Justia Public Benefits Opinion Summaries

The issue this case presented to the Supreme Court was whether the Washington legislature's 2007 repeal of gain sharing-a pension enhancement provided in years of extraordinary investment return-unconstitutionally impaired the contract between the State and its employees. The Court held that the legislature reserved its right to repeal a benefit in the original enactment of that benefit and the enactment did not impair any preexisting contractual right. As to the employees' alternative argument, the Court held that the explanatory materials provided by the Department of Retirement Systems (DRS) do not rise to the level of making a promise or creating an inconsistent statement and thus reject the employees' contention that the state was estopped from repealing the gain-sharing benefit at issue in this case. Accordingly, the Court reversed the trial court's award of summary judgment to the employees. View "Wash. Educ. Ass'n v. Dep't of Ret. Sys." on Justia Law

Mary Bell was a disabled person who drew Social Security Insurance benefits and participated in a federally-funded, community-based program operated by the Cabinet for Health and Family Services. When Thomas Bell, Mary’s father, retired and began to draw his Social Security benefits, Mary became eligible for Old Age, Survivor and Disability Insurance. Consequently, Mary was charged $60 per month for her continued program participation. Thomas filed an administrative appeal on Mary’s behalf. The matter ultimately reached the circuit court, which held that Mary could not be charged to participate in the program. Thereafter, the circuit court (1) awarded attorney’s fees against the Cabinet due to the Cabinet’s “egregious government behavior,” and (2) ordered the Cabinet to disclose the personal information of all other participants in the program. The court of appeals reversed. The Supreme Court affirmed, holding that the trial court erred by (1) ordering the payment of attorney’s fees solely for egregious conduct without statutory authorization or a contract providing for such fees; and (2) ordering the disclosure of records of all persons participating in the program without the other persons having filed claims and no class action being certified.View "Bell v. Commonwealth" on Justia Law

The Hospital filed suit against various federal agencies and officials, seeking a declaratory judgment that 18 U.S.C. 4006(b)(1), where Congress has elected to impose the Medicare rate as full compensation for medical services rendered to federal detainees, is unconstitutional as applied. The court concluded that the Hospital voluntarily opted into the Medicare program and is, as a result, required to provide emergency services to federal detainees. Consequently, the Hospital was foreclosed from challenging this compensation scheme as an unconstitutional taking under the Fifth Amendment. The court noted that the Hospital's most effective remedy may lie with Congress rather than the courts. Accordingly, the court affirmed the district court's dismissal of the action. View "Baker County Medical Services v. U.S. Attorney General, et al." on Justia Law

Moon was a 26-year-old mother who had worked as a cashier, bank teller, and certified nursing assistant. She suffered from documented back and joint problems, mild sleep apnea, depression, and migraine headaches. Most of these problems are related to exceptional obesity: at a height of 5’5”, she weighs more than 400 pounds. In support of her application for disability benefits, Moon submitted extensive medical records. Her migraine headaches were diagnosed as early as 2005 and she saw doctors about her headaches many times. She was taking Imitrex and Motrin at the time of her May 2010 hearing. In his written decision denying benefits, the ALJ went through the standard five-step analysis and found that Moon was no longer engaged in substantial gainful activity and that her combination of impairments qualified as “severe,” but that she was still capable of doing sedentary work if she would be permitted to sit or stand at will. The ALJ relied on the opinions of two doctors who had reviewed medical records but had not examined Moon. The ALJ referred to “alleged headaches” dismissively. The Appeals Council and the district court upheld the denial. The Seventh Circuit reversed. The ALJ improperly discounted evidence of chronic migraine headaches. Because Moon is receiving disability benefits based on a later application, the only issue on remand will be whether she was disabled between August 2008 and the later date from which benefits have been paid.View "Moon v. Colvin" on Justia Law

Relator was injured while working for Employer. Relator began receiving workers’ compensation benefits in 2010. In 2012, Relator began receiving a retirement annuity from the Public Employees Retirement Association (PERA). At some point, Relator began receiving federal social security retirement benefits. While Employer was entitled under Minn. Stat. 176.101(4) to offset Relator’s permanent total disability benefits by the amount of her social security retirement benefits, the parties disagreed as to whether Employer was entitled to apply the offset to Relator’s PERA retirement benefits. A compensation judge granted Employer the offset. The Workers’ Compensation Court of Appeals (WCCA) affirmed, concluding that Relator’s PERA retirement annuity was an “old age and survivor insurance benefit.” The Supreme Court reversed, holding that, under the reasoning in Ekdahl v. Independent School District #213, also decided today, section 176.101(4) does not permit permanent total disability benefits to be offset by public employee pension benefits. Remanded. View "Hartwig v. Traverse Care Ctr." on Justia Law

