Justia Public Benefits Opinion Summaries

Articles Posted in North Dakota Supreme Court
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This appeal arose from a district court order affirming the North Dakota Department of Human Services’ determination that Harold Ring was ineligible for Medicaid. In Ring v. North Dakota Department of Human Services, 2020 ND 217, 950 N.W.2d 142 (“Ring I”), the North Dakota Supreme Court remanded the case for the district court to determine whether a party should be substituted due to Ring’s death, which occurred before the court entered its order. On remand, the district court found substitution of a party was unwarranted and entered an order dismissing the case. The North Dakota Supreme Court affirmed the dismissal order. View "Ring v. NDDHS" on Justia Law

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North Dakota Workforce Safety and Insurance (“WSI”) appealed a district court judgment reversing an administrative order sustaining a WSI order denying Bruce Bahmiller’s claim for workers’ compensation benefits. After review, the North Dakota Supreme Court affirmed the district court judgment, concluding the administrative law judge’s (“ALJ”) finding that Bahmiller failed to file a timely claim for benefits within one year of his work injury was not supported by the weight of the evidence. View "Bahmiller v. WSI, et. al." on Justia Law

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The district court affirmed the North Dakota Department of Human Service’s determination that Harold Ring was ineligible for Medicaid. When these proceedings began, Ring was ninety-six years old and living in the Good Samaritan Home in Mohall. An application for Medicaid was submitted on his behalf in April 2018. It was denied due to disqualifying transfers. Ring’s daughter, Nancy Ring, filed a second Medicaid application on Ring’s behalf in November 2018. The November application was also denied because Ring’s “client share (recipient liability) is more than the medical expenses.” Ring died after the Department issued its decision but before the district court affirmed. No party was substituted on Ring’s behalf for purposes of the district court proceedings. In 2020, Ring's attorney filed a notice of appeal to the North Dakota Supreme Court, claiming the Department’s imposition of a penalty period due to disqualifying transfers was inappropriate because Ring was a vulnerable adult who was financially exploited. On May 1, 2020, the Good Samaritan Society and the Department stipulated to dismissal of the probate petition because “a Special Administrator is not needed at this time.” The court dismissed the petition on May 5, 2020. The Supreme Court determined that essential issues remained unresolved in this matter: since neither side filed a notice of death or moved to substitute a party, the district court did not determine whether this action survived Ring's death, and if it did, whether a proper successor was available for substitution. The matter was remanded for these findings and substitution. View "Ring v. NDDHS" on Justia Law

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Jerilyn Braaten, the personal representative of the Frederick Ardell Krueger Estate, appealed an order holding the Department of Human Services could recover 100 percent of the net proceeds from the sale of Krueger's home to pay for medical assistance benefits previously received by his deceased spouse. The North Dakota Supreme Court concluded the district court erred in ruling the Department is entitled to 100 percent of the net sale proceeds. For purposes of Medicaid recovery from a surviving spouse's estate, the Department's recovery from a deceased recipient's joint tenancy property is limited to the deceased recipient's fractional interest in the property. The matter was reversed and remanded fo the trial court to permit the Department to recover 50 percent of the net sale proceeds. View "Estate of Krueger" on Justia Law

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The North Dakota Department of Human Services appealed a district court judgment reversing the Department's order deciding Sanford HealthCare Accessories received overpayments for medical equipment supplied to Medicaid recipients and ordering recoupment. The North Dakota Supreme Court reversed and remanded, concluding the district court erred in deciding the Department's failure to comply with the statutory time requirement for issuing its final order precluded the Department from acting. View "Sanford Healthcare Accessories, LLC v. N.D. Dep't of Human Services" on Justia Law

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The North Dakota Department of Human Services appealed a district court judgment reversing the Department's order deciding Sanford HealthCare Accessories received overpayments for medical equipment supplied to Medicaid recipients and ordering recoupment. The North Dakota Supreme Court reversed and remanded, concluding the district court erred in deciding the Department's failure to comply with the statutory time requirement for issuing its final order precluded the Department from acting. View "Sanford Healthcare Accessories, LLC v. N.D. Dep't of Human Services" on Justia Law

