Justia Public Benefits Opinion Summaries

Olivia, born in 2000, apparently healthy, became ill after her first vaccinations. Her condition required extensive hospitalization; she still requires a ventilator and a wheelchair. Her parents filed a petition with the National Vaccine Injury Compensation Program, 42 U.S.C. 300aa-1 to34. Olivia's injuries are not covered by a table of injuries presumed to be caused by vaccines, so the parents were required to show that one of the administered vaccines caused or significantly aggravated her condition. They submitted two reports by experts. The special master identified unanswered questions, but the parents took the position that it was unreasonable to require such detail at the pre-hearing stage. Based on failure to submit a supplemental report and failure to identify a clear theory of causation, the special master dismissed. The claims court affirmed. The Federal Circuit reversed. The special master did not appropriately review the evidence of causation under the summary judgment standard. View "Simanski v. Sec'y of Health & Human Servs." on Justia Law

Plaintiffs brought a putative class action under the Employee Retirement Income Security Act, 29 U.S.C. 1001, to recover benefits under long-term disability benefit plans maintained by their former employers. The plans provide for reduction of benefits if the disabled employee also receives benefits under the Social Security Act, as both plaintiffs do. They dispute calculation of the reduction, claiming that the plans do not authorize inclusion in the offset of benefits paid to dependent children. Both plans require offsets for "loss of time disability" benefits. The district court dismissed. The Seventh Circuit affirmed, holding that children's Social Security disability benefits paid based on a parent's disability are "loss of time disability" benefits under the language of the plans. View "Schultz v. Aviall Inc. Long Term Disability Plan" on Justia Law

Plaintiff represented a class of legal immigrants in the state of Washington adversely affected by its recent termination of a state-funded food assistance program for legal immigrants, which exclusively benefitted Washington resident aliens who became ineligible for federal food stamps following the enactment of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 8 U.S.C. 1601 et seq. Plaintiff contended that the state, by eliminating food assistance to class members while continuing to administer federal food assistance to U.S. citizens and certain qualified aliens, violated the Fourteenth Amendment's Equal Protection Clause and, by failing to provide class members adequate pre-deprivation notice and opportunity to be heard, also violated the Fourteenth Amendment's Due Process Clause. Because plaintiff failed even to allege that the State treated her less favorably than a similarly situated citizen of the State, her claim of alienage discrimination failed on the merits. The court agreed with the State that plaintiff lacked the concrete and particularized interest required for standing to claim a procedural due process violation. Consequently, plaintiff either lacked standing or would not succeed on the merits of her claims. Therefore, the court reversed the district court's order granting the motion for a preliminary injunction, vacated the injunction, and remanded for further proceedings. View "Pimentel v. Dreyfus, et al." on Justia Law

The Court granted certiorari in these cases to decide whether Medicaid providers and recipients could maintain a cause of action under the Supremacy Clause to enforce a federal Medicaid law. Since the Court granted certiorari, however, the relevant circumstances have changed. The federal agency in charge of administering Medicaid, CMS, approved the state statutes as consistent with the federal law. In light of the changed circumstances, the Court believed that the question before it was whether, once the agency approved the state statutes, groups of Medicaid providers and beneficiaries could still maintain a Supremacy Clause action asserting that the state statutes were inconsistent with the federal Medicaid law. Given the present posture of the cases, the Court did not address whether the Ninth Circuit properly recognized a Supremacy Clause action to enforce the federal law before the agency took final action. To decide whether these cases could proceed under the Supremacy Clause now that the agency has acted, it would be necessary on remand to consider at least the matters addressed by the Court. Accordingly, the Court vacated the judgment and remanded for further proceedings. View "Douglas v. Independent Living Center of Southern Cal., Inc." on Justia Law

Appellant sued to recover $373.00 in expenses he incurred from the alleged unlawful levy of his social security benefits under 26 U.S.C. 7433. The district court concluded that appellant's suit was untimely because he did not bring suit within two years of when he had a "reasonable opportunity to discover all essential elements of a possible cause of action." The court agreed and affirmed, holding that the two-year statute of limitations on appellant's cause of action began to run no later than June 2005 after he received notice of the levy on his benefits. Because appellant did not sue until December 2008, more than three years after he received notice of the levy, his claim was time-barred. View "Keohane v. United States" on Justia Law

