Justia Public Benefits Opinion Summaries

Snyder served in the Army for fewer than 50 days in 1974, during the Vietnam “period of war,” 38 C.F.R. 3.2(f). He received an honorable discharge when a knee injury rendered him unfit. Four decades later, he was diagnosed with Amyotrophic Lateral Sclerosis (ALS). He sought disability benefits under 38 U.S.C. 1110. The Veterans Court denied his claim, rejecting Snyder’s argument under a VA regulation, made final in 2009, that provides a presumption of service connection for veterans with ALS if specified preconditions are satisfied, 38 C.F.R. 3.318(a), (b).The Federal Circuit affirmed the denial. Snyder does not satisfy one of the preconditions—that the veteran “have active, continuous service of 90 days or more.” That precondition is not contrary to the statutory scheme nor arbitrary and capricious; 38 U.S.C. 501(a) supplies the required statutory authority for the regulation and section 3.318, as an exercise of that authority, is not contrary to other statutory provisions cited by Snyder. The Secretary found no reliable evidence of a correlation between ALS and service periods as short as 90 days; it was reasonable to choose a familiar short period to avoid too demanding an evidentiary standard (no presumption) or too lenient a standard (no minimum service period) for applying the statutory requirement of service connection to ALS. View "Snyder v. McDonough" on Justia Law

Langdon served on active duty in the Navy, 1980-1996. After leaving service, Langdon sought disability compensation for a “spine condition especially [the] thorac[ic] [and] lumbar regions.” The VA determined Langdon had a service-connected thoracic spine injury, a non-service-connected lumbar spine injury, and only 55 degrees of forward flexion for his thoracolumbar spine. It also determined that Langdon’s service-connected thoracic spine injury caused no functional impairment; the non-service-connected lumbar spine injury caused his reduced flexion. Because his service-connected injury caused no functional impairment, the VA assigned Langdon a zero percent disability rating under 38 C.F.R. 4.71a. The Board of Veterans’ Appeals rejected his claim of entitlement to a 20 percent rating based on his limited thoracolumbar flexion but increased Langdon’s rating to 10 percent based on upper back pain under a different regulation, 38 C.F.R. 4.45(f), 4.59. The Veterans Court affirmed.The Federal Circuit reversed. The VA’s regulation requires it to rate the thoracolumbar spine as a unit when applying the General Rating Formula. Under this interpretation, the VA does not dispute that Langdon has a service-connected thoracic injury with reduced thoracolumbar flexion that entitles him to a 20 percent disability rating under the General Rating Formula. View "Langdon v. McDonough" on Justia Law

The Eleventh Circuit reversed and remanded the denial of social security disability benefits to plaintiff, who stated that he was no longer able to work due to various psychiatric conditions, which included chronic depression, anxiety, and bipolar disorder. The court held that the SSA's denial of plaintiff's application for disability benefits was not supported by substantial evidence where the ALJ did not articulate adequate reasons for discounting evidence of plaintiff's mental illness, which provided support for a finding of disability. In this case, the ALJ gave little or no weight to three pieces of evidence in the record indicating that plaintiff's mental illness prevents him from maintaining a job: (1) the opinions of plaintiff's treating psychiatrist, (2) the opinions of a consulting psychologist who examined plaintiff at the request of the SSA, and (3) plaintiff's own testimony as to the severity of his symptoms. View "Simon v. Commissioner, Social Security Administration" on Justia Law

