Justia Public Benefits Opinion Summaries
Articles Posted in Public Benefits
State v. Morgan
Montreal Morgan participated in a home invasion robbery that resulted in the death of Fabian Alvarez. Following the incident, the Department of Labor and Industries (L&I) paid $10,480 in benefits under Washington’s Crime Victims Compensation Act (CVCA) for Alvarez’s medical and funeral expenses. Morgan pleaded guilty to conspiracy to commit murder in the second degree and unlawful possession of a firearm in the second degree. At his restitution hearing, Morgan requested a reduction in the restitution amount due to mitigating factors, but the trial court believed it lacked discretion under RCW 9.94A.753(7) and ordered the full amount of restitution requested by the State.The trial court’s decision was affirmed by the Court of Appeals, which agreed that RCW 9.94A.753(7) does not afford trial courts discretion to impose less restitution than the amount of CVCA benefits paid. Morgan then petitioned for review, which was granted by the Supreme Court of the State of Washington.The Supreme Court of the State of Washington held that RCW 9.94A.753(7) does not allow a trial court discretion to modify the amount of restitution owed to L&I for CVCA benefits. The court emphasized that the statutory language is unambiguous and requires the court to order restitution in the amount of benefits paid by L&I. The court affirmed the Court of Appeals' decision and upheld Morgan’s restitution order, concluding that the trial court correctly interpreted the statute as mandating full restitution for CVCA benefits without discretion for reduction based on mitigating factors. View "State v. Morgan" on Justia Law
NEVIN V. COLVIN
The plaintiff filed two successive applications for disability benefits under Title XVI of the Social Security Act. Her first application, alleging disability beginning June 24, 2017, was denied by an Administrative Law Judge (ALJ) on September 18, 2018. While appealing this denial to the district court, she filed a second application for benefits for a later period. Washington State Disability Determination Services (DDS) reviewed the second application and awarded benefits, determining she was disabled starting September 19, 2018, the day after the ALJ denied her first application.The district court partially ruled in her favor on the first application and remanded it for further proceedings. The Appeals Council remanded the case to the ALJ with instructions. On June 23, 2021, the ALJ reopened the second application and denied the benefits previously granted by DDS. The ALJ concluded that the plaintiff was disabled beginning July 14, 2020, on her first application. The district court held it lacked jurisdiction to review the ALJ’s reopening and denial of benefits on the second application.The United States Court of Appeals for the Ninth Circuit reversed the district court’s decision, holding that the district court had jurisdiction to review the ALJ’s reopening of the second application. The Appeals Council did not reopen the second application, and the ALJ’s reopening occurred more than two years after the award, which is only permissible in cases of fraud or similar fault. Finding no evidence of fraud or similar fault, the Ninth Circuit held that the ALJ erred in reopening and reversing the award of benefits on the second application. The court remanded for the district court to direct the agency to award benefits according to DDS’s decision. The Ninth Circuit affirmed the district court’s decision on the first application, concluding that the ALJ’s finding that the plaintiff was not disabled between June 24, 2017, and September 19, 2018, was supported by substantial evidence. View "NEVIN V. COLVIN" on Justia Law
Kertz v. Colvin
Jason Kertz applied for social security disability benefits in October 2019, citing disabilities including PTSD, back and leg problems, and sleep apnea, with an onset date of March 16, 2018. His initial claim was denied, and an SSA administrative law judge (ALJ) also found him not disabled after a hearing. The SSA Appeals Council upheld this decision in February 2021. Kertz then hired attorney Nicholas Coleman to represent him in federal court. Coleman and Kertz agreed on a contingent-fee arrangement of 25% of any past-due benefits awarded.Coleman filed a civil action in the Eastern District of Arkansas, which resulted in the court remanding the case to the SSA for further proceedings. The district court awarded Coleman $5,426.08 in attorney’s fees under the Equal Access to Justice Act (EAJA). On remand, the ALJ issued a Fully Favorable Decision in December 2022, finding Kertz disabled since the alleged onset date. The SSA notified Kertz of his entitlement to $96,349.00 in past-due benefits, withholding 25% as potential attorney fees. Coleman then sought 25% of the past-due benefits as per the contingent-fee agreement.The United States District Court for the Eastern District of Arkansas granted Coleman’s motion for attorney’s fees in part, awarding $10,667.50 instead of the requested $24,087.25. The court found that the full 25% fee was not reasonable given the circumstances, including the limited time Coleman spent on the case and the lack of substantive court review due to the unopposed remand.The United States Court of Appeals for the Eighth Circuit reviewed the case and affirmed the district court’s decision. The appellate court held that the district court did not abuse its discretion in reducing the fee award, as it appropriately considered the reasonableness of the fee in light of the services rendered and avoided a windfall to the attorney. View "Kertz v. Colvin" on Justia Law
United States v. Charles
