Justia Public Benefits Opinion Summaries

Plaintiff-appellant Alphonso Myers was injured on the job. He received social security benefits due to his inability to work. While claiming benefits, he applied for a job as an armed guard with defendant-appellee Knight Protective Service. On his job application, plaintiff made no mention of his prior injury. Supervisors at Knight noticed that plaintiff appeared to be in pain. Plaintiff then admitted that he had undergone a series of surgeries from the prior workplace injury. Concerned that this pain might interfere with his duties as an armed guard, Knight required plaintiff to submit to a physical exam before resuming his duties as a guard. Plaintiff waited months for the exam - long enough that plaintiff considered the delay as an effective termination from his job. Plaintiff then filed suit, arguing that he had been discriminated against on the basis of his race and disability. The district court granted summary judgment to Knight, and plaintiff appealed. Finding no reversible error, the Tenth Circuit affirmed the district court's judgment. View "Myers v. Knight Protective Service" on Justia Law

Todd, born in 1963, was a high school graduate, and worked primarily as a laborer, often for temporary services. Todd’s last employment before seeking disability benefits ended in April 2007 because the temporary job was completed. Todd claimed inability to work due to anxiety, cramping in his feet, and difficulty breathing. Until his death in July 2009, Todd was treated for major depressive disorder, alcoholism, alcohol dependence, emphysema, and generalized anxiety disorder. Todd also experienced tremors of unknown etiology. An ALJ decided: Todd had not engaged in substantial gainful activity since April 14, 2007; Todd suffered from emphysema, tremors, an affective disorder, an anxiety disorder, and alcohol dependence; Todd did not have an impairment or combination of impairments so severe as to meet or equal the criteria of a listed impairment; Todd had the residual functional capacity to perform light work and was capable of performing his past relevant work as a laborer; and Todd was “not under a disability.” The district court agreed. Although the ALJ improperly weighed the medical professionals’ opinions, the error was harmless because substantial evidence supported a finding that Todd’s limitations would not be disabling if he stopped using alcohol. The Eighth Circuit affirmed. View "Bernard v. Colvin" on Justia Law

After the U.S. Department of Veterans Affairs determined Evans was no longer competent to manage his veterans’ benefits, it appointed his daughter as the federal fiduciary. The VA later terminated her appointment and appointed the Greenfield Banking Company. Evans’s wife and daughter filed suit asserting breach of fiduciary duty and conversion by the Bank and sought creation of a constructive trust. The complaint alleges that the Bank complied with the terms of its obligations to the VA as federal fiduciary but that doing so meant it breached its fiduciary duty to Evans. The complaint did not claim misuse of funds, mismanagement depriving him of the use of any funds, embezzlement, or the like. The daughter was apparently not fully reimbursed for expenditures she made on behalf of Evans while pursuing a guardianship in state court. Evans died in 2012. The district court dismissed. The Seventh Circuit affirmed, stating that the complaint is really a challenge to a federal fiduciary appointment and to veteran benefits distribution and, as such, not within the court’s jurisdiction. View "Stump v. Greenfield Banking Co," on Justia Law

Brian Shaffer, who had severe autism and chemical sensitivities, resided with his mother, Delores Shaffer, who was paid to provide private duty nursing (PDN) care to Brian. In 2011, Brian’s Medicaid coverage was transferred to Coventry Health Care of Nebraska, Inc. When Coventry determined that the nursing services were not medically necessary, Shaffer requested a State fair hearing with the Nebraska Department of Health and Human Services. Coventry participated in the administrative proceedings, at which a hearing officer concluded that the PDN services were not medically necessary. Delores sought judicial review of the order, but the petition did not name Coventry as a respondent. The district court reversed the order of the Department, finding the PDN services that Delores provided to Brian were medically necessary. Coventry appealed. The Supreme Court vacated the order of the district court, holding that Coventry was a “party of record” at the State fair hearing and therefore a necessary party in the subsequent appeal to the district court, and the failure to make Coventry a party to the appeal deprived the district court of jurisdiction. View "Shaffer v. Neb. Dep’t of Health & Human Servs." on Justia Law

David and Melinda’s two children lived with Melinda, and David paid child support. The Napa County Department of Child Support Services moved to modify David’s child support obligation. (Fam. Code, 17400). After a hearing, the court found that David’s income, for purposes of calculating child support, was the monthly Social Security disability payment he received, ordered him to pay a portion of that to Melinda as child support, and found Melinda received $796 per month in derivative Social Security disability benefits as the representative payee of the children based on David’s disability, 42 U.S.C. 402(d). Melinda argued these benefits should be treated as part of David’s income when calculating his monthly income for purposes of his support obligation. The court concluded the derivative benefits were the income of the children, not of David, so that the $796 in derivative disability benefits would partially satisfy David’s support obligation. The monthly benefits would be credited first toward his current child support, and any excess would be credited to pay off arrears. The court of appeal affirmed. View "Daugherty v. Daugherty" on Justia Law

