security taxes on his wages for inactive-duty training before 1988 or on his civil-service wages.In 2009, Babcock retired and began receiving monthly CSRS payments and separate military retirement pay. For several years after his retirement, Babcock flew medical-evacuation helicopters for hospitals. This private-sector income was subject to Social Security taxes. Babcock fully retired in 2014. The government reduced his Social Security benefits under the Windfall Elimination Provision (WEP) because of his CSRS pension. Babcock cited a WEP exception for payments “based wholly on service as a member of a uniformed service.” While Babcock's case was pending, the Eleventh Circuit rejected the Eighth Circuit’s contrary analysis and held that the uniformed-services exception does not apply to dual-status technicians. The Sixth Circuit subsequently agreed that a federal civil-service pension based on work as a National Guard dual-status technician does not qualify as “a payment based wholly on service as a member of a uniformed service.” View "Babcock v. Commissioner of Social Security" on Justia Law

Brett Woolley appealed an Idaho Industrial Commission (“Commission”) decision that found him ineligible for unemployment benefits. The Commission determined that Woolley was ineligible for benefits because he was a corporate officer whose claim for benefits was based on wages from a corporation in which he had an ownership interest. The Commission also determined Woolley willfully made a false statement by saying he had not received wages or performed services as a corporate officer. After review, the Idaho Supreme Court affirmed the Commission’s determination that Woolley was ineligible for benefits due to his status as a corporate officer because it was supported by substantial and competent evidence. However, the Court found Woolley did not willfully misrepresent his status as a corporate officer, "The statute makes no mention of a claimant’s performance of services as a corporate officer. To compound the confusion, IDOL provides no information in the unemployment handbook or on its website to explain why it is necessary for claimants to report their corporate officer status when filing a claim for benefits. To serve as the basis for a willful failure to report a material fact, the question to be answered by a claimant must be accurately grounded in the legal requirements of the statute." View "Woolley v. Idaho Dept. of Labor" on Justia Law