Justia Public Benefits Opinion Summaries

by
Perks applied for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. An ALJ denied Perks's application. On appeal to the appeals council, Perks submitted additional evidence. The appeals council noted the receipt of the additional evidence but denied further review of Perks's claim. The district court affirmed. The Eighth Circuit Court of Appeals affirmed, holding (1) substantial evidence supported the ALJ's finding that Perks was not disabled; and (2) the additional evidence submitted to the appeals council did not undermine the ALJ's determination, as the ALJ would not have reached a different result with the additional evidence and the ALJ's decision was supported by substantial evidence in the record as a whole. View "Perks v. Astrue" on Justia Law

by
Kevin Byes applied for disability insurance benefits and supplemental security income on July 30, 2007, claiming disability since November 1, 2005. The Commissioner of Social Security Administration (Commissioner) denied benefits. An administrative law judge (ALJ) upheld the Commissioner's decision, concluding that Byes was not disabled from November 1, 2005 through the date of the decision. The district court agreed with the ALJ's decision. The Eighth Circuit Court of Appeals affirmed, holding that substantial evidence supported the ALJ's finding of no severe mental impairment; and (2) the district court correctly concluded that the ALJ had applied the incorrect grid rule in order to determine Byes was not disabled but that the error was harmless. View "Byes v. Astrue" on Justia Law

by
Palmquist, a veteran, injured in a helicopter crash that caused residual brain injury, was entitled to preference in federal employment, 5 U.S.C. 2108(3)(C), 3309(1), 3313(2)(A). The VA hired him as a medical support assistant. Aichner was his supervisor. Palmquist applied for promotion but did not receive an interview. He believed that the VA had not honored his preference, and told Aichner that he was going to complain to the equal employment opportunity specialist and his congressman. He did so. Aichner and Palmquist maintained a generally positive relationship for the next two years, but Palmquist was sometimes preoccupied, left the unit during working hours to do personal business, distracted other employees, and used his computer for personal purposes. Palmquist sought a new position. An interview went well. Interviewers warned Palmquist against unsolicited post-interview contact, but he e-mailed both to reiterate his qualifications. Aichner gave a generally favorable recommendation, but the recommendation was one factor in Palmquist not getting the job. The court rejected his claim under the Rehabilitation Act, 29 U.S.C. 701-796. The First Circuit affirmed. The Act does not entitle a plaintiff to relief when retaliation for complaints about disability discrimination is a motivating factor in, but not the “but-for” cause of, adverse employment action. View "Palmquist v. Shinseki" on Justia Law

by
Gallo served as an FAA air traffic control specialist from 1982 until 1995 when she experienced a job-related injury for which she received OWCP benefits. Gallo recovered enough to return to light duty. In 1996 she lost her medical certification to continue as an operational ATCS. Until 2000 she was assigned to a “non-operational” automation specialist position, which did not provide the same retirement credit or weekend pay. She received OWCP benefits for the differential. Gallo fully recovered in 2000 and received medical clearance; the Agency terminated OWCP benefit. She applied for restoration under 5 U.S.C. 8151(b)(2), which provides the right to priority consideration for restoration to federal employees who have overcome a compensable injury. The Agency assigned Gallo to a supervisory ATCS position. In setting her salary, the Agency did not take into account pay increases granted to operational ATCS employees during while Gallo was working as an automation specialist. The Merit Systems Protection Board denied her claim. The Federal Circuit reversed. The Board erred in interpreting “resumes employment with the Federal Government” under section 8151(a), and any pay increases that Gallo would have received based on her creditable service time with the federal government are “benefits based on length of service.” View "Gallo v. Dep't of Transp." on Justia Law

by
Plaintiff Rebecca Gonzalez (Relator) brought a qui tam action under the False Claims Act (FCA) against Defendants, Fresenius Medical Care N.A., Fresenius Medical Care Holdings, Inc., Bio-Medical Applications of Texas, Inc. (collectively, Fresenius), and Dr. Alfonzo Chavez. Relator also brought retaliation claims against Fresenius and her former supervisor Larry Ramirez. The district court granted in part and denied in part Defendants' motions for judgment as a matter of law, and the jury returned a verdict in favor of Defendants on the remaining claims. The district court then awarded Fresenius $15,360 in attorney's fees from Relator's counsel. The Fifth Circuit Court of Appeals affirmed the district court's judgment in all instances, holding (1) the district court correctly granted Defendants' motion for judgment as a matter of law on Relator's FCA claims, and the court's FCA jury instructions were not in error; (2) the district court did not err in granting Defendants' motion for judgment as a matter of law on Relator's retaliation claims; and (3) the district court did not abuse its discretion in awarding sanctions under 28 U.S.C. 1927. View "Gonzalez v. Fresenius Med. Care N.A." on Justia Law

