Justia Public Benefits Opinion Summaries

This case addressed the effect of a pooled special-needs trust created by an over-65-year-old beneficiary on his medicaid benefits. The Center for Special Needs Trust Administration appealed a summary judgment in favor of the North Dakota Department of Human Services. Invoking 42 U.S.C. 1983 and the Constitution's Supremacy Clause, the Center alleged that North Dakota's demand for reimbursement and its state regulations violated a paragraph of the Medicaid Act, 42 U.S.C. 1396p(d)(4)(C). The court held that the district court properly determined that section 1396p(d)(4)(C) afforded the Center a right of action under section 1983; that North Dakota did not waive its claim to recover for reimbursements and should not be estopped from making that claim; that the Center's claim was without merit; and that preemption did not apply. View "Center for Special Needs, etc. v. Olson, etc." on Justia Law

Plaintiff appealed the district court's order affirming the Commissioner's denial of his application for supplemental security income benefits. Specifically, he objected to the ALJ's finding, without considering the testimony of a vocational expert, that plaintiff was able to engage in gainful activity. The court concluded that the ALJ erred by relying solely on the guidelines to determine plaintiff was "not disabled." Because the ALJ determined that plaintiff suffered from severe mental impairments, the ALJ should have consulted a vocational expert in determining whether plaintiff had the residual functional capacity to perform other jobs that existed in significant number in the national economy. Accordingly, the court reversed and remanded for further proceedings. View "Brock v. Astrue" on Justia Law

Appellant appealed the district court's affirmance of the Social Security Commissioner's decision to deny him disability benefits and supplemental security income (SSI) under the Social Security Act, 42 U.S.C. 423, 1382. On appeal, defendant claimed that the district court should have found that he submitted a medical report from Dr. Mary Ellen Ziolko to the Appeals Council that was not considered and this case should therefore have been remanded to the Appeals Council for consideration of the new and material evidence. The court agreed that the district court should have determined whether appellant submitted the new evidence under 20 C.F.R. 404.970(b), and thus the court remanded to the district court to make that determination. View "Whitney v. Astrue" on Justia Law

This case arose when defendant denied plaintiff's application for Medicaid benefits on the grounds that she had transferred property in 2005-2006 valued at $340,000. The district court subsequently dismissed plaintiff's 42 U.S.C. 1983 claim against defendants based on the abstention doctrine set forth in Younger v. Harris. Plaintiff appealed, contending that the district court should not have abstained from hearing her claim. Because, under Alleghany Corp. v. McCartney, abstention was appropriate in administrative proceedings like plaintiff's, the court held that the district court did not err in abstaining. View "Hudson v. Campbell, et al." on Justia Law

Two administrative hearing panels (Panels) concluded that the school district failed to provide plaintiffs' twin sons with a free appropriate public education (FAPE) in 2005, pursuant to the Individuals with Disabilities Education Act (IDEA), 20 U.S.C. 1400 et seq., but did provide one in 2006. The district court upheld these decisions and later awarded attorney's fees to plaintiffs. Plaintiffs and the school district cross appealed. The court held that the school district offered the twins a FAPE in 2005 and therefore, reversed the award of a reduced attorney's fee. The court affirmed, however, the district court's ruling that plaintiffs waived or abandoned their appeal of the Panels' 2006 FAPE decision.

Appellee applied for supplemental security income under Title XVI of the Social Security Act, 42 U.S.C. 1382. The Commissioner of the Social Security Administration subsequently appealed the district court's decision, arguing that the ALJ permissibly discounted appellee's testimony and that the district court substituted its own judgment for that of the ALJ in concluding otherwise. In the alternative, the Commissioner asserted that even if the ALJ erred, the district court should have remanded for additional proceedings and erred in directing the entry of an award of benefits. The court held that valid reasons supported the ALJ's adverse credibility determination and that substantial evidence in the record supported the ALJ's determination that appellee could perform sedentary work as long as he had the option of alternating between sitting and standing. Therefore, the court reversed the district court's decision and remanded for the district court to affirm the decision of the Commissioner.

Appellee sued the Commissioner of the Social Security Administration (SSA), seeking review of the SSA's denial of benefits to her daughter. At issue was whether a child conceived through artificial insemination more than a year after her father's death qualified for benefits under the Social Security Act, 42 U.S.C. 402, 416. The Commissioner interpreted the Act to provide that a natural child of the decedent was not entitled to benefits unless she had inheritance rights under state law or could satisfy certain additional statutory requirements. The court held that the Commissioner's interpretation was, at a minimum, reasonable and entitled to deference, and that the relevant state law did not entitle the applicant in this case to benefits. Therefore, the court reversed the district court's judgments.

Appellant appealed the district court's order, which affirmed the decision of the Commissioner of the Social Security Administration (Commissioner), denying appellant's application for disability benefits (DIB) under Title II of the Social Security Act, 42 U.S.C. 401 et seq. At issue was whether the ALJ committed legal error by failing to correctly apply the requisite five-step sequential evaluation process. The court held that the ALJ's failure to follow the mandated procedure was more than a mere oversight in opinion writing and that the ALJ was required to follow one of two paths at step five of the sequential process and there was no record indicating that the ALJ followed either path. Accordingly, the court reversed the district court's order affirming the Commissioner's decision and instructed the district court to remand the case to the Commissioner for further proceedings.

Defendant was convicted of one count of making a false statement to obtain Social Security Disability benefits and two counts of knowingly concealing that he earned wages above the income threshold for disability benefits. On appeal, defendant argued that his sentence was unreasonable and filed pro se motions seeking reversal. The court held that the district court considered appropriate factors and provided adequate, internally consistent reasons in imposing a reasonable sentence. The court also held that the pro se motions were better left to a collateral proceeding where the court had an undeveloped record on such claims. Accordingly, the judgment of the district court was affirmed.

Appellant alleged that he was disabled as a result of Post Traumatic Stress Disorder, Parkinson's disease, Attention Deficit Disorder, and peripheral neuropathy and that these mental and physical limitations he had as a result of these conditions, combined with his advanced age and limited job skills, rendered him unable to perform any work available in the national economy. Appellant challenged the district court's affirmance of the Social Security Administration's (SSA) denial of his claim for disability benefits. The court affirmed the judgment and held that the ALJ's findings were supported by substantial evidence.