Justia Public Benefits Opinion Summaries

Articles Posted in U.S. 10th Circuit Court of Appeals
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Rebecca Mays appealed the denial of her application for disability benefits. After careful consideration of the Social Security Administration's decision and the district court order affirming the Administration's decision, the Tenth Circuit found no reversible error. View "Mays v. Colvin" on Justia Law

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In a social security disability or Supplemental Security Income (SSI) case, an administrative law judge (ALJ) must evaluate the effect of a claimant's mental impairments on her ability to work using a "special technique" prescribed by the Commissioner's regulations. At the second step of a five-step analysis, the ALJ must determine whether the mental impairment is "severe" or "not severe." If "not," then the ALJ must determine and discuss them as part of his residual functional capacity (RFC) analysis at step four. A question that is frequently encountered in social security disability appeals cases is how much further discussion of a non-severe impairment is required at step four? The Tenth Circuit found that in assessing the claimant's RFC, the ALJ must consider the combined effect of all of the claimant's medically determinable impairments; the Commissioner's procedures do not permit the ALJ to simply rely on his finding of non-severity as a substitute for a proper RFC analysis. In this case, the ALJ found that Petitioner's alleged mental impairments were medically determinable but non-severe. He then used language suggesting he had excluded them from consideration as part of his RFC assessment, based on his determination of non-severity. Under the regulations, however, a finding of non-severity alone would not support a decision to prepare an RFC assessment omitting any mental restriction. The ALJ's specific conclusions he reached in this portion of his analysis were unsupported by substantial evidence. Accordingly, the Tenth Circuit reversed the district court's affirmance of the ALJ's decision and remand to the district court with instructions to remand to the Commissioner for further proceedings at step four. View "Wells v. Colvin" on Justia Law

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Plaintiff-Appellant Tyla Newbold appealed a magistrate judge's order that granted her Social Security benefits from October 2006 to November 2007, but denied them thereafter. The Commissioner of the Social Security Administration determined Plaintiff had been disabled during that period due to physical and mental impairments, but that she recovered and the disability ceased. The issue on appeal to the Tenth Circuit was whether the administrative law judge (ALJ) used the proper medical-improvement standard in deciding Plaintiff ceased being disabled. Finding that the ALJ used the proper standard, the Tenth Circuit affirmed. View "Newbold v. Astrue" on Justia Law

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Full Life Hospice participates in the federal Medicare program. It sought reimbursement for hospice services provided to Medicare recipients from the Department of Health and Human Services (HHS). A fiscal intermediary, acting on behalf of HHS, later contested some of these reimbursements and demanded repayment of funds that it claimed were distributed in excess of a spending cap. Full Life unsuccessfully challenged HHS intermediary’s determination through an administrative appeal, which was denied as untimely. On appeal to the district court, the court found no basis to excuse Full Life's untimely challenge. Upon review, the Tenth Circuit agreed with the district court that it lacked subject matter jurisdiction because of Full Life's failure to file a timely administrative appeal. View "Full Life Hospice v. Sebelius" on Justia Law

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The dispute before the Tenth Circuit in this case centered on interest earned on block grants made to Indian tribes pursuant to the Native American Housing Assistance and Self-Determination Act. Specifically, Appellant Muscogee (Creek) Nation's Division of Housing challenged both a regulation placing a two-year limit on the investment of grant funds and two notices issued by the U.S. Department of Housing and Urban Development stating that any interest accrued after the expiration of this two-year period must be returned to the Department. The Nation sought declaratory relief invalidating the regulation and notices as well as an injunction to prevent HUD from recouping interest earned on grant funds. The Nation also sought recoupment of the approximately $1.3 million of earned interest it wired to HUD after HUD sent a letter threatening an enforcement action based on the Nation’s investment of grant funds for longer than two years. The district court dismissed the complaint, holding that HUD’s sovereign immunity was not waived by the Administrative Procedures Act and, in the alternative, that the Nation had failed to state a claim on which relief could be granted because HUD’s interpretation of the statute was permissible. Upon review, the Tenth Circuit concluded that HUD was authorized to promulgate a regulation limiting the period for investments, and required to demand remittance of interest earned in violation of the regulation. The Nation was therefore not entitled to recouping the interest it paid to HUD pursuant to HUD's enforcement of its rules. View "Muscogee (Creek) Nation v. HUD, et al" on Justia Law

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Debtor Fred Fausett Cranmer filed a Chapter 13 repayment plan, which excluded Social Security income (SSI) from the projected disposable income calculation. The bankruptcy trustee objected to the plan on that basis. The bankruptcy court denied confirmation of the plan, concluding, inter alia, SSI must be included in the projected disposable income calculation and Cranmer's failure to do so meant he did not propose his plan in good faith. Cranmer appealed and the district court reversed. Upon review, the Tenth Circuit Court of Appeals concluded that SSI need not be included in the calculation of projected disposable income and Cranmer's failure to include it was not grounds for finding he did not propose his plan in good faith. View "Anderson v. Cranmer" on Justia Law

