Justia Public Benefits Opinion Summaries

Articles Posted in US Court of Appeals for the Ninth Circuit
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The Ninth Circuit reversed the district court's decision affirming the ALJ's 2019 decision denying claimant's application for social security disability benefits. The panel concluded that, although the ALJ's conclusion that claimant was not disabled at the time of the hearing was supported by substantial evidence, the ALJ did not adequately consider claimant's symptoms over time. The panel explained that the ALJ's failure to consider these changes over time impacted both her assessment of claimant's credibility and her analysis of the medical opinions. Therefore, on remand, the ALJ shall consider whether claimant was disabled and thus entitled to benefits, for some qualifying, earlier portion of his alleged disability period. View "Smith v. Kijakazi" on Justia Law

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Wade filed her claim for Social Security Disability Insurance benefits and Supplemental Security Income in 2015. An ALJ denied Wade’s claim in 2017, finding her not disabled. Following an unsuccessful administrative appeal, Wade filed suit, seeking leave to proceed in forma pauperis (IFP). The district court granted Wade’s IFP motion and, in 2020, entered judgment in the Commissioner’s favor. Wade proceeded IFP with her appeal. The Ninth Circuit found that the ALJ erred, reversed the order affirming the denial of benefits, and remanded for further administrative review. Wade then submitted a bill of appellate costs, seeking $169.65 from the government for copies of briefs and excerpts of record.The Ninth Circuit denied the request. A party who proceeds IFP and prevails on appeal is not entitled to recover taxable costs from the United States, 28 U.S.C. 1915(f)(1); “judgment may be rendered for costs at the conclusion of the suit or action as in other proceedings, but the United States shall not be liable for any of the costs thus incurred.” View "Wade v. Kijakazi" on Justia Law

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Alliance alleged that County and City policies and inaction have created a dangerous environment in the Skid Row area, claiming that the County violated its mandatory duty to provide medically necessary care and that the municipalities have facilitated public nuisance violations by failing to clear encampments, violated disability access laws by failing to clear sidewalks of encampments, and violated constitutional rights by providing disparate services to those within the Skid Row area and by enacting policies resulting in a state-created danger to area residents and businesses. The district court issued a preliminary injunction, ordering the escrow of $1 billion to address homelessness, offers of shelter to all unhoused individuals in Skid Row within 180 days, and numerous reports. The court found that structural racism was behind Los Angeles’s homelessness crisis and its disproportionate impact on the Black community.The Ninth Circuit vacated. The plaintiffs lacked standing on all but their ADA claim; no claims were based on racial discrimination. The district court impermissibly resorted to independent research and extra-record evidence. There was no allegation that any individual plaintiff was Black nor that there was a special relationship between the City and unhoused residents nor that any individual plaintiff was deprived of medically necessary care or general assistance. Two plaintiffs who use wheelchairs and cannot traverse Skid Row sidewalks because of homeless encampments had standing to bring ADA claims but had not shown a likelihood of success on the merits. View "LA Alliance for Human Rights v. County of Los Angeles" on Justia Law

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The Ninth Circuit affirmed the district court's grant of summary judgment in favor of the high school and school district in an action brought by plaintiff under Title II of the Americans with Disabilities Act (ADA) and section 504 of the Rehabilitation Act. Plaintiff, a student with attention deficit disorder, sought damages after he was assaulted and seriously injured by another student at a high school football game. Petitioner argues that guidance issued by the DOE in various Dear Colleague Letters should be binding, and that the school's failure to adopt all of the Letters' suggestions for preventing harassment of disabled students amounts to disability discrimination.The panel concluded that guidance issued by the DOE in the Letters was not binding and that plaintiff may not use the Letters to leapfrog over the statutory requirements to assert a cognizable claim under the ADA or the Rehabilitation Act. The panel explained that the Letters do not adjust the legal framework governing private party lawsuits brought under the ADA or Rehabilitation Act. Therefore, plaintiff's claims—which rely entirely on the enforceability of the Letters as distinct legal obligations—fail. In this case, the Letters did not make plaintiff's need for social accommodation "obvious," such that failure to enact their recommendations constituted a denial of a reasonable accommodation with deliberate indifference. Furthermore, no request for a social-related accommodation was ever made and no prior incidents of bullying or harassment involving plaintiff were observed or reported by the school prior to the assault during the football game. View "Csutoras v. Paradise High School" on Justia Law

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After two administrative hearings, Brown was awarded disability insurance benefits and supplemental security income benefits by an ALJ, who concluded that, as of April 25, 2018, Brown was “disabled” within the meaning of the Social Security Act, 42 U.S.C. 416(i), 423(d), 1382c(a)(3)(A), but rejected Brown’s claim that he was disabled prior to that date. The district court upheld the ALJ’s decision.The Ninth Circuit remanded with instructions to set aside the ALJ’s determination and to conduct a new disability hearing before a different, and properly appointed ALJ. The ALJ who conducted Brown’s hearings was not appointed in conformity with the Appointments Clause of the Constitution. Because this proceeding did not arise from a direct appeal from a decision of one or more invalidly appointed officers, nor was it a direct petition for review that might similarly have brought the entirety of the administrative decision before the court, the Commissioner may not challenge the portions of that decision that are favorable to Brown. The court held that it had no authority under 42 U.S.C. 405(g). to set aside, or to disturb, the grant of benefits for the time period on or after April 25, 2018, View "Brown v. Kijakazi" on Justia Law

