Justia Public Benefits Opinion Summaries

Yonek served on active duty in the Navy from 1973 to 1977 and in 1991-1992. In 1991, Yonek aggravated a preexisting injury to his right shoulder, leaving the motion of his arm permanently limited. The VA regional office granted service connection for the injury, assigning a rating of 10 percent. Over the next 17 years, Yonek underwent at least 15 examinations, measuring his range of motion for flexion, elevation of the arm in a forward direction, and abduction, elevation of the arm outward from the side of the body. The results showed a range of motion of anywhere between 80 and 180 degrees in flexion and 60 and 180 degrees in abduction. In 1999, the RO increased the rating to 20 percent, concluding that motion was limited to a point at or below shoulder level but past the midpoint between the side and the shoulder (between 45 and 90 degrees). The Board of Veterans’ Appeals denied his appeal. The Veterans Court held that diagnostic code 5201 only allows a single disability rating for each injured shoulder even though Yonek’s shoulder manifests limitation of motion with respect to both flexion and abduction. The Federal Circuit affirmed, finding that the schedule in 38 C.F.R. 4.71a only allows a single disability rating. View "Yonek v. Shinseki" on Justia Law

These consolidated cases involved claims for survivors' benefits under the Black Lung Benefits Act, 30 U.S.C. 901 et seq. Petitioners, the coal mine operators responsible for payment of respondents' benefits, petitioned for review, claiming that principles of res judicata foreclosed respondents - each of whom previously and unsuccessfully sought survivors' benefits under the Act - from relying on a recent amendment to the Act to pursue benefits again through a "subsequent claim." The court affirmed the Board's awards, concluding that res judicata did not bar the subsequent claims because the amendment created a new cause of action that was unavailable to respondents when they brought their initial claims. View "Union Carbide Corp. v. Richard" on Justia Law

The Clinics filed suit challenging California Welfare and Institutions Code 14131.10, which eliminated certain Medi-Cal benefits that the state deemed optional, including adult dental, podiatry, optometry, and chiropractic services. The court reversed the district court's holding that the Clinics have a private right of action to challenge the Department's implementation of the state plan amendments (SPA) prior to obtaining approval; affirmed that the Clinics have a private right of action to bring a claim pursuant to 42 U.S.C. 1983 challenging the validity of section 14131.10; and reversed the district court's interpretation of the Medicaid Act, 42 U.S.C. 1396 et seq., holding that section 14131.10 impermissibly eliminated mandatory services from coverage. View "California Ass'n of Rural Health Clinics v. Douglas" on Justia Law

Plaintiff, by and through her adoptive parents, brought this action challenging South Carolina's reduction of monthly adoption assistance benefits, claiming that the reduction violated the Adoption Assistance and Child Welfare Act, 42 U.S.C. 670 et seq. The court held in this case that section 673(a)(3) did set forth a privately enforceable right under 42 U.S.C. 1983, but that the parents have failed to plead any violation of that right by defendants. Accordingly, the court reversed and remanded. View "Hensley v. Koller" on Justia Law

Bartlett, who served on active duty from 1943 to 1963, submitted a claim in 2002 to increase his rating for service-connected Post Traumatic Stress Disorder. The Board of Veterans’ Appeals issued its first final decision in 2005, increasing Bartlett’s rating from 30% to 100% and remanded to the regional office. After that decision, but before a decision on remand, Bartlett entered into a fee agreement with attorney Cameron, calling for a contingent fee of 20 percent of any past due VA benefits awarded on the basis of his claims. The regional office then increased Bartlett’s disability to 100%, effective April 2002, when Bartlett filed his claim. Cameron sought fees for the past-due benefits award. The regional office denied entitlement to attorney fees, finding that, because the decision was the Board’s first final decision in this claim, 38 U.S.C. 5904(c)(1) precluded entitlement to fees based on benefits arising from the decision. Cameron also appealed the assigned effective date. The regional office assigned a new date, approximately 15 months earlier, granted Bartlett $45,995.93 in past-due benefit, and set aside attorney fees for Cameron: 20% of the additional award occasioned by the change in the effective date. The Board, the Veterans’ Court, and the Federal Circuit affirmed. View "Cameron v. Shinseki" on Justia Law

