Justia Public Benefits Opinion Summaries

Plaintiff’s 1998 dislocation of a kneecap required implantation of a steel plate; a year later a shattered femur required implantation of a steel rod from hip to knee. In 2011, he fractured an ankle. A podiatrist inserted a bar with pins in the ankle and later repeated the procedure. Months later, plaintiff’s ankle pain returned and he was prescribed Vicodin and Percocet, providing limited relief. Two treating physicians reported that he could sit, stand, and walk for only 15 minutes at a time and for no more than one hour in an eight-hour work day; that he could lift a weight of 10-20 pounds only occasionally; and that he could not reach up with his right arm at all. One reported that plaintiff was “fully and completely disabled” with constant and worsening pain that caused constipation, drowsiness, and upset stomach, with a “poor” prognosis. An ALJ denied social security disability benefits, noting that the medical records varied from the reports and finding that plaintiff’s injuries were severe, but he could perform unskilled sedentary jobs. The Seventh Circuit reversed. The question was not whether plaintiff was less disabled than he was four years ago, but whether he was sufficiently recovered to hold down a 40-hour-a-week job; the ALJ did not adequately explain what jobs plaintiff might be capable of. View "Forsythe v. Colvin" on Justia Law

Stage slipped two discs while working in a factory in 1985. She continued working. Her pain became more severe. By 2007, she had been diagnosed with arthritis in her back, hips, left leg, and shoulders; spinal degeneration; a tear in a disc joint; and mild degenerative disc disease. Stage is 5’6” tall and weighed over 200 pounds and also suffered from hyperlipidemia, hypertension, and hypothyroidism, which made her obesity difficult to control. Stage applied for benefits, claiming that debilitating back and hip pain rendered her unable to work after October 2009. Her last job was general kitchen work at a residential‐care facility. She had previously worked as a cook, bartender, and factory laborer. The district court upheld denial of her application for supplemental security income, disability insurance benefits, and disabled widow’s benefits. Stage was then 56 years old. The Seventh Circuit reversed, finding that the ALJ discounted significant new evidence submitted after an agency doctor reviewed Stage's medical records, gave little weight to her treating physician’s opinion, discredited her testimony about pain without adequate support, and overstated her residual functional capacity. The ALJ’s evaluation of her medical evidence was unreasonable; substantial evidence did not support his finding that she remained capable of performing light work. View "Stage v. Colvin" on Justia Law

Loveless, age 56, applied for Disability Insurance Benefits claiming that he could not work because of a shoulder impairment, diabetes, and pancreatitis. An Administrative Law Judge concluded, however, that Loveless could perform light work with restrictions. The Appeals Council and the district court upheld that determination. The Seventh Circuit affirmed, rejecting an argument that the ALJ erred by minimizing the opinion of Loveless’s personal physician and disbelieving his own testimony about the limiting effects of his impairments. The adverse credibility determination was supported by substantial evidence. View "Loveless v. Colvin" on Justia Law

In 2011, Bogina sued under the False Claims Act, 31 U.S.C. 3729, seeking compensation for exposing fraud allegedly perpetrated against the federal government and several state governments. Defendants included a major supplier of medical equipment to institutions reimbursed by Medicare and other federal programs and its customer, a chain of nursing homes. The district judge dismissed the federal claims as being too similar to those in a prior suit and relinquished jurisdiction over the state claims. The Seventh Circuit affirmed, finding differences between this suit and an earlier suit “unimpressive” and stating that it did not matter that the alleged fraud continued. View "Bogina v. Medline Indus., Inc." on Justia Law

Plaintiff applied for disability benefits, listing eight impairments. The Social Security Administration denied Plaintiff’s application and did so again on reconsideration. The next year, Plaintiff testified before an Administrative Law Judge (ALJ). The ALJ disbelieved Plaintiff’s testimony that she could not sit, stand, or walk for extended periods of time and denied Plaintiff’s application for Disability Insurance Benefits and Supplemental Security Income. The Appeals Council denied review, making the ALJ’s decision the final decision of the Commissioner of Social Security. Plaintiff challenged the ALJ’s adverse credibility finding on appeal. The Seventh Circuit reversed, holding that the ALJ’s analysis was flawed in several respects, and the ALJ’s mistakes in evaluating Plaintiff’s credibility were not harmless. Remanded. View "Hill v. Colvin" on Justia Law

The Centralia state-operated developmental center, one of seven Illinois SODCs, houses approximately 200 severely disabled individuals, some having the mentality of an infant or toddler. Many also have serious aggressive, or self-destructive behavioral disorders. The seven SODCs have, in total, about 1800 residents, while about 10,000 people with severe developmental disabilities live in community-based facilities: houses or apartments in residential settings that accommodate one to eight residents. The state agency provides services (such as housing and medical care) to approximately 25,000 developmentally disabled persons. Another 23,000 or so are on a waiting list; 6000 are considered to be in emergency situations. Since 2012 Illinois has been trying to shift SODC residents to community-based facilities, in accordance with a national trend: community-based facilities are cheaper than SODCs and there is evidence that even persons who are severely disabled mentally or behaviorally or both do better in community-based facilities. A suit, on behalf of the Centralia SODC residents, alleged violation of the Americans with Disabilities Act, 42 U.S.C. 12132. The Seventh Circuit affirmed denial of a preliminary injunction to prevent assessment and transfer of those residents, reasoning that the urgency required for emergency relief had not been shown. View "Ill. League of Advocates for Developmentally Disabled v. Ill. Dep't of Human Servs." on Justia Law