Justia Public Benefits Opinion Summaries

The Ninth Circuit affirmed the denial of Social Security Disability Insurance (SSDI) benefits and the partial denial of Supplemental Security Income (SSI) benefits. The panel held that the ALJ did not err by finding plaintiff's disability onset date without calling on a medical advisor at the hearing. In this case, the record was adequate even before plaintiff saw a mental health specialist and no reasonable medical expert could have inferred that her disability began before May 2010. Therefore, Social Security Ruling 83-20 did not require the ALJ to consult a medical advisor before determining plaintiff's disability onset date. View "Wellington v. Berryhill" on Justia Law

Cullinan unsuccessfully sought Disability Insurance Benefits and Supplemental Security Income based on several impairments, most of which arose after she suffered a stroke: anxiety, depression, peripheral blindness in one eye, diabetes, obesity, and sleep apnea. An administrative law judge determined that although Cullinan has several impairments, she is not disabled. The Seventh Circuit vacated. The ALJ’s decision to discredit Cullinan’s testimony and that of her treating psychologist was unsupported by the record because the ALJ’s examples of Cullinan’s daily activities and social interactions did “not remotely describe a ‘very active’ lifestyle.” The ALJ did not adequately explain the conclusion that the doctor’s notes were inconsistent with his opinion and did not consider Cullinan’s daily extended naps and frequent debilitating headaches in determining her residual functional capacity. No evidence contradicted Cullinan’s testimony about those limitations. The vocational expert said that needing to take a two-hour nap every day would rule out all work. The ALJ has the burden to develop the record and assess whether symptoms are disabling. View "Cullinan v. Berryhill" on Justia Law

Ebanks sought veterans benefits for service-connected posttraumatic stress disorder, hearing loss, and arthritis. His claim for an increased disability rating was denied by the VA Regional Office (RO) in October 2014; in December he sought Board of Veterans Appeals review, with a video-conference hearing (38 U.S.C. 7107). Two years later, the Board had not scheduled a hearing. Ebanks sought a writ of mandamus. The Veterans Court denied relief. While his appeal was pending, the Board held his hearing in October 2017. The Federal Circuit vacated, finding the matter moot so that it lacked jurisdiction. The delay is typical and any Board hearings on remand are subject to expedited treatment under 38 U.S.C. 7112. Congress has recently overhauled the review process for RO decisions, so that veterans may now choose one of three tracks for further review of an RO decision, Given these many contingencies, Ebanks has not shown a sufficiently reasonable expectation that he will again be subjected to the same delays. Even if this case were not moot, the court questioned “the appropriateness of granting individual relief to veterans who claim unreasonable delays in VA’s first-come-first-served queue.” The “issue seems best addressed in the class-action context,.” View "Ebanks v. Shulkin" on Justia Law

The Fifth Circuit affirmed the district court's denial of social security disability benefits to plaintiff. The court held that the ALJ's decision not to follow the VA's 100% disability rating determination was supported by substantial evidence where the court considered, but ultimately rejected the VA's findings, in part because the VA relied heavily on a one-time evaluation by a doctor who had not formed a treating relationship with plaintiff. The court explained that reports by two state-agency consultants cut against the VA's determination, and it was emphatically the ALJ's province to weigh the evidence and decide among these competing accounts. The court rejected plaintiff's remaining claims. View "Garcia v. Berryhill" on Justia Law

The First Circuit affirmed the district court’s dismissal of Plaintiffs’ suit challenging the Social Security Administration’s (SSA) termination of tier disability benefits for lack of subject matter jurisdiction based on Plaintiffs’ failure to have exhausted their administrative remedies.After the SSA terminated the disability benefits that Plaintiffs had been receiving, Plaintiffs challenged that decision administratively. Before they had exhausted the administrative review process, however, Plaintiffs filed suit in federal court seeking various kinds of relief based presumably on the same grounds as the claims that had presented to the SSA in seeking to continue to receive their benefits. The district court granted the government’s motion to dismiss for lack of subject matter jurisdiction, concluding that Plaintiffs failed to exhaust their administrative remedies. The First Circuit affirmed, holding that Plaintiffs failed to show that they could not obtain a restoration of their benefits through the administrative review process, despite evidence suggesting that they would have a substantial chance of doing so. View "Justiniano v. Social Security Administration" on Justia Law

