Justia Public Benefits Opinion Summaries

Plaintiff, a minor, challenged the district court's orders upholding the OAH's partial denial of reimbursement for educational costs under the Individuals with Disabilities Education Act (IDEA) in No. 12-55715 and granting in part and denying in part a related motion for attorney's fees in No. 12-56796. The district court affirmed the OAH's finding that the school districts denied the student a free appropriate public education for the 2007/2008 school year when they failed to comply with a previous settlement agreement's assessment requirements. The court concluded that the private placement was appropriate. As such, the child should be reimbursed for the cost of tuition. Because the court found that the private placement was an appropriate placement, the child was also entitled to transportation reimbursement; and the district court did not err in partially rejecting reimbursement for the cost of the private aides. Accordingly, the court affirmed in part and reversed in part No. 12-55715. The court dismissed No. 12-56796 for lack of jurisdiction to hear the untimely appeal of the district court's order on fees. View "S. L. v. Upland Unified Sch. Dist., et al." on Justia Law

In enacting comprehensive welfare reform in 1996, Congress rendered various groups of aliens ineligible for federal benefits and also restricted states' ability to use their own funds to provide benefits to certain aliens. As a condition of receiving federal funds, Congress required states to limit eligibility for federal benefits, such as Medicaid, to citizens and certain aliens. Plaintiffs filed suit claiming that Basic Health Hawai'i violated the Equal Protection Clause of the Fourteenth Amendment because it provided less health coverage to nonimmigrant aliens residing in Hawai'i (COFA Residents) than the health coverage that Hawai'i provided to citizens and qualified aliens who are eligible for federal reimbursements through Medicaid. The court concluded that Congress has plenary power to regulate immigration and the conditions on which aliens remain in the United States, and Congress has authorized states to do exactly what Hawai'i had done here - determine the eligibility for, and terms of, state benefits for aliens in a narrow third category, with regard to whom Congress expressly gave states limited discretion. Hawai'i has no constitutional obligation to fill the gap left by Congress's withdrawal of federal funding for COFA Residents. Accordingly, the court vacated the district court's grant of a preliminary injunction preventing Hawai'i from reducing state-paid health benefits for COFA Residents because Hawai'i is not obligated to backfill the loss of federal funds with state funds and its decision not to do so was subject to rational-basis review. View "Korab v. Fink" on Justia Law

Plaintiff appealed the denial of his claims for supplemental security income (SSI). At issue was whether the ALJ failed to make an adequate showing that a significant number of jobs existed in the region in which plaintiff lived or in several regions of the country. The court concluded that the ALJ did not err by defining "region" for purposes of 42 U.S.C. 1382c(a)(3)(B) as the State of California, and 2,500 jobs in California constituted a significant number of jobs in the region. The court also concluded that 25,000 jobs also signified a significant number of jobs in several regions of the country. Accordingly, the court affirmed the judgment of the district court. View "Gutierrez v. Comm'r of Soc. Sec." on Justia Law

Plaintiff, who has an IQ score of 71, appealed the denial of his supplemental security income benefits. The court concluded that plaintiff did not show that his impairments medically equal an IQ score of 60-70, so he has not shown equivalence to all three individual criteria under Listing 12.05C and his condition thus does not equal the listing. Accordingly, the court affirmed the district court's denial of benefits. View "Kennedy v. Colvin" on Justia Law

Plaintiff first applied for social security disability insurance (SSI) benefits ten years ago. When the benefits were denied, plaintiff requested a hearing but the SSA ruled that her request was untimely and denied a subsequent application on the ground of res judicata. The SSA never explained why it rejected plaintiff's facially valid excuse for the delay in her hearing request. The district court then dismissed her action for lack of subject matter jurisdiction. The court reversed and remanded, concluding that the ALJ failed to consider whether plaintiff's facially valid reasons constituted good cause excusing the delay, and deprived plaintiff of her due process right to a meaningful opportunity to be heard and to seek reconsideration of an adverse benefits determination. View "Dexter v. Astrue" on Justia Law