Duarte joined the California State Teachers’ Retirement System (CalSTRS) in 1993. He earned 2.023 years of service. He took unpaid personal leave for Duarte for the 1995-1996 school year and unpaid educational leave for 1996-1997 and 1997-1998. Duarte worked one season as a forest firefighter, attended law school, and worked as a paralegal. In 2003, Duarte returned to teaching in Oakland. On his second day he was assaulted and threatened by students. Duarte has not returned to teaching. In 2004, Duarte filed a worker’s compensation claim. After four evaluations, he entered into a stipulated settlement that indicated a “serious dispute” regarding the scope of Duarte’s disability. In 2006, Duarte sought social security disability benefits; it was determined that he was disabled from the date of the 2003 incident and became eligible for monthly disability benefits in 2005. Duarte’s student loans were forgiven. In 2008, Duarte sought CalSTRS disability retirement benefits. CalSTRS repeatedly asked Duarte to submit medical records and other documents. An ALJ upheld denial of Duarte’s application because he refused to complete the independent medical evaluation ordered under Education Code 24103 (b),. The trial court and court of appeal affirmed, rejecting an argument that the doctrine of collateral estoppel bars CalSTRS from relitigating his disability because several other state agencies have found him to be disabled. View "Duarte v. CA. State Teachers' Ret. Sys." on Justia Law

Blubaugh served in the Army, 1964-1966 and was a gunner in Vietnam. In 1988, he sought service connection for multiple medical conditions, including post-traumatic stress disorder (PTSD). The VA denied service connection, finding that his VA psychological examination did not support a diagnosis of PTSD. Blubaugh did not appeal, but in 1992, sought to reopen his claim. The VA concluded that a second examination did not support a PTSD diagnosis and noted the “absence of a definitive confirmable stressor.” In 2008, Blubaugh filed a second request to reopen. Unlike his previous submissions, this request included a statement describing his experiences in Vietnam and post-service difficulties. The VA also received, for the first time, medical documentation showing a positive diagnosis of PTSD. The VA granted service connection for PTSD and assigned a 10 percent disability rating effective 2008. The Federal Circuit affirmed. The effective date for a disability rating is generally determined by the date the disabling condition arose, or the date the claim was submitted, whichever is later. An exception for claims granted based on certain service department records that were associated with the veteran’s claims file after the claim was first decided does not apply to Blubaugh’s case. View "Blubaugh v. McDonald" on Justia Law

Serban worked as a massage therapist at Voda Spa. Serban and Voda Spa disagree as to why he left that work, but the trial court found Serban had good cause to leave and that finding was not challenged. They also disputed whether Serban was an employee or independent contractor. The California Unemployment Insurance Appeals Board found that he was an employee, not an independent contractor, and the trial court agreed with the Board that its decision was not subject to judicial review because both the California Constitution and the Unemployment Insurance Code bar actions whose purpose is to prevent the collection of state taxes. The court of appeal reversed, agreeing that the case does not challenge the imposition of a tax. View "W. Hollywood Cmty. Health & Fitness Ctr. v. CA Unemp. Ins. Appeals Bd." on Justia Law

Herrmann’s application for Supplemental Security Income for benefits for the period before she turned 55 was rejected by an administrative law judge, but because of the less demanding showing of disability, she was deemed to have become disabled when she reached 55. She appealed the partial denial unsuccessfully. Her treating physicians, with three consultative physicians selected by the Social Security Administration, advised the administrative law judge that she suffers from fibromyalgia, spinal disk disease, abnormal sensitivity to light, and other ailments, and that she walks haltingly, has difficulty gripping objects, experiences difficulty in rising from a sitting position, has trouble concentrating in a bright room or when looking at a computer screen, and as a result of this assemblage of impairments cannot do even light work on a full-time basis. The Seventh Circuit reversed, questioning the testimony of the vocational expert concerning available jobs. View "Herrmann v. Colvin" on Justia Law

Systemic juvenile idiopathic arthritis (SJIA), an autoinflammatory disease, has symptoms including arthritis, fever, rash, and muscle and joint pain, caused by dysfunctional production of proteins, which cells release almost immediately after contact with an antigen. Gardasil, a vaccine against HPV administered in three doses, contains virus-like particles created from an HPV protein, and an adjuvant to generate a robust immune response. Vanessia, born in 1995, was healthy until 2008. After receiving two doses of Gardasil, she experienced an all-over rash. Days later, she had joint pain and high fever. The hospital discharged her with a presumptive diagnosis of SJIA. Vanessia’s family history included SJIA. Her rheumatologist communicated these findings to the doctor who administered Vanessia’s third dose of Gardasil on August 19. Vanessia experienced a SJIA flare on August 25. Vanessia’s Vaccine Act injury claim was rejected. Injuries that do not appear on the Vaccine Injury Table, 42 C.F.R. 100.3, require proof of a medical theory causally connecting the vaccination to the injury; a logical sequence of cause and effect; and proximate temporal relationship between the vaccine and injury. The Claims Court and Federal Circuit affirmed, finding that the claim did not meet the burden of demonstrating proximate temporal relationship. View "Koehn v. Sec'y of Health & Human Servs." on Justia Law