The North Dakota Department of Human Services appealed a district court judgment reversing the Department's order deciding Altru Specialty Services, doing business as Yorhom Medical Essentials, received overpayments for medical equipment supplied to Medicaid recipients and ordering recoupment. The North Dakota Supreme Court concluded the district court did not have jurisdiction and the appeal should have been dismissed because Yorhom failed to satisfy statutory requirements for perfecting an appeal. View "Altru Specialty Services, Inc. v. N.D. Dep't of Human Services" on Justia Law

The "credit-as-true rule" permits, but does not require, a direct award of benefits on review but only where the ALJ has not provided sufficient reasoning for rejecting testimony and there are no outstanding issues on which further proceedings in the administrative court would be useful. The Ninth Circuit affirmed the district court's decision to remand for further administrative proceedings in a claimant's action seeking Title II disability insurance benefits. The panel clarified the district court's remand order, instructing the district court to remand to the ALJ consistent with the requirements pursuant to Treichler v. Comm'r of Soc. Sec. Admin., 775 F.3d 1090, 1101-02 (9th Cir. 2014), with an open record on the issue of claimant's fatigue related to his capacity to undertake full time employment. On remand, claimant shall be permitted to cross-examine the Commissioner's medical consultants, but only to the extent such cross-examination concerns the issue of claimant's fatigue. View "Leon v. Berryhill" on Justia Law

Simmons contacted counsel in 2011, claiming that he developed Guillain-Barre Syndrome as a result of his 2010 flu vaccination. He provided his vaccination record. Counsel agreed to represent him. Counsel was subsequently unable to contact Simmons and sent a letter in 2013, stating that their attorney-client relationship had terminated. That letter was returned as undeliverable. Nearly two years later, shortly before the limitations period on his Vaccine Act claim would expire, Simmons contacted counsel’ and expressed that he would like to proceed. Counsel spoke with Simmons one additional time. The next day, on October 22, 2013, counsel filed Simmons’s petition, without any medical records or other supporting evidence. In January 2014, the special master ordered counsel to produce medical records. Counsel stated that counsel had again lost contact with Simmons and was unable to acquire those records. The master dismissed the case for failure to prosecute. Counsel then filed petitions seeking $8,267.89 in fees and costs. The master noted that because there was no direct evidence of bad faith and counsel had a vaccination receipt, counsel had satisfied the good faith and reasonable basis requirements and awarded fees. The Claims Court and Federal Circuit disagreed. The master erred in finding that counsel had a reasonable basis for Simmons’s claim. The fact that the statute of limitations was about to expire did not excuse counsel’s obligation to show some basis for the claim that Simmons suffered Guillain-Barre beyond their conversations. View "Simmons v. Secretary of Health and Human Services" on Justia Law

The Eleventh Circuit affirmed the denial of disability insurance benefits and supplemental security income (SSI) to plaintiff. The court held that substantial evidence supported the ALJ's decision to give little weight to the treating physician's opinion because it was inconsistent with his own medical records and the records as a whole; the ALJ's finding that plaintiff had the residual functioning capacity (RFC) to perform a full range of unskilled sedentary work was supported by substantial evidence; Social Security Ruling 16-3p applied only prospectively and did not provide a basis for remand; and the Appeals Council was not required to consider new evidence because it was not chronologically relevant. View "Hargress v. Social Security Administration" on Justia Law

Kerr sought judicial review of the final determination that Kerr’s husband was not disabled and not entitled to any Social Security disability insurance benefits before his death. Kerr was due to receive any payment owed to Mr. Kerr. The parties stipulated to reversal and remand under 42 U.S.C. 405(g). Kerr then sought an award of $3,206.25 in attorney fees under the Equal Access to Justice Act, 28 U.S.C. 2412(d), with any fees awarded “be made payable to Plaintiff’s counsel,” attaching an “Affidavit and Assignment of EAJA Fee.” The Commissioner did not oppose the motion. The district court granted the award, declined to honor Kerr’s assignment, and concluded that it was required to order payment to Kerr as the prevailing party. The court held that it could not “ignore the Anti-Assignment Act,” which prohibits “an assignment of a claim against the United States that is executed before the claim is allowed, before the amount of the claim is decided, and before a warrant for payment of the claim has been issued” but “le[ft] it to the Commissioner’s discretion to determine whether to waive the Anti-Assignment Act and make the fee payable to Mr. Marks.” The Commissioner responded that she would accept [Kerr’s] assignment and suggested that the court deny as moot Kerr’s Rule 59(e) motion. The district court and Sixth Circuit agreed that Kerr’s motion was moot, and did not reconsider the application of the AAA to the EAJA assignment. View "Kerr v. Commissioner of Social Security" on Justia Law