Justia Public Benefits Opinion Summaries

Articles Posted in Public Benefits
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Rodriguez, a Gulf War veteran, served as a Santa Cruz police officer. 1995-2007. He applied for industrial disability retirement in 2011 with the California Public Employee’s Retirement System based on his PTSD diagnosis that was caused in part by his work for the city. After litigation, the city granted Rodriguez disability retirement but denied his claim of industrial causation. He began receiving benefits in December 2016. Rodriguez requested a finding that his disability was industrial from the Workers’ Compensation Appeals Board in April 2017. The Board concluded that Rodriguez’s disability was industrial, but that he was barred from receiving industrial disability retirement benefits because his claim for a finding of industrial causation was untimely under the five-year time limitation in Government Code section 21171. The court of appeal reversed. Section 21171 applies only to rescind, alter or amend an earlier industrial determination. Section 21174 applies to initial determinations and states that a retiree claiming an industrial disability that is disputed will not receive the additional benefits “unless the application for that determination is filed with the Workers’ Compensation Appeals Board... within two years after the effective date of the member’s retirement.” If a claimant applies for a determination of industrial causation within two years of retirement but more than five years after the injury, the Board cannot modify its determination that an injury is industrial or not; nothing precludes the Board from making the initial determination of industrial causation. View "Rodriguez v. Workers' Compensation Appeals Board" on Justia Law

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Brintley is blind. To navigate the internet, she uses a screen reader that scans webpages and narrates their contents. The technology struggles with some material, especially pictures and video. With some effort, companies can make their websites fully screen-reader compatible. The credit unions, established under Michigan law, maintain a limited brick-and-mortar presence; both operate websites. Brintley tried to browse these websites but found her screen reader unable to process some of their content. A “tester” of website compliance with the Americans with Disabilities Act, Brintley sued the credit unions, seeking compensatory and injunctive relief, arguing that the websites were a “service” offered through a “place of public accommodation,” entitling her to the “full and equal enjoyment” of the websites. 42 U.S.C. 12182(a). The district court rejected an argument that Brintley failed to satisfy Article III standing. The Sixth Circuit reversed. To establish standing, Brintley must show that she sustained an injury in fact, that she can trace the injury to the credit unions’ conduct, and that a decision in her favor would redress the injury. Brintley must show an invasion of a “legally protected interest” that is “concrete and particularized” and “actual or imminent” and that affects her in some “personal and individual way.” Brintley lacks eligibility under state law to join either credit union and her complaint does not convey any interest in becoming eligible to do so. View "Brintley v. Belle River Community Credit Union" on Justia Law

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A1 learned that government auditors thought that the company had overcharged a federal agency by several million dollars for services provided to Medicare beneficiaries. A1 challenged the auditors’ decisions at two levels of the Medicare appeals process but changed the auditors’ minds only in a few minor ways. The government tried to start collecting the money, as the regulatory regime allows, 42 U.S.C. 1395ff(a)(5), (c)(3)(E). Fearing bankruptcy from the government’s recoupment efforts, A1 obtained a preliminary injunction, barring the government from recouping the money until A1 received a hearing before an administrative law judge. The Sixth Circuit vacated the injunction, first holding that although A1 did not proceed to the third and fourth levels of the administrative appeal, the district court had jurisdiction over A1’s constitutional claims. On the merits, the court identified unanswered questions regarding the statistics concerning the relief likely to be obtained at the third level of administrative review; details about A1’s choice not to take advantage of an option to escalate its claim to the fourth and final level of administrative review; and the parties’ awareness of a recoupment option that might have allowed A1 to obtain an ALJ hearing before making most or even all of its recoupment payments. View "A1 Diabetes & Medical Supply v. Alex Azar II" on Justia Law

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The Eighth Circuit affirmed the denial of social security disability insurance benefits and supplemental security income to plaintiff. The court held that substantial evidence supported the ALJ's conclusion that plaintiff's work as a receptionist constituted "substantial gainful activity." In this case, she worked predominately as a receptionist, was paid for the work, and performed work that plainly involved significant physical or mental activities. The court held that plaintiff performed activities beyond her core duties as a receptionist only occasionally, and her responsibilities as a receptionist alone constituted substantial gainful activity. View "Sloan v. Saul" on Justia Law

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In February 2015, Johnson’s landlord under the Housing and Community Development Act Section 8 housing assistance program (42 U.S.C. 1437f(o)) served a “lease violation notice” informing Johnson that she had violated her lease by following another tenant to his apartment and using profanity. In June 2015, Landlord issued a “notice to cease” stating that management had received a complaint from a resident alleging that she had used pepper spray against him. On February 29, 2016, Landlord served a “ninety-day notice of termination of tenancy.” In June, when Johnson failed to vacate, Landlord filed an unlawful detainer action. In August, the action was settled by a stipulation; Landlord agreed to reinstate Johnson’s tenancy on the condition that she conform her conduct to the lease. Landlord retained the right to apply for entry of judgment based on specified evidence of breach. In October, Landlord applied for entry of judgment, claiming that Johnson violated the stipulation. Johnson was evicted in January 2017. In February, the Oakland Housing Authority, which administers the Section 8 program, terminated Johnson's benefits. The court of appeal found no violation of Johnson’s procedural due process rights in terminating her from the program. Johnson was given sufficient notice of the grounds for termination: she failed to supply the Authority with required eviction documentation; she committed and was evicted for serious repeated lease violations. The hearing officer did not abuse its discretion in refusing to excuse the violation. View "Johnson v. Housing Authority of City of Oakland" on Justia Law