A widow alleged that her husband developed cancer due to exposure to radiation while he was serving on active duty. Based on regulations that presume causation for certain diseases, the Board of Veterans' Appeals awarded service connection with an effective date of 1988. The Board did not determine whether she established a direct service connection that was not based on the presumptions. The Veterans Court remanded for such findings. The Federal Circuit affirmed, rejecting the widow's argument that the evidence in the record supported reversal and an earlier effective date. View "Byron v. Shinseki" on Justia Law

Firefighters, who suffered career-ending injuries during required training exercises, obtained line-of-duty disability pensions and sought continuing health coverage under the Public Safety Employee Benefits Act, 820 ILCS 320/10, which requires employers of full-time firefighters to pay health insurance premiums for the firefighter and family if the firefighter suffers a catastrophic injury as a result of a response to what is reasonably believed to be an emergency. The trial court dismissed a declaratory judgment action by one firefighter and affirmed denial of the insurance benefit for one firefighter. The appellate court affirmed. The supreme court held that an "emergency" means an unforeseen circumstance calling for urgent and immediate action and can arise in a training exercise. The other firefighter had obtained a declaratory judgment, which was affirmed by the appellate court. The supreme court distinguished the situation because, although he was instructed to "respond as if it were an actual emergency," he was not injured while making an urgent response to unforeseen circumstances involving an imminent danger to person or property. View "Gaffney v. Bd. of Tr. of Orland Fire Prot. Dist." on Justia Law

Plaintiff contracted for satellite TV service. Equipment costs are amortized in monthly payments; a customer who discontinues service owes a fee to cover the unpaid portion of equipment cost. Plaintiff authorized a charge to her debit card should that occur. Plaintiff stopped paying the monthly charge. Defendant collected the termination fee via the debit card. Plaintiff argued that the Social Security Act, 42 U.S.C. 407(a), provides that benefits may not be assigned or subject to attachment or garnishment at the behest of creditors, and that, unbeknownst to defendant, all funds in her account came from Social Security benefits. The district court ruled in favor of defendant. The Seventh Circuit affirmed. Plaintiff's arrangement was consensual, unlike "legal process." The statute does not authorize private parties to sue for damages based on assignments of Social Security benefits. View "Townsel v. DISH Network L.L.C." on Justia Law

Appellant appealed the district court's affirmance of the Social Security Commissioner's decision to deny him disability benefits and supplemental security income (SSI) under the Social Security Act, 42 U.S.C. 423, 1382. On appeal, defendant claimed that the district court should have found that he submitted a medical report from Dr. Mary Ellen Ziolko to the Appeals Council that was not considered and this case should therefore have been remanded to the Appeals Council for consideration of the new and material evidence. The court agreed that the district court should have determined whether appellant submitted the new evidence under 20 C.F.R. 404.970(b), and thus the court remanded to the district court to make that determination. View "Whitney v. Astrue" on Justia Law

Upon granting Husband and Wife a divorce, the family court directed Husband to pay $1,000 per month in spousal support. The court found that the award did not need to be paid out of Husband's veteran's disability benefits. The circuit court set aside the award of permanent spousal support and directed Husband to pay supposal support in the amount of $500 per month for eighteen months. The Supreme Court reversed, holding (1) in determining the amount of spousal support to be awarded, federal service-connected veterans disability benefits received by the payor spouse may be considered by the family court as a resource, along with the payor's other income, in assessing the ability of the payor to pay spousal support; and (2) because the circuit court, among other things, (i) failed to address with any specificity Husband's veterans benefits or the parties' Social Security awards, (ii) failed to address with specificity how those disability benefits were taken into account in setting aside the family court decision, and (iii) did not determine that any of the factual findings of the family court were clearly erroneous, the action was remanded to the circuit court for further proceedings. View "Zickefoose v. Zickefoose" on Justia Law