Justia Public Benefits Opinion Summaries

Linda Thompson appealed from a Superior Court judgment reversing the determination of the Unemployment Appeals Board (UIAB) that good cause existed for Thompson's voluntary resignation and granting her unemployment benefits. Thompson contended that good cause existed for voluntarily terminating her employment, that she exhausted her administrative remedies, and that substantial evidence in the record supported the UIAB's decision. The court affirmed the judgment of the Superior Court and held that substantial evidence did not support the UIAB's decision and the UIAB erred as a matter of law by concluding that Thompson was entitled to benefits pursuant to 19 Del. C. 3314(1).

Petitioner Patricia Kalar petitioned the Supreme Court to challenge the reduction of her benefits by Respondent New Hampshire Department of Health and Human Services. The Department conducted an inquiry into Petitioner's income and expenses as part of a mandatory, periodic "recertification" process for determining Petitioner's food stamp benefits. At the last inquiry, the Department determined that Petitioner's food stamp benefit should be reduced. Petitioner argued on appeal that the Department erred in its calculation that served as the basis of its reduction determination. Upon review, the Supreme Court could not conclude that the reduction in Petitioner's benefits was due to miscalculations by the Department. The Court affirmed the Department's decision.

Petitioner's claim for Social Security disability insurance benefits (42 U.S.C. 423(a)(1)(E)) and supplemental security income payments after suffering serious injuries in a motorcycle crash were denied by the Social Security Administration. An ALJ also denied the claim after conducting a hearing, finding that petitioner could perform a significant number of jobs. The district court the denial. The Seventh Circuit affirmed the denial as supported by substantial evidence that petitioner is qualified to work in positions that are available in substantial numbers.

Appellant appealed the district court's order, which affirmed the decision of the Commissioner of the Social Security Administration (Commissioner), denying appellant's application for disability benefits (DIB) under Title II of the Social Security Act, 42 U.S.C. 401 et seq. At issue was whether the ALJ committed legal error by failing to correctly apply the requisite five-step sequential evaluation process. The court held that the ALJ's failure to follow the mandated procedure was more than a mere oversight in opinion writing and that the ALJ was required to follow one of two paths at step five of the sequential process and there was no record indicating that the ALJ followed either path. Accordingly, the court reversed the district court's order affirming the Commissioner's decision and instructed the district court to remand the case to the Commissioner for further proceedings.

Defendant was convicted of one count of making a false statement to obtain Social Security Disability benefits and two counts of knowingly concealing that he earned wages above the income threshold for disability benefits. On appeal, defendant argued that his sentence was unreasonable and filed pro se motions seeking reversal. The court held that the district court considered appropriate factors and provided adequate, internally consistent reasons in imposing a reasonable sentence. The court also held that the pro se motions were better left to a collateral proceeding where the court had an undeveloped record on such claims. Accordingly, the judgment of the district court was affirmed.

A veteran of the Vietnam War, who suffers from post-traumatic stress disorder and schizophrenia, applied for disability benefits in 1981 but his claim was rejected. Years later, the Veterans Court concluded that he was entitled to benefits stemming from the initial claim. The veteran challenged the procedures of the Board of Veterans Appeals in retrospectively assessing his level of disability during the years 1980 to 2007. The Federal Circuit upheld the determination, stating that the legal process was sufficient to satisfy Fifth Amendment rights. The veteran has had his day in court concerning the staged rating assessment, which included a total disability period exceeding five years and reduction of the rating during subsequent periods.

Based on her part in billing Indiana Medicaid for ambulance service while running a car service to take patients to medical appointments, defendant was convicted of Medicaid fraud, 18 U.S.C. 1347, and conspiracy to defraud the U.S. government, 18 U.S.C. 371. She was sentenced to 33 months in prison and to pay restitution of $846,115. The Seventh Circuit affirmed. Data relating to time-stamping of bills, which may have established that multiple people submitted bills, was not concealed; the government simply failed to extract (before trial) information to which it and the defense had access. Even if the data was "Brady" material, it would not have changed the outcome. The judge did not err in telling the jury that a scheduled witness was ill without saying that the witness had refused treatment.

Petitioner served in active military duty from 1972 to 1979, and in the National Guard before and after active service. He also worked as a laborer in a supply company and in coal mines and as a carpenter. In 1997, he claimed entitlement to TDIU, which provides a veteran with a total disability rating when his disability rating is below 100% if the veteran is at least 60% disabled, meets other disability rating criteria, and is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 1 C.F.R. 4.16(a). The VA rejected the claim and, on three remands, petitioner underwent a total of five VA medical examinations. In 2007, the Board denied the claim. The Veterans Court and Federal Circuit affirmed. The VA was not obligated to obtain an industrial survey from a vocational expert in order to evaluate whether petitioner was employable in a job other than his former occupation (i.e., a job that did not involve heavy manual labor).

After prevailing in a suit for social security disability benefits, plaintiff asked for attorney's fees of $25,200 under the Equal Access to Justice Act, 28 U.S.C. 2412(d)(2)(A). The district judge awarded $6,625, cutting the hours from 112 or 116 to 53, adopting objections made by Social Security Administration lawyer, and the hourly rate from $225 to the rate specified in the statute $ 125. The Seventh Circuit reversed and remanded, noting that the Social Security Act provides for awarding a "reasonable fee" for representation in the administrative proceeding and in a successful appeal, 42 U.S.C. 406(a)(1), but the EJA does not provide for "market rate" and creates a presumptive ceiling of $125. The district court did not consider the special circumstances and factors that may be considered under the Act.

After prevailing in a suit for social security disability benefits, plaintiff asked for attorney's fees of $25,200 under the Equal Access to Justice Act, 28 U.S.C. 2412(d)(2)(A). The district judge awarded $6,625, cutting the hours from 112 or 116 to 53, adopting objections made by Social Security Administration lawyer, and the hourly rate from $225 to the rate specified in the statute $ 125. The Seventh Circuit reversed and remanded, noting that the Social Security Act provides for awarding a "reasonable fee" for representation in the administrative proceeding and in a successful appeal, 42 U.S.C. 406(a)(1), but the EJA does not provide for "market rate" and creates a presumptive ceiling of $125. The district court did not consider the special circumstances and factors that may be considered under the Act.