Justia Public Benefits Opinion Summaries

The Louisiana Supreme Court granted certiorari to determine whether the Sledge Jeansonne Louisiana Insurance Fraud Prevention Act, and the Louisiana Unfair Trade Practice and Consumer Protection Act, could be applied retroactively to defendant’s criminal misconduct which occurred prior to the effective dates of these statutes. Defendant Lynn Foret, a medical doctor who specialized in orthopedic surgery, pled guilty in federal court to one count of health care fraud, for criminal acts that occurred between 2003 and 2009. The trial court granted Dr. Foret’s declinatory exceptions, dismissing with prejudice, the State's action for penalties under the Sledge Jeansonne Act and dismissed with prejudice causes of action under the Louisiana Unfair Trade Practices Act. The court of appeal affirmed the trial court’s rulings, finding that the conduct regulated by the substantive statute was the underlying fraud, rather than the subsequent guilty plea. Therefore, even though the State's cause of action could not have accrued until Dr. Foret pled guilty, application of the Acts nonetheless attached new consequences to his criminal misconduct, which occurred before the Acts became effective. One judge on the appellate panel dissented, reasoning the plain language of the Sledge Jeansonne Act demonstrated it was the guilty plea that gave the State Attorney General the authority to act, not the criminal activity, and because the guilty plea was entered after the effective date of the statute, its application herein would be prospective, not retroactive. The State appealed to the Supreme Court, arguing that the Sledge Jeansonne Act was not an impermissible retroactive application of the law. After review, the Supreme Court held that both the Sledge Jeansonne Act and Louisiana Unfair Trade Practice and Consumer Protection Act operated prospectively only, applying to causes of action arising after the effective date of each Act. The Court affirmed the court ofappeal ruling finding that the statutes at issue could not be retroactively applied to this defendant’s past criminal conduct. View "Louisiana v. Foret" on Justia Law

Plaintiff Leslie Taylor asked the Colorado Medicaid program to combine the benefits she received through two assistance programs to help her get to medical appointments. If approved, this combination would allow the agency to pay attendants for time driving Taylor to and from her appointments. The agency refused, and the plaintiffs in this case alleged that the refusal constituted discrimination against Taylor based on her disability. The Tenth Circuit concluded that this refusal did not constitute discriminate against Taylor based on her disability. View "Taylor v. Colorado Dept of Health Care" on Justia Law

The Department appealed a judgment awarding plaintiffs reimbursement under the Individuals with Disabilities Education Act (IDEA), 20 U.S.C. 1400 et seq., for one year of private school education for their daughter, L.K. The court concluded that the Department’s refusal to discuss the bullying of L.K. with her parents during the process of developing L.K.’s individualized education program (IEP), violated the IDEA. The court also concluded that plaintiffs have met their burden to show that their choice of a private placement for L.K. was appropriate and that the equities favored reimbursing them. Accordingly, the court affirmed the judgment. View "T.K. v. N.Y.C. Dept. of Educ." on Justia Law

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

Plaintiffs seek to represent a class of dual status National Guard technicians who had their benefits determined prior to the court's issuance of Petersen v. Astrue and would like to have their benefits readjusted to take advantage of the decision to avoid application of the Windfall Elimination Provision (WEP). The district court dismissed the complaint for lack of jurisdiction. The court affirmed the district court's decision to reject the application of mandamus jurisdiction where the district court held that there is no clear, nondiscretionary duty on behalf of the SSA to apply the Peterson decision to plaintiffs. The court also concluded that plaintiffs failed to present a colorable constitutional claim on equal protection grounds that would justify the application of the exception to 42 U.S.C. 405(g)’s jurisdictional limitations. Plaintiffs’ due process claim also does not support application of an exception to 405(g). Accordingly, the court affirmed the judgment. View "Mitchael 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

