Justia Public Benefits Opinion Summaries

Luke Joerg (“Luke”) was a developmentally disabled adult who had lived with his parents his entire life and had never worked. Luke was struck by a car in 2007. John Joerg (“Joerg”), Luke’s father, filed an action against State Farm Mutual Automobile Insurance Company, Joerg’s uninsured motorist carrier. Joerg filed a motion in limine to exclude evidence of any collateral source benefits to which Luke was entitled, including discounted benefits under Medicare and Medicaid. The trial court precluded State Farm from introducing evidence of Luke’s future Medicare or Medicaid benefits. The jury awarded a total of $1,491,875 in damages, including $469,076 for future medical expenses. The Second District Court of Appeal reversed the award for future damages, concluding that Luke’s Medicare benefits should not have been excluded by the collateral source rule. The Supreme Court quashed the decision below, holding that the trial court properly excluded evidence of Luke’s eligibility for future benefits from Medicare, Medicaid, and other social legislation as collateral sources. View "Joerg v. State Farm Mut. Auto. Ins. Co." 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

The Supreme Court granted certiorari in this matter to determine whether a retiree of the City of Slidell, plaintiff Dean Born, could continue participating in the City of Slidell's health insurance plan following the City's adoption of Ordinance No. 3493, which required each city retiree to apply for Medicare coverage upon reaching the age of sixty-five. After review, the Supreme Court affirmed the Court of Appeal's finding that the City could not terminate plaintiff's desired plan coverage and require him to accept Medicare coverage, because plaintiff retired before the effective date of the Ordinance. View "Born v. City of Slidell" on Justia Law

In 2009, plaintiff Dr. Ralph Slaughter retired as president of Southern University System (“Southern”) after thirty-five years of service. Upon retirement, the Louisiana State Employees’ Retirement System (“LASERS”) began paying plaintiff retirement benefits. Plaintiff filed suit against Southern for past due wages. The district court ruled that Southern had miscalculated plaintiff’s income base by including supplemental pay plaintiff had received from the Southern University Foundation, and determined plaintiff’s terminal pay (500 hours of unused leave) and retirement should have been calculated only on his annual base salary due from Southern. The court of appeal affirmed on appeal, noting plaintiff “manipulated the system and used his position for his own benefit.” Southern sent a letter to LASERS advising it had committed an error in including supplemental funds in plaintiff’s earnings. Because plaintiff's lawsuit was ongoing at the time, LASERS filed a concursus proceeding seeking to deposit the disputed amount of plaintiff’s benefit in the registry of court pending resolution of the litigation. Plaintiff filed an exception of no cause of action. The district court granted the exception and dismissed the second suit with prejudice. LASERS did not appeal this judgment. After the first suit became final, LASERS sent correspondence to plaintiff advising it intended to retroactively reduce his retirement benefit starting June 1, 2012 “due to an error made by Southern University in the reporting of your earnings.” Relying on La. R.S. 11:192, LASERS maintained it could adjust benefits and further reduce the corrected benefit to recover overpayment within a reasonable number of months. Plaintiff then filed the instant suit against LASERS, seeking a writ of mandamus, injunctive relief, and a declaratory judgment confirming LASERS had no authority or ability to reduce his retirement benefits. The petition alleged plaintiff’s retirement benefits should have been calculated based on the entirety of his earnings over thirty-five years of employment, including salary supplements. The Supreme Court was called on to determine whether the lower courts erred in finding the defendant retirement system failed to prove that it followed the proper procedure before initiating action to reduce and recoup plaintiff’s retirement benefits. The Court found the lower courts did not apply the proper statutory analysis and reached an erroneous result. The case was remanded for further proceedings. View "Slaughter v. Louisiana State Employees' Retirement System" on Justia Law

Plaintiff appealed the denial of his application for disability insurance benefits and supplementary security income, arguing that the ALJ erred in refusing to give proper weight to the opinion of a consultative examining physician, and in finding that plaintiff's 2012 testimony was not credible and failing to consider his vision limitations when evaluating his residual functioning capacity. The court agreed that the ALJ erred in both respects and reversed the judgment of the district court, remanding for further proceedings. View "Henry v. Commissioner" on Justia Law