The Secretary appealed the district court's order certifying a nationwide class of Medicare beneficiaries and granting summary judgment in the beneficiaries' favor. The beneficiaries raised two claims: (1) the Secretary's practice of demand "up front" reimbursement for secondary payments from beneficiaries who have appealed a reimbursement determination or sought waiver of the reimbursement obligation was inconsistent with the secondary payer provisions of the Medicare statutory scheme; and (2) the Secretary's practice violated their due process rights. The court concluded that Patricia Haro had Article III standing on behalf of the class; John Balentine, as counsel for Haro, had Article III standing on his individual claim; and the beneficiaries' claims for injunctive relief were not moot and Article III's justiciability requirements were satisfied. The court concluded, however, that the beneficiaries' claim was not adequately presented to the agency at the administrative level and therefore the district court lacked subject matter jurisdiction under 42 U.S.C. 405(g). On the merits of Balentine's claim, the court concluded that the Secretary's interpretation of the secondary payer provisions was reasonable. Therefore, the court vacated the district court's injunctions, reversed the district court's summary judgment order, and remanded for consideration of the beneficiaries' due process claim. View "Haro v. Sebelius" on Justia Law

Planned Parenthood and others filed suit challenging Ariz. Rev. Stat. 35-196.05(B) as a violation of the federal Medicaid Act, 42 U.S.C. 1396a. Ariz. Rev. Stat. 35-196.05(B) barred patients eligible for the state's Medicaid program from obtaining covered family planning services through health care providers who performed abortions in cases other than medical necessity, rape, or incest. The court concluded that the district court's entry of final judgment and a permanent injunction mooted Arizona's appeal of the district court's preliminary injunction. Therefore, the court dismissed that appeal (Case No. 12-17558), and considered only Arizona's appeal of the summary judgment order and permanent injunction (Case No. 13-15506). The court held that the Medicaid Act's free-choice-of-provider requirement conferred a private right of action under 42 U.S.C. 1983. The court also held that the Arizona statute contravenes the Medicaid Act's requirement that states give Medicaid recipients a free choice of qualified provider. Accordingly, the court affirmed the district court's summary judgment and permanent injunction. View "Planned Parenthood v. Betlach" on Justia Law

Plaintiff filed suit against the district alleging claims for disability discrimination and failure to accommodate under the Americans with Disabilities Act of 1990 (ADA), 42 U.S.C. 12101-12213. On appeal, plaintiff challenged the district court's grant of summary judgment in favor of the district. The court concluded that the district court did not abuse its discretion by reconsidering its prior order denying summary judgment where the district court found that it had committed clear error by not considering whether plaintiff gave a sufficient explanation for the conflict between her ADA claim and her Nevada Public Employees' Retirement Systems (PERS) application under the Supreme Court's decision in Cleveland v. Policy Mgmt. Sys. Corp. Under the standard set forth in Cleveland, the court concluded that plaintiff gave sufficient explanations for the inconsistencies between her ADA claim and her PERS and Family Medical Leave Act (FMLA), 29 U.S.C. 2601, applications to survive summary judgment. Accordingly, the court affirmed in part and reversed in part, remanding for further proceedings. View "Smith v. Clark County School District" on Justia Law

Plaintiff, a severely disabled student, filed suit arguing that he was entitled to remain at a private school he had been attending since the age of seven. The Department issued a formal notice that plaintiff's special education placement at the school would end when he turned 20 years old. Plaintiff argued that he was entitled to remain at the school until he was 22 years old. At issue on appeal was whether the "stay put" provision in the Individuals with Disabilities Education Act (IDEA), 20 U.S.C. 1415j, applied to a student who has exceeded a state-imposed age limit on eligibility for public education. The court affirmed the judgment of the district court, concluding that the district court correctly granted plaintiff's motion for stay put. Plaintiff was entitled to remain at the school as his stay-put placement from the date he filed his administrative complaint and he was entitled to remain there until his case was finally resolved. View "A.D. v. State of Hawaii Dep't of Educ." on Justia Law

This case involves a federal rent-subsidy program for Indian Tribes and Tribally Designated Housing Entities (TDHE) that lease housing to Indians. Fort Belknap, a TDHE, petitioned for review of HUD's decision to withhold overpayments from future program payments. The court held that 25 U.S.C. 4161(d) allows an appeal only when HUD takes action pursuant to section 4161(a). In this instance, because HUD has taken no action pursuant to section 4161(a), the court dismissed the petition for lack of jurisdiction. View "Fort Belknap v. Office of Pub. & Indian Hous." on Justia Law