Four elderly sisters were accused of defrauding the United States by falsely claiming benefits under two federal programs. Each sister pled guilty to one count of conspiracy, preserving the right to appeal two pretrial rulings: the denial of a motion to suppress evidence and the denial of a motion to dismiss the indictment for untimeliness.The United States District Court for the Eastern District of Arkansas denied the motion to suppress, ruling that the sisters lacked standing to challenge the search of a property because they had no possessory interest in it. The court also found that even if the search was unconstitutional, the affidavits supporting the search warrants still provided probable cause. The motion to dismiss the indictment was denied because the court held that the statute of limitations for mail fraud begins on the date of mailing, not the date of the last overt act.The United States Court of Appeals for the Eighth Circuit reviewed the case. The court affirmed the district court's denial of the motion to suppress, agreeing that the affidavits were sufficient to support the search warrants even without the contested information. The court also affirmed the denial of the motion to dismiss, stating that the aiding and abetting mail fraud charges were filed within the five-year limitations period. Additionally, the court found no abuse of discretion in the district court's decision not to hold an evidentiary hearing on the motions, as the alleged disputes of fact were immaterial to the legal conclusions.The Eighth Circuit affirmed the district court's rulings, upholding the convictions and sentences of the four sisters. View "United States v. Charles" on Justia Law
Ortega v. Albin
An employee, Matthew I. Ortega, voluntarily quit his job as an office manager at Island Towing after 17 years, citing work-related stress from interactions with law enforcement as the reason. Ortega applied for unemployment benefits, stating that the stress affected his mental health and ability to perform his job. The Nebraska Department of Labor denied his application, finding that he did not have good cause to quit.Ortega appealed to the Nebraska Department of Labor’s Appeal Tribunal, where both he and his supervisor, Chloe Aguilar, testified. Ortega described two specific incidents involving law enforcement that caused him significant stress, one of which occurred 2½ years prior to his resignation. Aguilar confirmed the ongoing negative interactions with law enforcement but stated that there was no way to alleviate the stress. The Appeal Tribunal upheld the denial, stating that Ortega did not provide sufficient evidence, such as medical documentation, to prove that his stress constituted good cause for quitting.Ortega then appealed to the district court for Hall County, which affirmed the Appeal Tribunal’s decision. The district court agreed that Ortega’s stress was a health concern requiring medical evidence and noted that Ortega had not pursued alternative solutions to preserve the employment relationship, such as seeking a leave of absence or modifying his job duties.The Nebraska Supreme Court reviewed the case and affirmed the district court’s judgment. The court held that Ortega failed to meet his burden of proof to show good cause for voluntarily leaving his employment. The court found that the evidence provided, including the details of only one specific negative interaction with law enforcement, was insufficient to establish that Ortega’s work conditions were an increasingly unreasonable burden affecting his health or sense of well-being. View "Ortega v. Albin" on Justia Law
United States v. Phillips
Brandon Phillips, who had several Missouri marijuana-possession convictions, pleaded guilty to a federal felon-in-possession charge. Despite Missouri legalizing marijuana and planning to expunge certain convictions, the district court sentenced him to 120 months in prison and imposed a lifetime ban on federal benefits.The United States District Court for the Eastern District of Missouri overruled Phillips's objection that his criminal history was overstated due to Missouri's legalization of marijuana. The court stated it would have imposed the same sentence regardless of the marijuana convictions. Phillips's marijuana convictions were still on record at the time of sentencing, although they were later expunged. Phillips argued that the expungement should require resentencing.The United States Court of Appeals for the Eighth Circuit reviewed the case. The court found that Phillips did not preserve the expungement issue for appellate review, as he did not clearly state the grounds for his objection in the district court. The court also determined that even if the issue had been preserved, the district court would have imposed the same sentence based on the 18 U.S.C. § 3553(a) factors, considering Phillips's reoffending on parole and possession of a large quantity of fentanyl.However, the Eighth Circuit vacated the federal-benefits ban, finding it was a plain error to apply it to Phillips, as the ban only applies to drug distributors, not gun possessors. The court held that the district court's application of the ban was clearly incorrect and affected Phillips's substantial rights. The court affirmed the 120-month prison sentence but vacated the federal-benefits ban. View "United States v. Phillips" on Justia Law
Scott v. Home Depot USA, Inc.
Chesla A. Scott challenged the Idaho Department of Labor's service of three determination notices, claiming she did not receive them while temporarily working out-of-state. The Department mailed the notices to her last known address, and Scott missed the fourteen-day appeal period. When she attempted to appeal, the Department's Appeals Examiner dismissed her appeal as untimely. Scott argued that the Department's service by mail did not meet constitutional due process requirements.The Appeals Examiner conducted a hearing and concluded that Scott's appeal was untimely under Idaho Code section 72-1368(3) and (5). The Idaho Industrial Commission affirmed this decision, denying Scott's request for a new hearing and conducting a de novo review of the record. The Commission also concluded that Scott had not timely filed her appeal.Scott appealed to the Idaho Supreme Court, arguing that the Department's service by mail was constitutionally inadequate. The Court reviewed whether Scott exhausted her administrative remedies and preserved her constitutional challenge. The Court held that Scott had exhausted her administrative remedies and preserved her due process claim, allowing it to be reviewed.The Idaho Supreme Court affirmed the Commission's decision, holding that the Department's mailing of the determination notices was reasonable under all the circumstances and did not violate due process. The Court found that the Department's method of service was reasonably calculated to provide notice, and Scott's failure to receive the notices was not due to any fault of the Department. The Court did not award attorney fees to either party but awarded costs to the Department. View "Scott v. Home Depot USA, Inc." on Justia Law
In re appeal of S.S.
