Justia Public Benefits Opinion Summaries

Plaintiffs, 54 residents of Ryderwood residential community, filed an action against the Ryderwood Improvement and Service Association ("RISA") alleging that the age restrictions imposed by RISA violated the Fair Housing Act ("FHA"), 42 U.S.C. 3604(a)-(e), 3605, 3606, 3617, and that RISA had never satisfied the requirements of the Housing for Old Persons Act exemption ("HOPA"), Pub. L. No. 104-76, section 2, 109 Stat. 787. At issue was whether RISA was exempt from the FHA's prohibitions on familial status discrimination under one of the housing for older persons exemptions set out in section 3607(b). The court vacated in part and remanded for further proceedings holding that a residential community that had continuously operated as a retirement community for persons age 55 or older could qualify for the housing for older persons exemption from the FHA's prohibition on familial status discrimination by establishing that it currently satisfied the exemptions' three statutory and regulatory criteria at the time of the alleged violation, even if the community enforced age restrictions when it first achieved compliance with the exemption's age verification requirement.

Appellees, the parents of a child with moderate-to-severe autism, filed due process proceedings against the Sumter County School District #17 ("District") seeking a determination that the District did not provide a free and appropriate public education ("FAPE") to the child as required by the Individuals with Disabilities Education Act ("IDEA"), 20 U.S.C. 1412(a)(1)(A). At issue was whether the district court erred by concluding that the District failed to provide the child with a FAPE and that the program established by the child's parents to educate him at home was appropriate. The court held that that the district court did not err in concluding that the District failed to provide the child with FAPE for the 2005-2006 school year where the district court considered the evidence of the child's small improvements in a few tested areas against the District's conceded failure to provide the hours of therapy required for the child, the evidence that the lead teacher and aides did not understand or use proper techniques, and the evidence that it took one teacher months of working with the child to correct the problems caused by the improper techniques. The court also held that the district court did not err by finding that the District was not capable of providing FAPE to the child where the District's evidence was not compelling enough to establish it's improved capabilities at the time of the due process hearing. The court also held that the evidence was sufficient to support the district court's findings that the home placement was reasonably calculated to enable the child to receive educational benefits.

Appellant, a former student in the Forest Grove School District ("Forest Grove"), appealed the district court's determination that he was not entitled to an award of reimbursement for his private school tuition under the Individuals with Disabilities Education Act ("IDEA"), 20 U.S.C. 1415(i)(2)(C). At issue was whether the district court abused its discretion in holding that equitable considerations did not support any award of private-school tuition at Mount Bachelor Academy as a result of Forest Grove's failure to provide appellant with a Free and Appropriate Education ("FAPE") under the IDEA. The court held that the district court did not abuse its discretion in holding that there was sufficient evidence in the record to support the district court's factual determination where appellant's parents enrolled him at Mount Bachelor solely because of his drug abuse and behavioral problems.

Plaintiff, the Department of Fair Employment and Housing ("DFEH") and plaintiff-intervenor appealed the district court's grant of summary judgment in favor of defendant, Lucent Technologies, Inc. ("Lucent"), plaintiff-intervenor's former employer, on claims that he was terminated in violation of the California Fair Employment and Housing Act, ("FEHA"), Cal.Gov't Code 12920.5. DFEH also challenged the district court's finding of diversity jurisdiction and plaintiff-intervenor challenged the district court's denial of his motion to intervene. The court held that the district court correctly determined that it possessed jurisdiction where the statutory scheme did not support a finding that DFEH was a real party in the controversy for the purposes of diversity jurisdiction. The court also held that the district court's denial of plaintiff-intervenor's motion to intervene as a right was not in error where he failed to demonstrate that he was not adequately represented by California and that the court did not abuse its discretion in placing various limitations on him as a permissive intervenor. The court further held that summary judgment was proper where there was no genuine issue of material fact as to DFEH's claims and where DFEH failed to raise a genuine issue of material fact as to pretext. The court finally held that there was no genuine issue of material fact as to plaintiff-intervenor's wrongful termination claim where DFEH could not prevail on any of its claims under the FEHA.

Forsyth Memorial Hospital, Inc. and other providers (collectively "appellants") appealed the district court's grant of summary judgment in favor of the Secretary of Health and Human Services ("HHS") upholding the denial of their reimbursement claims arising from the merger of Presbyterian Health Services Corporation ("Presbyterian") and Carolina Medicorp, Inc. ("Carolina"). At issue was whether the denial of the reimbursement claims was arbitrary and capricious, an abuse of discretion, contrary to law, or unsupported by substantial evidence. The court affirmed the denial of the reimbursement claims and held that the district court properly concluded that it was neither arbitrary and capricious nor contrary to law for the Administrator of the Centers for Medicare & Medicaid Services ("Administrator") to find that appellants were not entitled to reimbursement where, in the merger between Carolina and Presbyterian, no bona fide sale took place and the parties were related.