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The North Dakota Department of Human Services appealed a district court judgment reversing the Department's order deciding Altru Specialty Services, doing business as Yorhom Medical Essentials, received overpayments for medical equipment supplied to Medicaid recipients and ordering recoupment. The North Dakota Supreme Court concluded the district court did not have jurisdiction and the appeal should have been dismissed because Yorhom failed to satisfy statutory requirements for perfecting an appeal. View "Altru Specialty Services, Inc. v. N.D. Dep't of Human Services" on Justia Law

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Petitioner Wanda Gottus appealed a district court judgment that affirmed a decision of Job Service North Dakota denying her unemployment benefits and concluding she was discharged for actions constituting misconduct. In January 2008, Petitioner began working as a cashier for Service Oil Inc. d/b/a Stamart. In addition to acting as a cashier, Petitioner's job duties included attending to the store's shelves, light cleaning, and other similar tasks. Petitioner's employment with Stamart ended in August 2010 when she was discharged for poor job performance. Petitioner subsequently filed for unemployment insurance benefits. Job Service initially approved Petitioner for unemployment benefits indicating she was not discharged for misconduct. Stamart appealed this decision, and a telephone hearing was held before an appeals referee. Testimony and evidence presented during the hearing revealed there were at least sixteen instances when Petitioner's job performance fell below the level expected of Stamart employees. The Job Service reviewed the record and affirmed the referee's decision. Petitioner argued on appeal her job performance was merely unsatisfactory but did not constitute misconduct. The district court rejected her argument and affirmed Job Service's decision. The Supreme Court concluded Job Service's findings of fact were supported by a preponderance of the evidence, and its conclusion that Petitioner's actions constituted disqualifying misconduct was supported by the findings.

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Claimant Claud Sloan appealed a district court judgment that affirmed a Workforce Safety & Insurance (WSI) order awarding him additional permanent impairment benefits. In December 1985, Sloan sustained a compensable work-related injury while employed at a coal gasification plant in Beulah, North Dakota. WSI awarded Sloan permanent impairment benefits for his injury and has issued several permanent partial impairment orders since his original injury. Effective April 1, 2009, WSI promulgated N.D. Admin. Code 92-01-02-25(4) to address pain impairment ratings. Based on the newly adopted rule, WSI reviewed Sloan's pain rating and determined he had sustained an eight percent impairment for pain which, when combined with his prior impairment ratings, totaled a whole body impairment rating of 38 percent. On June 11, 2009, WSI issued an order awarding Sloan additional permanent impairment benefits, based on his combined whole body impairment of 38 percent for his cervical spine, depression, dysphagia, and chronic pain. Sloan requested a rehearing. At a November 2009, hearing before an administrative law judge, a staff attorney for WSI appeared as the only witness and testified regarding the WSI's promulgation of N.D. Admin. Code 92-01-02-25. The ALJ subsequently issued an order affirming WSI's June 2009 order awarding Sloan additional permanent impairment benefits. Sloan appealed to the district court, which affirmed the order. Upon review, the Supreme Court concluded WSI's promulgation of administrative rules for assessing pain impairment did not conflict with its statutory authority and was not arbitrary, capricious, or unreasonable.

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Petitioner Toni Weeks appealed a district court judgment that affirmed a decision by Workforce Safety and Insurance (WSI) that reduced her disability benefits. Petitioner was injured at work after being exposed to anhydrous ammonia while employed by Dakota Gasification Company, in Beulah, North Dakota. In 2009, WSI received confirmation that on November 1, 2009, Weeks' social security disability benefits would convert to social security retirement benefits. WSI issued a notice of intention to discontinue or reduce benefits, in which Petitioner was informed that her permanent total disability benefits would end on October 31, 2009, and she would receive an "additional benefit payable" beginning November 1, 2009. Petitioner requested reconsideration. In November 2009, WSI issued an order denying Petitioner further disability benefits after October 31, 2009. Upon review, the Supreme Court found that because Petitioner failed to adequately brief her argument that WSI's reduction of her wage loss benefits violated equal protection under the federal and state constitutions, the Supreme Court declined to address her argument and otherwise affirmed the judgment.