The plaintiffs retired from the Louisville Metropolitan police department and received free health insurance, administered by Kentucky Retirement Systems. Kentucky initially paid all of their healthcare costs. After the officers turned 65, Medicare became the primary payer, leaving Kentucky to cover secondary expenses. Each officer came out of retirement, joining county agencies different from the ones they served before retiring. They became eligible for healthcare benefits in their new positions. Kentucky notified them that federal law “mandate[d]” that it “cannot offer coverage secondary to Medicare” for retirees “eligible to be on [their] employer’s group health plan” as “active employees.” Some of the officers then paid for insurance through their new employers; others kept their retirement insurance by quitting or going part-time. The officers sued.The district court granted summary judgment to the officers, ordered Kentucky to reinstate their retirement health insurance, and awarded the officers some of the monetary damages requested. The Sixth Circuit affirmed. The officers have a cognizable breach-of-contract claim. Under Kentucky law, the Kentucky Retirement Systems formed an “inviolable contract” with the officers to provide free retirement health insurance and to refrain from reducing their benefits, then breached that contract. The Medicare Secondary Payer Act of 1980 did not bar Kentucky from providing Medicare-eligible police officers with state retirement insurance after they reentered the workforce and became eligible again for employer-based insurance coverage, 42 U.S.C. 1395y. View "River City Fraternal Order of Police v. Kentucky Retirement Systems" on Justia Law

Lynch served on active duty in the Marine Corps, 1972-1976. In 2015, Lynch was evaluated on two separate occasions by Dr. Newsome, a private psychologist. Lynch described phobias about confined spaces, panic attacks, memory problems, mood swings, frequent nightmares, antisocial behaviors, and depression, which he attributed to intrusive memories from his time in service. Dr. Newsome reported that Lynch’s symptoms and the results of the PTSD Checklist supported a diagnosis of PTSD.Lynch filed a claim of entitlement to disability benefits for PTSD and underwent a VA PTSD examination. The VA examiner reported that Lynch’s PTSD did not result in symptoms that were severe enough to interfere with occupational or social functioning or to require continuous medication and that the level of impairment observed by Dr. Newsome was not observed during the VA examination. The regional office granted Lynch’s claim with a 30% disability rating. Lynch filed a Notice of Disagreement and submitted two additional psychological evaluations conducted by a private psychiatrist, Dr. Jabbour. He underwent a second VA PTSD examination. The examiner found some of Jabbour’s conclusions “more extreme than what was supported by available evidence.”The Veterans Court rejected Lynch’s argument that the Board misapplied 38 U.S.C. 5107(b) and wrongly found that he was not entitled to the “benefit of the doubt.” The Federal Circuit affirmed. The benefit of the doubt rule is inapplicable when the preponderance of the evidence is found to be against the claimant. View "Lynch v. McDonough" on Justia Law

The Ninth Circuit affirmed the denial of social security disability benefits to claimant. At issue is whether knowledge of the Social Security Administration's longstanding interpretation of the term "medium work" as requiring standing or walking for approximately six hours out of an eight-hour workday can be imputed to a qualified vocational expert.The panel held that an expert in this field is presumptively aware of the agency's well-established definition of this term of art. Therefore, when the ALJ asked the expert in this case whether jobs existed for a hypothetical individual who was limited to medium work, that question adequately communicated the term's attendant standing and walking limitations. In this case, it follows that the expert's resulting testimony that a significant number of jobs existed in the national economy for an individual with claimant's limitations constituted substantial evidence in support of the ALJ's determination that he was not disabled within the meaning of the Social Security Act. View "Terry v. Saul" on Justia Law

The American Rescue Plan Act of 2021 allocated $29 billion for grants to help restaurant owners. The Small Business Administration (SBA) processed applications and distributed funds on a first-come, first-served basis. During the first 21 days, it gave grants only to priority applicants--restaurants at least 51% owned and controlled by women, veterans, or the “socially and economically disadvantaged,” defined by reference to the Small Business Act, which refers to those who have been “subjected to racial or ethnic prejudice” or “cultural bias” based solely on immutable characteristics, 15 U.S.C. 637(a)(5). A person is considered “economically disadvantaged” if he is socially disadvantaged and he faces “diminished capital and credit opportunities” compared to non-socially disadvantaged people who operate in the same industry. Under a pre-pandemic regulation, the SBA presumes certain applicants are socially disadvantaged including: “Black Americans,” “Hispanic Americans,” “Asian Pacific Americans,” “Native Americans,” and “Subcontinent Asian Americans.” After reviewing evidence, the SBA will consider an applicant a victim of “individual social disadvantage” based on specific findings.Vitolo (white) and his wife (Hispanic) own a restaurant and submitted an application. Vitolo sued, seeking a preliminary injunction to prohibit the government from disbursing grants based on race or sex. The Sixth Circuit ordered the government to fund the plaintiffs’ application, if approved, before all later-filed applications, without regard to processing time or the applicants’ race or sex. The government failed to provide an exceedingly persuasive justification that would allow the classification to stand. The government may continue the preference for veteran-owned restaurants. View "Vitolo v. Guzman" on Justia Law