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California State Teachers’ Retirement System (CalSTRS) manages contributions made by employees and member school districts to the State Teachers’ Retirement Fund. (Ed. Code 22000.) In 2014, the Baxter petitioners, formerly employed by the Salinas Unified High School District sought to prevent CalSTRS from continuing to reduce their monthly retirement benefit payments and to restore prior monies they claimed CalSTRS had wrongfully withheld to recoup overpayments made as a result of a years-long miscalculation by the District. The trial court held that a three-year limitations period barred CalSTRS from recouping the prior overpayments. The court of appeal reversed, finding that the continuous accrual theory applied. A second suit challenged the reductions. Before the court of appeal addressed Baxter, the trial court granted relief in the second suit, finding CalSTRS’s claims time-barred. The court of appeal followed Baxter, holding that the continuous accrual theory applies. CalSTRS was time-barred from pursuing any claim against teachers as to pension benefit overpayments made more than three years before CalSTRS commenced an action but is not time-barred from pursuing any claim concerning periodic overpayments to teachers and adjustments to teachers’ future monthly benefits, where the payment accrued not more than three years prior to commencement of an action. The reduction in benefits made by CalSTRS did not constitute the commencement of an “action.” CalSTRS constructively commenced an “action” when these teachers filed their verified petition and complaint in the superior court on February 1, 2016. View "Blaser v. State Teachers' Retirement System" on Justia Law

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After appellant successfully litigated her claim to supplemental social security income, she challenged the district court's denial of her application for attorney's fees under 42 U.S.C. 406(b).The Second Circuit affirmed the denial of appellant's attorney's fee application as untimely, because she filed well beyond the 14 days prescribed by Federal Rule of Civil Procedure 54(d)(2)(B). Assuming the court would entertain appellant's argument, it failed on the merits because she provided no factual basis to support a claim that it was reasonable to delay the filing of her section 406(b) application for more than six months after she received notice of the benefits calculation on remand. View "Sinkler v. Berryhill" on Justia Law

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Crump applied for social security disability benefits based on her long history of numerous mental health impairments, including bipolar disorder and polysubstance abuse disorder. An administrative law judge denied benefits, finding that Crump, despite her severe impairments, could perform work limited to simple and repetitive tasks. The district court affirmed. The Seventh Circuit vacated. The ALJ did not adequately account for Crump’s difficulties with concentration, persistence, or pace in the workplace. An ALJ generally may not rely merely on catch-all terms like “’simple, repetitive tasks’” because there is no basis to conclude that they account for problems of concentration, persistence or pace. In addition, observing that a person can perform simple and repetitive tasks says nothing about whether the individual can do so on a sustained basis. Beyond disregarding the Vocational Expert’s opinion in response to a second hypothetical, the ALJ gave short shrift to the medical opinions of Crump’s treating psychiatrist. View "Crump v. Saul" on Justia Law

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The ALJ who ruled on Hess’s application for social security disability benefits concluded that Hess had “moderate difficulties” in “concentration, persistence or pace,” but offered a detailed explanation for why she believed those difficulties were not serious and why Hess was capable of performing simple tasks. She found that Hess was “limited to jobs requiring understanding, remembering, and carrying out only simple instructions and making only simple work-related decisions[.]” In a series of hypothetical questions meant to include Hess’s limitations, she asked a vocational expert whether there were jobs in the national economy available to someone with those limitations. The expert said there were. The ALJ decided that Hess was not disabled and rejected his claim. The district court determined that the ALJ had erred because, in her hypothetical questions to the vocational expert, she failed to include or account for her finding that Hess had “moderate” difficulties in “concentration, persistence, or pace.” The Third Circuit reversed, refusing to elevate “form over substance.” An ALJ’s statement of a limitation confining a person to “simple tasks” is permissible after a finding of “moderate” difficulties in “concentration, persistence, or pace,” if the ALJ offers a “valid explanation” for it. The explanation given by the ALJ was “valid.” View "Hess v. Commissioner of Social Security" on Justia Law

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The Eighth Circuit affirmed the denial of social security disability benefits to plaintiff. The court held that plaintiff clearly suffered from back pain, but substantial evidence supported the ALJ's finding that plaintiff had the residual functional capacity to perform light work. Furthermore, the ALJ did not err by failing to order a consultative examination, because the evidence in the record provided a sufficient basis for the ALJ's decision, and substantial evidence supported the ALJ's credibility determination on the record as a whole. View "Swink v. Saul" on Justia Law