S.S. was receiving temporary housing assistance through the Department for Children and Families (DCF) and staying at a shelter. After a confrontation with shelter staff over a mistakenly reassigned locker, S.S. was asked to vacate the shelter without prior warning. Consequently, DCF imposed a thirty-day period of ineligibility for further temporary housing assistance due to the shelter-rule violation. S.S. requested a fair hearing to challenge this decision, and a hearing officer recommended reversing the ineligibility period, which DCF subsequently did.S.S. then filed a motion with the Human Services Board to adopt the hearing officer’s findings and issue a final order. The hearing officer questioned the mootness of the case since DCF had already lifted the ineligibility period. The Board ultimately dismissed the case as moot, concluding there was no further relief it could provide since DCF had already granted S.S. the requested relief.The Vermont Supreme Court reviewed the case and affirmed the Board’s decision. The Court held that the Board lacked the statutory authority to provide the relief S.S. sought, as the Board can only affirm, modify, or reverse DCF decisions and provide appropriate relief. Since DCF had already reversed the ineligibility period, there was no live controversy for the Board to address. The Court also found that the capable-of-repetition-yet-evading-review exception to the mootness doctrine did not apply, as S.S. did not demonstrate a reasonable expectation of being subjected to the same action again. Consequently, the Board’s dismissal of the case was appropriate. View "In re appeal of S.S." on Justia Law
Island Creek Coal Co. v. Blankenship
Jerry L. Blankenship applied for living miner benefits under the Black Lung Benefits Act, claiming he suffered from coal dust-induced pneumoconiosis and was totally disabled. An Administrative Law Judge (ALJ) found Blankenship entitled to a rebuttable presumption of total disability due to pneumoconiosis under 30 U.S.C. § 921(c)(4) and determined that his former employer, Island Creek Coal Company, failed to rebut this presumption. Consequently, Blankenship was awarded benefits. The Benefits Review Board affirmed the ALJ’s decision.Island Creek petitioned for review, arguing that the ALJ improperly conflated the presence of pneumoconiosis and disability causation with the separate total disability analysis. Additionally, Island Creek contended that the ALJ failed to adequately explain his decision to credit the opinions of Blankenship’s medical experts over those of Island Creek’s experts.The United States Court of Appeals for the Fourth Circuit reviewed the case and agreed with Island Creek. The court found that the ALJ improperly relied on the presence of pneumoconiosis and the causation of Blankenship’s impairment in concluding that he was totally disabled. The court also determined that the ALJ failed to provide a sufficient explanation for crediting the medical opinions of Drs. Nader and Green over those of Drs. McSharry and Sargent, violating the duty of explanation under the Administrative Procedure Act.The Fourth Circuit granted Island Creek’s petition for review, vacated the decision of the Benefits Review Board, and remanded the case with instructions for the Board to return Blankenship’s case to the ALJ for reconsideration consistent with the court’s opinion. View "Island Creek Coal Co. v. Blankenship" on Justia Law
Schmitz v. Colvin
Amra Schmitz, a 52-year-old former public relations representative, applied for Social Security disability benefits in February 2020, claiming disability since January 2018. After a telephonic hearing, the Administrative Law Judge (ALJ) applied the five-step disability analysis and concluded that despite Schmitz's limitations and inability to perform her past job, there were still jobs she could perform. The ALJ found that Schmitz had severe impairments but did not meet the criteria for disability. The ALJ determined that Schmitz could perform light work with certain restrictions and identified six types of unskilled jobs she could do.The Appeals Council denied review of the ALJ's decision, and Schmitz filed suit in the United States District Court for the Central District of Illinois. Schmitz argued that the ALJ's decision was not supported by substantial evidence, particularly criticizing the vocational expert's (VE) testimony regarding the number of available jobs. The district court found that Schmitz had forfeited this objection by not raising it during the hearing or in post-hearing briefs and upheld the ALJ's decision.The United States Court of Appeals for the Seventh Circuit reviewed the district court's decision de novo, applying the same deferential standard. The court noted that Schmitz did not object to the VE's testimony during the hearing, thus forfeiting her objection. The court found that the VE's testimony was coherent, plausible, and based on her expertise. The court also determined that the ALJ had no duty to further investigate the VE's job-number estimates in the absence of an objection. The court concluded that the ALJ's decision was supported by substantial evidence and affirmed the district court's judgment. View "Schmitz v. Colvin" on Justia Law