Justia Public Benefits Opinion SummariesArticles Posted in U.S. Court of Appeals for the Fifth Circuit
Kneeland v. Berryhill
Plaintiff suffers from physical, cognitive, and psychological impairments. In this appeal, plaintiff challenged the denial of her social security disability benefits. The court concluded that the ALJ legally erred by rejecting an examining physician's opinion without explanation. In this case, the physician opined that plaintiff could not work any job that entailed standing for longer than 30 minutes or walking farther than 50 years. Accordingly, the court vacated and remanded for the ALJ to consider plaintiff's impairments, taking into account the examining physician's opinion. View "Kneeland v. Berryhill" on Justia Law
Jefferson Community Health Care Centers v. Jefferson Parish Government
In the underlying action, JCHCC sought to permanently enjoin the Parish from evicting it from two Parish-owned facilities in which JCHCC currently provides medical services to medically underserved populations. The district court granted JCHCC's motion for a preliminary injunction, enjoining the Parish from evicting JCHCC but allowing it to terminate the injunction by establishing that the medical needs of the population currently served by the relevant JCHCC facilities would be met if JCHCC were evicted. The court reversed, concluding that JCHCC has not established a substantial likelihood of success on the merits of the only claim that was properly before the court. In this case, JCHCC failed to establish a likelihood of success on the merits of its Medicaid violation claim where JCHCC does not point to any authority suggesting that every local government in every participating state must provide the relevant medical services, nor does it point to authority establishing that the Parish has any obligation under Louisiana state law to provide such services on behalf of the state. View "Jefferson Community Health Care Centers v. Jefferson Parish Government" on Justia Law
Graves v. Colvin
Plaintiff challenged the denial of disability insurance benefits, arguing that the ALJ erred by failing to ask a testifying vocational expert whether her testimony was consistent with the Dictionary of Occupational Titles (DOT), as required by an agency policy interpretation ruling, but nonetheless relying on that testimony. The court concluded that the ALJ's procedural error was harmless and does not warrant reversal. Because plaintiff does not raise any other grounds for reversal, the court affirmed the judgment. View "Graves v. Colvin" on Justia Law
Planned Parenthood v. Gee
In response to secretly recorded videos released by the Center for Medical Progress depicting conversations with Planned Parenthood employees elsewhere, LDHH terminated PPGC Louisiana Medicaid provider agreements. PPGC and the Individual Plaintiffs filed suit against LDHH under 42 U.S.C. 1983, alleging violations of 42 U.S.C. 1396a(a)(23) and the First and Fourteenth Amendments of the U.S. Constitution. The Individual Plaintiffs, three women who are Medicaid beneficiaries and who receive medical care from one of PPGC’s Louisiana facilities, seek to continue receiving care from PPGC’s facilities. The Individual Plaintiffs contend that LDHH’s termination action will deprive them of access to the qualified and willing provider of their choice, PPGC, in violation of Medicaid’s free-choice-of-provider provision. The district court entered a preliminary injunction against LDHH’s termination of PPGC’s Medicaid provider agreements. The court held that the Individual Plaintiffs met their burden to show their entitlement to a preliminary injunction; the district court did not abuse its discretion in preliminarily enjoining LDHH’s termination of PPGC’s provider agreements; and thus the court affirmed the district court's preliminary injunction, remanding for further proceedings. View "Planned Parenthood v. Gee" on Justia Law
Houten, Jr. v. City of Fort Worth
Plaintiffs filed suit against the City, arguing that the City's pension reforms violate the Texas Constitution, Tex. Const. art. XVI 66(d). Two district courts ruled in favor of the City. In these consolidated appeals, the court concluded that Section 66 permits prospective changes to the pension plans of the public employees within its reach. In this case, the Pension Reform complies with Section 66 where Section 66 did not turn plaintiffs’ variable-rate cost-of-living adjustment into a one-way ratchet capable only of upward movement. The court rejected claims raised by plaintiffs of Case No. 15-10416, that only the Texas legislature has the City of Dallas v. Trammel "reserved power" to amend pension plans and thus abrogate contractual rights. The court concluded that this argument is foreclosed by Klumb v. Houston Mun. Employees Pension Sys. Finally, the court concluded that the Pension Reform does not violate the United States Constitution’s contracts clause and takings clause where neither clause create property rights and the right to public pension benefits in Texas is subject to legislative power. Accordingly, the court affirmed the district court's judgments. View "Houten, Jr. v. City of Fort Worth" on Justia Law
Whitehead v. Colvin