Before enactment of the 2008 Veterans’ Benefits Improvement Act, if a veteran seeking DVA benefits died while his claim was pending, the veteran’s survivor could not take the place of the veteran and continue prosecuting the claim. The survivor had to file a claim for accrued benefits, 38 U.S.C. 5121, proceeding from the beginning of the process, regardless of how far the veteran’s claim had progressed. The Act, 38 U.S.C. 5121A, authorizes eligible survivors to be “substituted as the claimant for the purposes of processing the claim to completion.” The Federal Circuit rejected a challenge to regulations intended to implement the Act, which require that a request to substitute be filed with the agency of original jurisdiction (DVA regional office) within one year of the claimant’s death; the prospective substitute is required to submit evidence of his eligibility to substitute; and, if the claimant died while his appeal was pending before the Board of Veterans’ Appeals, the Board must dismiss the appeal without prejudice so that the agency of original jurisdiction can address the substitution request. If the agency of original jurisdiction grants the request to substitute, then the case returns to the same place on the Board’s docket that it held at the time of the veteran’s death. View "Nat'l Org. of Veterans Advocates, Inc. v. Sec'y of Veterans Affairs" on Justia Law

A Welfare and Institutions Code section 602 petition alleging violations of Penal Code section 288, subdivision (a) (lewd or lascivious acts with a child under the age of 14) was sustained against A.A., a juvenile court dependent from 2007-2015. A.A. was committed to a period of confinement with the DJJ. A.A. subsequently turned 18 years old and the juvenile court terminated its dependency jurisdiction over him. In this appeal, the court rejected A.A.'s contention that the juvenile court should have maintained dependency jurisdiction over him and provided him with services under the California Fostering Connections to Success Act, Assembly Bill No. 12. In this case, A.A. is not eligible for A.B. 12 benefits where A.A. is not a nonminor dependent; the juvenile court reasonably concluded that A.A. did not wish to remain subject to dependency jurisdiction; and the juvenile court did not err in concluding that A.A. was not participating in a transition to living independently case plan where he was committed to a juvenile detention facility. Further, DCFS has complied with the requirements of section 391, subdivision (b), and the juvenile court's order did not violate section 303, subdivision (b). Accordingly, the court affirmed the judgment. View "LA Cnty. DCFS v. A.A." on Justia Law

Cogburn served in the Army, 1968-1971, including 12 months in Vietnam. In 1974, Cogburn sought VA disability compensation and pension benefits based on a severe nervous condition. A 1975 denial of his pension claim did not address the disability claim. He did not appeal. In 1983, Cogburn again sought disability compensation and pension benefits. He was diagnosed with Post-PTSD after a VA examination that failed to connect Cogburn’s PTSD to stressors from military service; the VA granted a non-service connection pension but denied service connection. In 1985, the Board of Veterans’ Appeal concluded that the record did not identify any in-service traumatic events, noting that Cogburn repeatedly failed to attend VA examinations to determine if service-connected stressors caused his PTSD. The Board determined that “the preponderance of the medical evidence suggests that the veteran’s post service emotional and adjustment difficulties are manifestations of schizophrenia.” There was no opportunity for further review. In 2002, Cogburn claimed that his 1974 disability compensation claim was never adjudicated. The RO determined that the claim was adjudicated as a claim for PTSD and had been implicitly denied in the 1985 decision. In 2012, on remand, the Board affirmed the finding of implicit denial. The Veterans Court and Federal Circuit affirmed; the implicit denial rule applies to both formal and informal claims. Its use does not violate the VA due process regulation's notice provision.. View "Cogburn v. McDonald" on Justia Law

Plaintiffs, 194 employees who were terminated by Vanderbilt University on July 1, 2013, sued, claiming violation of the Worker Adjustment and Retraining Notification Act (WARN), 29 U.S.C. 2101, which requires certain employers to provide at least 60 days’ written notice to affected employees before a mass layoff. The plaintiffs’ class is insufficient to constitute a “mass layoff” (of 500 workers during a 30-day period) as defined by WARN; they cited the Act’s aggregation provision, which allows for separate layoffs within a 90-day period to be counted togetherf. They alleged that a second group of Vanderbilt employees was notified on September 17, 2013, that their jobs would be eliminated 60 days later, on November 16. Although they were no longer permitted to report for work, they continued to receive wages and accrue benefits after the notice was given. They were not eligible for state unemployment benefits until November 16, when they no longer received wages and accrued benefits. The Sixth Circuit ruled in favor of Vanderbilt. The employment relationship between Vanderbilt and the September employees did not end until November 16; they suffered an employment loss more than 90 days after the plaintiffs were terminated and thus cannot be counted under the aggregation provision. View "Morton v. Vanderbilt Univ." on Justia Law