The Juvenile Court found R.G., a nonminor dependent within the transition jurisdiction of the juvenile court (Welf. & Inst. Code, 450), ineligible for extended foster care support payments between January 13 and March 13, 2015, because he was neither employed at least 20 hours per week nor participating in a program or activity that promoted or removed barriers to employment, as is required to receive financial support pursuant to section subdivisions (b)(4) and (b)(3) of section 11403 of the California Fostering Connections to Success Act, under which certain youth in foster care may continue receiving financial assistance after turning 18. The court of appeal agreed and reversed. The undisputed evidence indicated that R.G.’s activities, which were primarily self-directed, included formulating a specific job search plan; applying online and in person to numerous jobs; following up with prospective employers; receiving feedback from an independent living skills program specialist on how to improve his resume and job applications; and maintaining contact with the social worker on his progress. This evidence showed that he was working toward his goals during the period in question as contemplated by the statute. View "In re R.G." on Justia Law

Mowlana, a native of Somalia, was admitted to the United States as a refugee in 2000 and became a lawful permanent resident in 2002. He was ordered removed from the U.S. after the Board of Immigration Appeals concluded that he had been convicted of an aggravated felony. The Board cited Mowlana’s prior conviction under 7 U.S.C. 2024(b), which forbids the knowing use, transfer, acquisition, alteration, or possession of benefits in a manner contrary to the statutes and regulations of the Supplemental Nutrition Assistance Program (food stamps). The Eighth Circuit dismissed his petition for review, agreeing that his offense was an aggravated felony, 8 U.S.C. 1227(a)(2)(A)(iii). View "Mowlana v. Holder" on Justia Law

In December, 2009, Heelan, a Vernon Hills police officer for approximately 20 years, responded to an emergency call, slipped on ice, and fell. He was ultimately diagnosed with significant osteoarthritis in both hips, aggravated by the fall, and had two hip replacement surgeries. He did not return to work. The Village Police Pension Board awarded a line-of-duty disability pension, 40 ILCS 5/3-114.1. The Village sought a declaration that it was not obligated to pay Heelan’s health insurance premium under the Public Safety Employee Benefits Act (the Act), 820 ILCS 320/10. The circuit court entered judgment in favor of Heelan. The appellate court and Illinois Supreme Court affirmed, Proof of a line-of-duty disability pension establishes a catastrophic injury under section 10(a) of the Act as a matter of law; a public safety officer’s employer-sponsored health insurance coverage expires upon the termination of the officer’s employment by the award of the line-of-duty disability pension. The Act lengthens such health insurance coverage beyond the termination of the officer’s employment. View "Village of Vernon Hills v. Heelan" on Justia Law

Defendant Christopher Boisvert appealed his conviction for welfare fraud. Defendant was the father of Carrie Gray's two children. He and Gray moved into a Bristol apartment in 2009 or 2010. Defendant's name was removed from the lease at some point prior to late 2010. On December 31, 2010, defendant filed an application for public assistance. On January 14, 2011, he met with a department of health and human services representative and stated that he was homeless and had no resources; he was certified to receive benefits. Defendant was recertified for benefits at six-month intervals, and again reported in June 2011 and December 2011 that he was homeless. Between December 2010 and March 2012, Gray received medical, food stamp, and cash public assistance. The total amount of assistance that she received was calculated based upon a household consisting only of Gray and her children. She would not have been eligible for the same level of benefits if defendant had disclosed that he was living in the apartment. At some point, the special investigations unit of the department of health and human services received an allegation of welfare fraud concerning Gray. After interviewing witnesses and reviewing records provided by Gray and defendant, the investigator concluded that the case should be referred to the county attorney's office. Defendant was subsequently indicted on one count of welfare fraud. Because it was alleged that the value of the fraudulently obtained payments exceeded $1,000, the offense was classified as a class A felony. The case went to trial, and at the close of the State's case, defendant moved to dismiss the charge, arguing that the State had failed to present sufficient evidence that he was living with Gray during the relevant time period. The trial court denied the motion, and the jury found defendant guilty. This appeal followed. He argued on appeal to the Supreme Court that the Superior Court erred by denying: (1) defendant's motion to dismiss that challenged the sufficiency of the evidence; and (2) his request to give an accomplice liability jury instruction. Finding no reversible error, the Supreme Court affirmed. View "New Hampshire v. Boisvert" on Justia Law

Plaintiff appealed the denial of his application for Social Security disability benefits (SSI). The district court granted defendant's motion for judgment on the pleadings. The court concluded, however, that the ALJ erred by failing to provide “good reasons” for giving little weight to the treating physician's opinion, and that this error was not harmless. Accordingly, the court vacated the district court's judgment and remanded for further proceedings. View "Greek v. Colvin" on Justia Law