Debtor appealed the district court's denial of the confirmation of his proposed Chapter 13 plan on the grounds that it did not accurately reflect his disposable income and that it was unfeasible if debtor's Social Security income was excluded from his "projected disposable income." The court vacated and remanded, holding that the plain language of the Bankruptcy Code excluded Social Security income from the calculation of "projected disposable income," but that such income nevertheless must be considered in the evaluation of a plan's feasibility. View "Ranta v. Gorman" on Justia Law

Plaintiff appealed the termination of her Medicaid benefits. At issue was the enforceability of a provision of the Medicaid Act, 42 U.S.C. 1396a(a)(8), under 42 U.S.C. 1983. The court concluded that section 1396a(a)(8) created a right enforceable under section 1983, and that exhaustion of Louisiana's procedure for judicial review was not required before a Medicaid claimant filed suit in federal court. Accordingly, the court affirmed the judgment of the district court denying DHH's motion to dismiss because plaintiff's claims were properly before the district court. View "Romano v. Greenstein" on Justia Law

FTM applied to the IRS for a charitable tax exemption under I.R.C. 501(a) and (c)(3) based on its trustee services. FTM subsequently filed this action seeking a declaration that it was a tax exempt charitable organization after the IRS preliminarily denied it's application. The court affirmed the district court's grant of summary judgment in favor of the government, agreeing with the district court that FTM was not operated exclusively for charitable purposes. View "Family Trust of MA, Inc. v. United States" on Justia Law

The Black Lung Benefits Act, 30 U.S.C. 901, originally included a “15-year presumption” that total pulmonary or respiratory impairment of a coal worker with 15 years of experience in the mines was due to pneumoconiosis (black lung). Congress removed this presumption in 1981, but in 2010 revived the presumption for claims filed after January 1, 2005, still pending on or after March 23, 2010. Bailey, employed by Consolidation Coal for 26 years, also smoked cigarettes for many years. He was diagnosed with chronic obstructive pulmonary disease and sought benefits. Three claims were considered during the interval when the 15-year presumption was withdrawn. Two were denied, and he withdrew a third. For his current claim, filed in 2007, three doctors agreed that Bailey is totally disabled by COPD. Because of the rejected claims, Bailey was required to show a change in condition. An ALJ, using the 15-year presumption, held that Bailey can now establish pneumoconiosis caused in part by coal dust exposure, two elements deficient in earlier claims, and awarded benefits. The Benefits Review Board affirmed. The Seventh Circuit affirmed. The ALJ correctly applied the 15-year presumption, addressed evidence relating to Bailey’s health and smoking history, and delivered a rational decision, supported by substantial evidence. View "Consolidation Coal Co. v. Dir., Office of Workers Comp. Programs" on Justia Law

Federal employees who are members of the National Guard are entitled to up to 15 days of annual military leave “without loss in pay, time, or performance or efficiency rating,” 5 U.S.C. 6323(a)(1). Before a 2000 amendment, the Office of Personnel Management interpreted the section as providing 15 calendar days of leave, rather than 15 workdays; federal employees who attended reserve training on non-work days were charged military leave. The Federal Circuit held that even before 2000, federal agencies were not entitled to charge employees military leave on non-workdays. Tierney worked at the DEA, 1974-2001, and was a member of the Air National Guard. He filed a Merit Systems Protection Board claim that the DEA charged him military leave for reserve duty on 44 non-workdays, so that he took annual leave or unpaid leave for military duty. An AJ ordered DEA to compensate Tierney for 17 days. The full Board reversed, finding that the Military Leave Summary and Tierney’s testimony were based solely on his military records and on speculation that DEA improperly charged military leave on intervening non-workdays and that the evidence was insufficient to prove that DEA charged him military leave on non-workdays or that he used annual leave for reserve duties. The Federal Circuit reversed and remanded, concluding that the decision was not supported by substantial evidence. View "Tierney v. Dep't of Justice" on Justia Law