Justia Public Benefits Opinion Summaries

While claimant-appellant Judith Weible was employed by Safeway, Inc., she requested time off because she had to have surgery. Safeway granted her request and agreed to hold her job until she was able to return to work, which she intended to do. She was gone for approximately six weeks. While on leave, claimant applied for unemployment benefits. She was denied because during her leave of absence she was still employed, even though she was not working. An appeals examiner upheld the denial, and the Industrial Commission upheld the appeals examiner. Finding no reversible error, the Supreme Court affirmed the Industrial Commission. View "Weible v. Dept of Labor" on Justia Law

Dreher had been a maintenance supervisor at an Alliance apartment complex for 74 days when he slipped and fell on concrete walkway in the complex in the rain. Dreher sustained a fractured pelvis and injuries to his neck, shoulder, leg, and knee. He suffered gait derangement, a sleep disorder, and headaches. Dreher required surgery to repair pelvic fractures, another surgery to repair a torn meniscus, and another surgery to address issues with his foot and ankle. Dreher sought compensation for a psychiatric injury. An evaluation concluded that Dreher suffered a psychiatric disability as a result of the accident, including depression, difficulty sleeping, and panic attacks. The ALJ found that Dreher sustained an injury arising out of and in the course of his employment but denied his claim as barred by section 3208.3(d) because Dreher was employed by Alliance for less than six months and his psychiatric injury did not result from a sudden and extraordinary employment condition. On reconsideration, the Workers’ Compensation Appeals Board found that the injury was not barred. The court of appeal annulled the decision. Dreher’s testimony that he was surprised by the slick surface because the other walkways had a rough surface, and that the walkway was later resurfaced, did not demonstrate that his injury was caused by an uncommon, unusual, or totally unexpected event. View "Travelers Cas. & Surety Co. v. Workers' Comp. Appeals Bd." on Justia Law

Sneed, who served on active duty 1964-1968, suffered service-connected disabilities. In 2001, Sneed suffered a spinal cord contusion from a fall, leaving him quadriplegic. In 2003, he died of smoke inhalation while living in a home for paralyzed veterans. His widow sought dependency and indemnity compensation, 38 U.S.C. 1310, alleging that Sneed’s service-connected spondylosis and spinal stenosis contributed to quadriplegia and that his service-connected PTSD and hearing loss prevented him from exiting during the fire. The Board of Veterans’ Appeals affirmed denial,mailing notice on April 5. Sneed’s notice of appeal was due 120 days after that mailing. On April 13, Sneed contacted attorney Eagle, requesting representation. According to Sneed, at the request of Eagle’s secretary, she transmitted case materials to and had oral communications with that office. On August 2, Sneed received a letter from Eagle, stating that the claim “does not meet the criteria,” declining representation, and stating that notice of appeal was due "no later than August 5.” The correct deadline was August 3. Several lawyers declined her case. Sneed filed notice on September 1, explaining her circumstances. The Veterans Court dismissed the appeal as untimely. On remand, Sneed argued attorney abandonment, warranting equitable tolling. The Veterans Court held, and the Federal Circuit affirmed, that equitable tolling was not warranted absent an agreement between Eagle and Sneed and that Sneed did not act diligently. View "Sneed v. McDonald" on Justia Law

Plaintiff, who suffers from Ehlers-Danlos Syndrome, filed suit against the Department after it denied him "shelter needy" benefits, raising claims under 42 U.S.C. 1983; the Americans with Disabilities Act (ADA), 12 U.S.C. 12101 et seq.; and the Rehabilitation Act (RA), 29 U.S.C. 701 et seq. The court concluded that the appeal was timely, rejecting the district court's conclusion that plaintiff did not timely file notice and proof of service; concluded that the Rooker-Feldman doctrine is inapplicable to judicial review of executive action, including determinations made by a state administrative agency; and disagreed with the district court’s conclusion that section 256.045 of the Minnesota statutes prevented the court from exercising supplemental jurisdiction over the appeal from a state agency’s decision. In interpreting Minn. Stat. 256.045, subd. 7, the court concluded that subdivision 7 lays out one permissible route through which an aggrieved party may appeal from the Commissioner’s order and thus prevent it from becoming final, but it does not strip the federal court of its authority to hear the same appeal through the exercise of supplemental jurisdiction. Because the district court improperly concluded that it lacked jurisdiction based solely on the state statute, the district court failed to determine whether it should exercise supplemental jurisdiction under 28 U.S.C. 1367 or whether any abstention doctrine applied. Therefore, the court vacated the decision dismissing the supplemental state-law claim and remanded for further consideration. Because the state agency’s decision was not final, the district court erred by finding that plaintiff’s ADA and RA claims were precluded. Finally, the court agreed with the district court that plaintiff's allegations failed to state a due process or equal protection claim. Because plaintiff’s equal protection claim is predicated on the same allegations as his ADA and RA claims, the district court did not err by dismissing the section 1983 claim. Accordingly, the court affirmed in part, vacated in part, and remanded for further proceedings. View "Wong v. Minnesota DHS" on Justia Law

Taskila, age 37, has several health issues. She was involved in serious car accidents in 1996, 2006, and 2010; underwent successful treatment in 2011 for a mass in her breast; and sought treatment for knee pain. She claims, the injuries have led to unremitting pain in her neck and back, to anxiety and depression, to memory problems, to incontinence, to carpal tunnel syndrome, to an inability to work. Taskila sought Social Security disability insurance and supplemental security income. An initial disability examiner denied her applications. After a hearing, an ALJ did the same. The appeals council denied review. The district court and Sixth Circuit affirmed, finding the denial supported by substantial evidence that Taskila could perform a significant number of jobs in the national economy. View "Taskila v. Comm'r of Social Sec." on Justia Law