The Equal Rights Center ("ERC") sued Post Properties, Inc. ("Post") alleging that Post designed, constructed, and operated its apartment complexes in a manner that violated the Fair Housing Act ("FHA"), as amended by the Fair Housing Amendments Act of 1988 ("FHAA"), 42 U.S.C. 3601-3631, and Title III of the Americans with Disabilities Act ("ADA"), 42 U.S.C. 12181-12189. At issue was whether the district court properly granted summary judgment to Post on the ground that the ERC lacked standing to bring suit where it failed to demonstrate an injury in fact. The court held that the ERC failed to demonstrate that its injury was actual or imminent at the time of the filed suit and held that the district court erroneously concluded that the ERC could not establish standing because it chose to redirect its resources to investigate Post's allegedly discriminatory practice. Therefore, the court focused on whether the organizational plaintiff undertook expenditures in response to, and to counteract, the effects of a defendant's alleged discrimination rather than in anticipation of litigation and determined that the ERC failed to demonstrate that it suffered an injury in fact that was actual or imminent at the time it filed the suit.

Plaintiff sued defendant seeking a declaratory judgment that defendant was required to comply with the rules laid out in Title XIX of the Social Security Act, section 1396-1396v, where there was a dispute as to what rate plaintiff must pay defendant when defendant provided emergency transportation services to plaintiff's Medicaid enrollees. At issue was whether the definition of emergency services in section 1396(u)-2(b)(2)(B) applied to section 1396(u)-2(b)(2)(D) and whether section 1396(u)-2(b)(2)(D) covered the services provided by defendants to members of plaintiff's Medicaid program. The court held that the definition of emergency services found in 1396(u)-2(b)(2)(B) applied to section 1396(u)-2(b)(2)(D) where applying different definitions to a single term of art within this one statute would be both cumbersome and illogical. The court also held that the district court erred in granting summary judgment to defendant where the plain meaning of the word outpatient and the structure of the statute supported a finding in favor of plaintiff.

Appellants, a child with a learning disability and his parents, sued the Special School District No. 1 ("School District") in Minneapolis, Minnesota alleging that the School District violated his rights under the Individuals with Disabilities Education Act ("IDEA"), 20 U.S.C. 1400, by denying him a free appropriate public education. At issue was whether the district court properly granted summary judgment in favor of the School District when it determined that the parents were not entitled to reimbursement from the School District for one year of private tuition when they transferred the child to a private education institution ("institution"). The court reversed the district court's decision and held that appellants were not precluded from reimbursement for tuition for the 2008-2009 academic year where the institution was a proper placement for the child and where the institution did not need to satisfy the least-restrictive environment requirement to be "proper" under the IDEA.

Appellant appealed the district court's order affirming the Social Security Administration's denial of his application for supplemental security income under 42 U.S.C. 405(g). At issue was whether the administrative law judge ("ALJ") failed to properly consider appellant's obesity, depression, and organic brain syndrome; improperly discredited appellant's subjective statements and certain medical evidence, and was biased against his doctor; and inadequately supported the ALJ's residual functional capacity assessment ("RFC"). The court held that the ALJ adequately considered appellant's obesity and that the ALJ's determination that appellant did not suffer from a debilitating mental impairment was supported by substantial evidence in the record as a whole. The court also held that the ALJ's decision to give less weight to a particular doctor's determination was reasonable where the doctor's determination contradicted other objective evidence in the record and that appellant provided no evidence to support his bias claims. The court further held that the ALJ adequately considered the evidence before deciding that appellant's subjective statements of pain were incredible. The court finally held that the ALJ considered all of appellant's physical and mental impairments which adequately supported the RFC assessment.

Plaintiff filed a qui tam action pursuant to 31 U.S.C. 3729 alleging that defendants fraudulently billed Medicare/Medicaid for medical procedures performed by unsupervised residents. At issue was whether the court had appellate jurisdiction over plaintiff's appeal from the district court's judgment and order dismissing his complaint and denying leave to amend. Also at issue was whether the district court abused its discretion by declining to reconsider its order that denied plaintiff's request for leave to amend. Further at issue was whether the district court erred in imposing an order granting sanctions under Federal Rule of Civil Procedure 11 or, alternatively, 28 U.S.C. 1927. The court held that it lacked appellate jurisdiction where plaintiff's Federal Rule of Civil Procedure 60(b) motion failed to toll his deadline to timely file a notice of appeal. The court also held that the district court properly exercised its discretion when it denied plaintiff's Rule 60(b) motion where plaintiff had not requested permission to amend as of right and that it made no mistake in not divining that he actually intended to do so. The court further held that the district court properly exercised its discretion to sanction pursuant to section 1927 and did not need to reach the court's alternative Rule 11 sanctions ruling.