Relator was injured while working for a School District. Relator eventually sought and was awarded permanent total disability (PTD) benefits. Relying on Minn. Stat. 176.101(4) and claiming that the statute authorizes an offset for “any old age and survivor insurance benefits,” the School District sought to offset its PTD benefit payment by the amount of government-service pension benefits Relator was receiving. A compensation judge concluded that the School District was not entitled to the offset. The Workers’ Compensation Court of Appeals (WCCA) reversed, concluding that government-service pension benefits are included in the phrase “old age and survivor insurance benefits” and therefore can be offset from the School District’s disability-benefit payment. The Supreme Court reversed the WCCA and reinstated the decision of the compensation judge, holding that the phrase “old age and survivor benefits” refers only to federal social security benefits, and therefore, the WCCA erred when it applied section 176.101(4) to Relator’s retirement annuity. View "Ekdahl v. Indep. Sch. Dist. #213" on Justia Law

Because of a 2007 car accident, Glenn suffers from degenerative disc disease, a closed head injury and cerebral concussion that cause dizziness and memory loss, left shoulder tendonitis, and post-traumatic headaches. She also suffers major depression, with slow thought processes, mood swings, agitation, poor concentration, anxiousness, feelings of anger and hopelessness, paranoia, auditory hallucinations, and suicidal and homicidal ideation. She has a chronic skin condition that has caused cysts around the vulva that occasionally prevent her from walking and require frequent bathroom breaks. In 2008, Glenn sought social security benefits. Following her hearing, at which Glenn appeared without counsel, the ALJ denied the application at the fifth step of the required analysis: whether, taking into account age, education, and work experience, the claimant can perform other work. The Appeals Council declined review. The district court remanded, based on five errors, but denied attorney’s fees under the Equal Access to Justice Act, finding that the government’s position on appeal was “substantially justified” because the magistrate rejected three of Glenn’s claims of error. The Sixth Circuit reversed the denial of fees. Regardless of what happens on remand, Glenn had to retain counsel to ensure that her claim would be properly adjudicated.View "Glenn v. Comm'r of Soc. Sec." on Justia Law

Petitioner David Eskeland began work at the New Hampshire Department of Fish and Game in 1990 and, accordingly, became a mandatory member of the New Hampshire Retirement System (NHRS). On October 1, 2010, he retired from the Department of Fish and Game with twenty years and three months of creditable service, at which point he began receiving his service retirement pension. After he retired, a friend told the petitioner that he should have retired on a disability retirement allowance rather than on a service retirement allowance. As a result of this conversation, and three months after he retired, petitioner filed an application for accidental disability retirement based upon work-related injuries he sustained in 2002 and 2004. In December, 2011, the board accepted the hearings examiner's recommendation to deny the petitioner's application for accidental disability retirement. The recommendation was based upon a medical certification that the petitioner was not permanently incapacitated by a work-related injury because he had worked full-time, without accommodation, for six years following his most recently accepted workers' compensation injury. Petitioner moved for reconsideration, and the board referred the request to the hearings examiner. In reviewing the request for reconsideration, the hearings examiner became aware of a potential jurisdictional issue and notified petitioner that, because he "was a beneficiary when he applied for disability retirement, his membership appears to have terminated and the Board of Trustees appears to lack jurisdiction to award him a disability retirement." After a three-day hearing, the hearings examiner recommended that the board find that it did not have jurisdiction to grant accidental disability retirement benefits. The board accepted the recommendation. Finding no reversible error with the Board's decision, the Supreme Court affirmed. View "Petition of David Eskeland" on Justia Law

In consolidated appeals, petitioners, both recipients of home-based long-term care benefits through Vermont's Medicaid-funded Choices for Care (Choices) program, appealed decisions of the Human Services Board disallowing deductions for personal care services from their patient-share obligation under federal and state Medicaid laws. Upon review of the cases, the Supreme Court concluded that to the extent the services in question were medically necessary, expenses for those services must be deducted from petitioners’ patient-share obligation even if they are of a type generally covered by Medicaid. Furthermore, the Court rejected the State’s claim that the decision of the Department of Disabilities, Aging and Independent Living not to provide the personal care services in question under the Choices program constituted a conclusive finding that the services were not medically necessary. View "In re Brett" on Justia Law

Plaintiff appealed the denial of disability insurance benefits under Title II of the Social Security Act, 42 U.S.C. 401-434. The court agreed with the district court that the ALJ properly articulated his reasons for granting little weight to plaintiff's physician's opinions, and for finding the physician's opinions to be inconsistent with the record as a whole; that the ALJ properly considered plaintiff's medical records, observations of treating physicians, and plaintiff's own description of his limitations in making the residual functional capacity (RFC) assessment for plaintiff; and that the ALJ made a proper RFC determination based on a fully and fairly developed record. The court also concluded that substantial evidence exists in the record to support the ALJ's adverse credibility finding, and the district court did not abuse its discretion by failing to remand for reconsideration under 42 U.S.C. 405(g). Accordingly, the court affirmed the judgment of the district court. View "Whitman v. Colvin" on Justia Law