Mission purchased the assets of South Coast and attempted by an assets-only purchase to avoid South Coast's potential liabilities under South Coast's Medicare provider agreement. These liabilities encompassed potential mandated reimbursement to Medicare for any previous overpayments made to South Coast. The Secretary determined that Mission was not entitled to bill Medicare for patient services at its new facility until that facility had a provider agreement of its own. Mission appealed the Secretary's decision. The court rejected Mission's assertion that former 42 C.F.R. 489.13(d)(1)(i) permitted it to avoid South Coast’s Medicare liabilities. The court cited to the Fifth Circuit's opinion in United States v. Vernon Home Health, Inc.: “federal law governs cases involving the rights of the United States arising under a nationwide federal program such as the Social Security Act. The authority of the United States in relation to funds disbursed and the rights acquired by it in relation to those funds are not dependent upon state law.” It is equally true that private parties have no power to alter their legal obligations with Medicare under their provider agreements. The court also rejected Mission's argument that it is entitled to the benefit of the retroactivity provision in 42 C.F.R. 489.13(d)(2). The court concluded that the Secretary's interpretations and decisions rendered by the DAB in this case were reasonable. Accordingly, the court affirmed the judgment. View "Mission Hosp. Reg'l Med. Ctr. v. Burwell" on Justia Law

Veterans’ Groups challenged regulations issued in 2014 by the Department of Veterans Affairs pursuant to its notice-and-comment rulemaking authority. The Final Rule amended the VA’s adjudication and appellate regulations to require that all claims for compensation “[f]or disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty . . . during a period of war” and related appeals originate on standard VA forms. The VA’s prior regulation provided that “[a]ny communication or action, indicating an intent to apply for . . . benefits[,] . . . may be considered an informal claim,” 38 C.F.R. 3.155(a). The Federal Circuit denied the petitions and found the Final Rule valid because it accords with applicable rulemaking procedures and is not arbitrary, capricious, an abuse of discretion, or otherwise contrary to law. The Rule does not contravene Congress’s mandate that the VA has a duty to develop veterans’ claims. View "Veterans Justice Grp., LLC v. Sec'y of Veterans Affairs" on Justia Law

Veterans’ Groups challenged regulations issued in 2014 by the Department of Veterans Affairs pursuant to its notice-and-comment rulemaking authority. The Final Rule amended the VA’s adjudication and appellate regulations to require that all claims for compensation “[f]or disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty . . . during a period of war” and related appeals originate on standard VA forms. The VA’s prior regulation provided that “[a]ny communication or action, indicating an intent to apply for . . . benefits[,] . . . may be considered an informal claim,” 38 C.F.R. 3.155(a). The Federal Circuit denied the petitions and found the Final Rule valid because it accords with applicable rulemaking procedures and is not arbitrary, capricious, an abuse of discretion, or otherwise contrary to law. The Rule does not contravene Congress’s mandate that the VA has a duty to develop veterans’ claims. View "Veterans Justice Grp., LLC v. Sec'y of Veterans Affairs" on Justia Law

Dover served in the Navy, 1956-1960, and, in 1968, filed a claim for service-connected disability benefits. His claim for a hand injury was denied; he did not appeal. In 2004, the VA regional office (RO) denied Dover's motion to reopen. In 2008, Dover requested clear and unmistakable error (CUE) review of both the 1968 decision and the 2004 refusal to reopen. In 2009, the RO granted service connection based on new medical evidence and assigned an effective date of March, 2006, the date of another request to reopen. In 2009, Dover appealed for an earlier effective date of 1968, but the RO found no CUE. In 2011, Dover provided more detailed arguments. The Board for Veterans’ Appeals issued a final ruling of no CUE. On appeal, the VA conceded that it erred by failing to dismiss Dover’s non-specific CUE claim. The Veterans Court remanded with instructions to allow and consider additional evidence and argument in support of the claim. The Board dismissed Dover’s 2008 claim without prejudice but treated the 2011 submission of additional arguments as a separate CUE claim and remanded to the RO. Dover moved under the Equal Access to Justice Act for attorney’s fees incurred on appeal, 28 U.S.C. 2412(d). The Veterans Court rejected the motion because it believed that its remand was for dismissal. The Federal Circuit reversed, stating that the remand expressly contemplated, and the appellant received, further proceedings, sufficient for prevailing party status. View "Dover v. McDonald" on Justia Law

Eilise was born in 1996 and had problems with gross motor skills and language development. After therapy, Eilise showed dramatic improvement. In 2001, Eilise received three vaccinations, including her second dose of the measles, mumps, and rubella vaccine. Five days later, Eilise’s brother witnessed her arching her back, thrusting her head back, rolling her eyes, and jerking. He did not know what was happening. Her parents, who did not witness the seizure, noted that Eilise was feverish and lethargic. Eilise had a grand mal seizure at school. She was taken to a hospital. She had another seizure there. Eilise’s MRI results were generally normal, but her EEG results were “consistent with a clinical diagnosis of epilepsy.” She continued to suffer seizures until she started a ketogenic diet. Her parents filed suit under the National Childhood Vaccine Injury Compensation Program, 42 U.S.C. 300aa, alleging that Eilise suffered from autism as a result of her vaccinations; they later amended to allege, instead, that Eilise suffered from a “seizure disorder and encephalopathy.” The Claims Court affirmed denial of her petition. The Federal Circuit vacated: in certain cases, a petitioner can prove a logical sequence of cause and effect between a vaccination and the injury with a physician’s opinion where the petitioner has proved that the vaccination can cause the injury and that the vaccination and injury have a close temporal proximity. View "Moriarty v. Sec'y of Health & Human Servs." on Justia Law