Plaintiff, complaining chiefly of neck pain, appealed the denial of his application for disability benefits. The court concluded that the newly submitted evidence - namely, updated treatment records - was not so significant as to require remand to the ALJ for additional consideration; substantial evidence supports the ALJ's determination at step three of the evaluation process that plaintiff did not meet or medically equal Listing 1.04(A); and the ALJ's residual functioning capacity (RFC) finding is supported by substantial evidence where the ALJ found that plaintiff was capable of performing light work with certain limitations. The court agreed with the ALJ's ultimate determination that plaintiff was not disabled and affirmed the judgment. View "Whitehead v. Colvin" on Justia Law
Frew v. Janek
Plaintiffs, a class of children eligible for Texas's Early and Periodic Screening, Diagnosis, and Treatment program, filed suit under 42 U.S.C. 1983 for violations of federal Medicaid law. Plaintiffs subsequently entered into a consent decree with various Texas state officials (defendants) calculated to improve implementation of the Program. In 2007, the parties agreed to a "Corrective Action Order." In 2013, defendants moved to terminate a portion of the Order and associated consent decree paragraphs under Rule 60(b)(5). The district court granted the motion and plaintiffs appealed. Determining that plaintiffs have not forfeited their appeal, the court concluded that the district court properly terminated the portion of bullet points 8-10 concerning the completion of the four assessments at issue. The court relied on certain district court decisions to interpret the proper interpretation of "shortage" - which compares the provider-to-class-member ratio with the average client load of the relevant class of provider - and concluded that the district court erred in terminating the portion of bullet points 8-10 that orders defendants to develop plans to address “shortage[s]” identified by the assessments. Accordingly, the court vacated the district court's order in part and remanded for further proceedings. The court affirmed the portion of the district court’s order terminating bullet points 6-7 and consent decree paragraph 93, and the court vacated the portion of the district court's order terminating the challenged sentence of bullet point 5. View "Frew v. Janek" on Justia Law
Rockwall Indep. Sch. Dist. v. M. C.
Parents of M.C. appealed the district court's denial of reimbursement for tuition in a private school under the Individuals with Disabilities Education Act (IDEA), 20 U.S.C. 1400 et seq. In this case, the parents adopted an all-or-nothing approach to the development of M.C.'s Individualized Educational Plan (IEP) and they adamantly refused to consider any of the school district's alternative proposals. The court affirmed the district court's denial of reimbursement because the district court’s findings and the underlying record support the conclusion that M.C.’s parents acted unreasonably in unilaterally terminating the process of developing M.C.’s IEP. View "Rockwall Indep. Sch. Dist. v. M. C." on Justia Law
Tina M. v. St. Tammany Parish Sch. Bd.
Plaintiffs filed suit on behalf of their minor son seeking attorneys' fees under the Individuals with Disabilities Education Act's (IDEA), 20 U.S.C. 1415(i)(3)(B), fee-shifting provision. The district court held that plaintiffs were the prevailing party by virtue of having obtained a “stay-put” order under the IDEA and awarded plaintiffs attorneys’ fees. The court held that plaintiffs are not the prevailing party by virtue of having invoked the IDEA's stay-put provision and the court concluded that its holding is consistent with several other circuit courts that have addressed the issue. Contrary to the district court’s conclusion, the ALJ’s stay-put order was not a ruling on the merits; nor is the stay-put order a “similar form of judicially sanctioned relief” sufficient to confer prevailing party status; the court disagreed with the district court’s reasoning that the stay-put order was essentially a preliminary injunction and that pursuant to the court's case law in this context, plaintiffs were entitled to attorneys’ fees; and, in Davis v. Abbott, the court recently reiterated the importance of a party having achieved relief on the merits for the purposes of determining prevailing party status in the context of interlocutory injunctive relief. Accordingly, the court reversed and rendered judgment for defendants. View "Tina M. v. St. Tammany Parish Sch. Bd." on Justia Law
Seth B. v. Orleans Parish Sch. Bd.
Parents of Seth B., a child diagnosed with autism, obtained an independent educational evaluation (IEE) and sought reimbursement. The district court subsequently ruled that the reimbursement was not warranted. The court concluded that the school board did not waive its right to refuse reimbursement and the proceedings before the district court were procedurally sound; the application of Bulletin 1508 did not violate the right to an IEE in this case; the court remanded for analysis under a substantial compliance standard where Seth’s IEE will “meet agency criteria” and merit reimbursement if it substantially complies with Bulletin 1508; but Parents will not be entitled to the full cost of the evaluation they obtained because they knew of the school board's cost cap of $3,000 and yet spent over $8,000. Accordingly, the court vacated and remanded. View "Seth B. v. Orleans Parish Sch. Bd." on Justia Law