Appellant N.A. was a nonminor former dependent (NFD). While a minor, she lived with a legal guardian, who received financial aid (aid to families with dependent children-foster care, or AFDC-FC) on N.A.’s behalf. When N.A. was 17 years old, she moved out of the guardian’s home. The San Diego County Health and Human Services Agency was not informed of this circumstance, and AFDC-FC payments to the guardian continued past N.A.’s 18th birthday. The guardian provided some financial support to N.A. after she moved out, but at some point, the guardian stopped providing support altogether. Thereafter, N.A. petitioned to return to juvenile court jurisdiction and foster care, which would provide her with certain services and financial aid, under Welfare & Institutions Code section 388.1. At that time, the Agency became aware of N.A.’s prior living circumstance and determined that she and the guardian became ineligible for AFDC-FC payments when N.A. moved out of the guardian’s home before N.A. turned 18. The Agency sent notice of its decision to the guardian. Based on its determination that N.A. was not actually eligible to receive AFDC-FC payments after she turned 18, the Agency recommended denying her petition for reentry. The juvenile court denied N.A.’s petition for reentry, but ordered the Agency to notify N.A. directly of its eligibility determination so that she could pursue administrative remedies. On appeal, N.A. contended the juvenile court’s order was based on an erroneous interpretation of section 388.1 and related statutes. Alternatively, N.A. argued that the court should have decided the AFDC-FC eligibility issue because exhausting the administrative hearing process would be futile under the circumstances. Finding no reversible error, the Court of Appeal affirmed the order. View "In re N.A." on Justia Law

Kirby received a flu shot in her arm on October 8, 2013. One week later, she complained of persistent arm pain, numbness, and tingling that began immediately after the injection. On October 16, Dr. Henry diagnosed Kirby with radial neuritis and complications due to vaccination. Two weeks later, Kirby reported that her wrist and hand had become “very weak.” On November 12, Kirby began working with a physical therapist. Her physical therapy discharge summary reported that Kirby’s pain was a “0/10,” she had regained full muscle strength except in right thumb extension, and her numbness had decreased by 80%. On December 12, Kirby reported mild right arm pain in the morning, almost normal strength, and occasional tingling, but no numbness in her thumb. Dr. Henry determined she had achieved maximum medical improvement.Kirby visited a nurse practitioner five times in January 2014-July 2015, for reasons unrelated to her vaccine injury and generally reported “feeling fine.” On October 13, 2015, she complained of mild, intermittent pain in her right arm. She had no imitations due to the pain, and no muscle weakness.The Federal Circuit reinstated Kirby’s compensation award under the Vaccine Act, 42 U.S.C. 300aa–1. A finding that Kirby’s vaccine injury lasted more than six months was not arbitrary. A reasonable fact-finder could conclude that Kirby’s testimony is not inconsistent with her medical records from January 2014 through July 2015. The court also rejected an argument concerning causation. View "Kirby v. Secretary of Health & Human Services" on Justia Law

The Eleventh Circuit affirmed the Commissioner's denial of plaintiff's application for disability insurance benefits pursuant to 42 U.S.C. 405(g). The court held that there is no apparent conflict between one's limitation to following simple instructions and positions that require the ability to follow "detailed but uninvolved" instructions. The court concluded that the decision to deny benefits is otherwise supported by substantial evidence. View "Buckwalter v. Acting Commissioner of Social Security" on Justia Law