by
The Department of Health and Human Services denied Medicare coverage of the BIO-1000, a piece of durable medical equipment used to treat osteoarthritis of the knee. In four decisions, the Medicare appeals counsel, the highest level of agency adjudication, ruled that the BIO-1000 had not been shown to be reasonable and necessary for the treatment at issue. The supplier of the device challenged those decisions. The district court granted summary judgment for the BIO-1000 supplier. The Ninth Circuit Court of Appeals reversed the district court's judgment and joined the Fourth Circuit in holding that the appeals council's coverage denials for the BIO-1000 were not arbitrary, capricious, or unsupported by substantial evidence, as (1) the appeals council adequately explained its reasons for denying coverage; and (2) the coverage denials were supported by substantial evidence. Remanded. View "Int'l Rehab. Scis. v. Sebelius" on Justia Law

by
Venti’s father received federal Civil Service Retirement System benefits. Venti’s father died in 1990, which should have terminated his benefits. The Office of Personnel Management continued to deposit the CSRS funds into a checking account that Venti had shared with his father. In 2003, Venti opened a new joint checking account at RFCU in the names of himself and his father and arranged for the CSRS benefits, as well as his own Social Security benefits, to be deposited in the new account. In 2005, OPM learned of the death of Venti's father and stopped depositing the CSRS benefits. In 2009, Venti was convicted of theft of government property (18 U.S.C. 641), one count for each of nine checks written in his father’s name during 2005, and was sentenced to 15 months. The First Circuit affirmed, rejecting an argument that one count was time-barred. If the count had been time-barred, the sentence would have been limited to one year because Venti would be treated as a misdemeanant rather than as a felon. View "United States v. Venti" on Justia Law

by
Defendant Barbara Norris, an organizational payee with the Social Security Administration, pled guilty to social security representative payee fraud. The district court sentenced Defendant to eighteen months in prison, the top of her guideline range. Defendant appealed, arguing that her sentence was substantively unreasonable. The Eighth Circuit Court of Appeals affirmed, holding that the district court did not abuse its discretion in sentencing Defendant to eighteen months in prison, as the court properly applied its wide latitude to weigh the factors in the federal sentencing statute and assigned some factors greater weight than others in determining an appropriate sentence. View "United States v. Norri" on Justia Law

by
Shideler suffers osteogenesis imperfecta, “brittle bone disease.” In 2006, at age 48, he applied for Social Security Disability Insurance benefits, 42 U.S.C. 423(d), alleging an onset date of 1995. His date last insured was 2000. The ALJ found that despite Shideler’s limitations, there were a sufficient number of jobs in the regional economy available to a person with his restrictions, and denied his application. The Appeals Council denied review. The district court and Seventh Circuit affirmed. The record supported the vocational expert’s testimony concerning available jobs as a clerk, assuming certain restrictions: never climb ladders, ropes, or scaffolds and only occasionally climb ramps or stairs; never crouch, kneel or crawl; never perform overhead reaching; avoid exposure to extreme heat and cold; and perform work that includes occasional, but not frequent, use of fingers. Despite his testimony that he had broken at least 55 bones over the course of his life, the record showed that Shideler had only four surgeries and made a full recovery. The record contained no evidence that Shideler visited any doctors between May 2000 and December 2006. View "Shideler v. Astrue" on Justia Law

by
The Secretary of the Department of Health and Human Services (HHS) imposed a civil money penalty on Greenbrier Nursing and Rehabilitation Center, a skilled nursing facility in Arkansas, for noncompliance with Medicare participation requirements. The Eighth Circuit Court of Appeals denied Greenbrier's petition for review, holding (1) substantial evidence supported HHS's finding that Greenbrier was not in substantial compliance with 42 C.F.R. 483.25; (2) the finding that Greenbrier's noncompliance with section 483.25 rose to the level of immediate jeopardy was not erroneous; and (3) judicial review of two of Greenbrier's objections to the monetary penalty was barred, and Greenbrier received adequate notice of its noncompliance. View "Greenbrier Nursing v. U.S. Dep't of Health & Human Servs." on Justia Law