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The Ninth Circuit affirmed the district court's dismissal based on failure to exhaust administrative remedies of plaintiffs' action under the Individuals with Disabilities Education Act (IDEA). Plaintiffs claim that the district court is failing its responsibilities to students under the IDEA by not timely identifying and evaluating students with disabilities, and, after identifying them, by providing them with insufficiently individualized, "cookie-cutter" accommodations and services. Although plaintiffs argue that exhaustion was not required because they are challenging district-wide policies that only a court can remedy, plaintiffs are unable to identify such policies. The panel agreed with the district court that plaintiffs have not satisfied any of the limited exceptions recognized by caselaw to the exhaustion requirement contained in 20 U.S.C. 1415(l). In this case, plaintiffs challenged what amounted to failures in practice by the school district, rather than policies or practices of general applicability. View "Student A v. San Francisco Unified School District" on Justia Law

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Decker employed Pehringer at its Montana open-pit surface mine, 1977-1999. There were periods when Pehringer did not work, including a roughly three-year-long strike. For most of his mining career, Pehringer was regularly exposed to coal dust while working primarily as a heavy equipment operator. After being laid off in 1999, Pehringer was awarded Social Security total disability benefits. He never worked again. In 2014 a month before his sixty-fifth birthday, Pehringer sought black lung benefits, citing his severe COPD, 30 U.S.C. 923(b). A physician determined that “Pehringer is 100% impaired from his COPD” and that coal “dust exposure and smoking are significant contributors to his COPD impairment.”The Benefits Review Board affirmed a Department of Labor (DOL) ALJ’s award of benefits. The Ninth Circuit affirmed, first rejecting a constitutional challenge to 5 U.S.C. 7521(a), which permits removal of an ALJ only for good cause determined by the Merits Systems Protection Board. DOL ALJ decisions are subject to vacatur by people without tenure protection; properly appointed, they can adjudicate cases without infringing the President’s executive power. The ALJ did not err in adjudicating Pehringer’s claim nor in rejecting untimely evidentiary submissions. Decker did not rebut the presumption of entitlement to benefits after a claimant established legal pneumoconiosis and causation, having worked for at least 15 years in substantially similar conditions to underground coal mines. View "Decker Coal Co. v. Pehringer" on Justia Law

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The Ninth Circuit reversed the district court's grant of summary judgment in favor of Agendia in an action alleging that the HHS wrongfully denied its claims for reimbursement for diagnostic tests under the Medicare health insurance program. Agendia contends that the denial was improper because the local coverage determination was issued without notice and opportunity for comment in violation of a provision of the Medicare Act—specifically, 42 U.S.C. 1395hh.The panel held that section 1395hh's notice-and-comment requirement does not apply to local coverage determinations, and that the district court erred in interpreting the statute otherwise. The panel rejected Agendia's alternative argument that the Medicare Act and its implementing regulations have unconstitutionally delegated regulatory authority to Medicare contractors by permitting them to issue local coverage determinations. The panel held that, because those contractors act subordinately to the HHS officials implementing Medicare, there is no unconstitutional delegation. View "Agendia, Inc. v. Becerra" on Justia Law

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The Ninth Circuit affirmed the district court's preliminary injunction ordering E.E.'s current educational placement as his "stay put" placement during the pendency of judicial proceedings in a suit brought under the Individuals with Disabilities Education Act (IDEA).The panel concluded that the ALJ acted without legal authority in determining that E.E.'s potential future placement in the 2020 individualized education plan (IEP) constituted his current placement for purposes of E.E.'s stay put placement. Therefore, because the ALJ acted ultra vires, her stay put determination was void. Consequently, the parents' stay put motion did not seek to modify an existing stay put order, so the district court correctly entered an automatic preliminary injunction pursuant to Joshua A. v. Rocklin Unified Sch. Dist., 559 F.3d 1036, 1037 (9th Cir. 2009). Furthermore, the school district's proposed exception to the stay put provision is not supported by either the text of the IDEA or any other legal authority, and the panel declined to adopt it. View "E.E. v. Norris School District" on Justia Law

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The Ninth Circuit affirmed the denial of social security disability benefits to claimant. At issue is whether knowledge of the Social Security Administration's longstanding interpretation of the term "medium work" as requiring standing or walking for approximately six hours out of an eight-hour workday can be imputed to a qualified vocational expert.The panel held that an expert in this field is presumptively aware of the agency's well-established definition of this term of art. Therefore, when the ALJ asked the expert in this case whether jobs existed for a hypothetical individual who was limited to medium work, that question adequately communicated the term's attendant standing and walking limitations. In this case, it follows that the expert's resulting testimony that a significant number of jobs existed in the national economy for an individual with claimant's limitations constituted substantial evidence in support of the ALJ's determination that he was not disabled within the meaning of the Social Security Act. View "Terry v. Saul" on Justia Law