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Plaintiff-Appellant Pennie Keyes-Zachary appealed a district court order that affirmed the Commissioner's decision denying her applications for Social Security disability and Supplemental Security Income benefits. Plaintiff alleged disability based on, among other things, neck, back, shoulder, elbow, wrist, hand, and knee problems, accompanied by pain; hearing loss; urinary frequency; anger-management problems; depression; and anxiety. The ALJ upheld the denial of her application for benefits. The Appeals Council denied her request for review of the ALJ's decision, and she then appealed to the district court. The district court remanded the case to the ALJ for further consideration. After the second hearing, the ALJ determined that Plaintiff retained residual functional capacity to perform light work with certain restrictions, but that she was not disabled within the meaning of the Social Security Act. The Appeals Council declined jurisdiction, and the ALJ's decision was then deemed the Commissioner's final decision. On appeal Plaintiff raised two issues: (1) that the ALJ "failed to properly consider, evaluate and discuss the medical source evidence;" and (2) the ALJ "failed to perform a proper credibility determination." Upon review, the Tenth Circuit found no error in the ALJ's decision and affirmed the Commission's final determination in Plaintiff's case. View "Keyes-Zachary v. Astrue" on Justia Law

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Petitioners Leroy and Glenda Morris brought suit under 42 U.S.C. 1983 and the Supremacy Clause to challenge the Oklahoma Department of Human Services' ("OKDHS") denial of Mrs. Morris' application for Medicaid benefits as inconsistent with federal law. After calculating the couple's resources and the Community Spouse Resource Allowance (CSRA), OKDHS determined that the Morrises were ineligible for benefits. In an effort to "spend down" their excess resources, the Morrises purchased an actuarially sound annuity payable to Mr. Morris. Despite this purchase, OKDHS determined that Mrs. Morris remained ineligible. The district court granted summary judgment in favor of OKDHS, upholding the agency's application of the Medicaid statutes. Upon review, the Tenth Circuit reversed and remanded the case for further proceedings. A couple may convert joint resources (which may affect Medicaid eligibility) into income for the community spouse (which does not impact eligibility) by purchasing certain types of annuities. In other words, a couple may purchase a qualifying annuity payable to the community spouse in addition to the community spouse's retention of the CSRA. View "Morris v. Oklahoma Dept. of Human Svcs." on Justia Law

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Plaintiff Lisa R. Chapo appealed a district court's order upholding the Commissioner of Social Security's denial of her application for disability and supplemental security income benefits. The Administrative Law Judge (ALJ) denied benefits at the last step of the five-step process for determining disability. At step five the ALJ found Plaintiff not disabled because, "[c]onsidering [her] age, education [high school], work experience, and residual functional capacity, there are jobs that exist in significant numbers in the national economy that [she] can perform," namely the jobs of appointment clerk, escort vehicle driver, and office helper identified by the vocational expert (VE) who testified at the evidentiary hearing. On appeal to the Appeals Council, Plaintiff challenged the ALJ’s decision in several respects, in particular the ALJ’s treatment of the opinion evidence in the record. Upon review of the record, the Tenth Circuit concluded that ALJ’s handling of a testifying doctor's findings was erroneous and, as a result, the dispositive hypothetical inquiry put to the VE was fatally defective. "Indeed, that hypothetical did not even include a restriction (to 'simple' work) that the ALJ himself recognized in his decision." The Court concluded that this matter be remanded for further proceedings, "wherein the ALJ must either obtain a mental RFC determination from an examining source to oppose [the doctor], articulate some other adequate basis for discounting [his] findings, or come back to the VE with a proper hypothetical including those limitations (and his own restriction to 'simple' work, should the ALJ find it appropriate to re-impose such a restriction in the RFC determined on remand)." View "Chapo v. Astrue" on Justia Law

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Plaintiff-Appellant John Conger appealed the Commissioner's denial of his application for supplemental social security income benefits. Plaintiff applied for benefits in 2005 alleging he was unable to work because of degenerative disk disease, spondylosis, arthritis, depression, and problems sleeping. His application was denied at the administrative level after a hearing before an administrative law judge (ALJ). The ALJ further found that Plaintiff had the residual functional capacity (RFC) to perform simple and routine medium exertional work that required no more than occasional stooping and no contact with the public. After the Appeals Council denied his request for review, Plaintiff filed his complaint in the district court. The district court adopted the report and affirmed the Commissioner's denial of benefits. Upon review, the Tenth Circuit found no error in the ALJ's RFC finding and that the decision was supported by substantial evidence. The Court affirmed the district court and Commissioner's rulings. View "Conger v. Astrue" on Justia Law