Justia Public Benefits Opinion Summaries

Lynch served on active duty in the Marine Corps, 1972-1976. In 2015, Lynch was evaluated on two separate occasions by Dr. Newsome, a private psychologist. Lynch described phobias about confined spaces, panic attacks, memory problems, mood swings, frequent nightmares, antisocial behaviors, and depression, which he attributed to intrusive memories from his time in service. Dr. Newsome reported that Lynch’s symptoms and the results of the PTSD Checklist supported a diagnosis of PTSD.Lynch filed a claim of entitlement to disability benefits for PTSD and underwent a VA PTSD examination. The VA examiner reported that Lynch’s PTSD did not result in symptoms that were severe enough to interfere with occupational or social functioning or to require continuous medication and that the level of impairment observed by Dr. Newsome was not observed during the VA examination. The regional office granted Lynch’s claim with a 30% disability rating. Lynch filed a Notice of Disagreement and submitted two additional psychological evaluations conducted by a private psychiatrist, Dr. Jabbour. He underwent a second VA PTSD examination. The examiner found some of Jabbour’s conclusions “more extreme than what was supported by available evidence.”The Veterans Court rejected Lynch’s argument that the Board misapplied 38 U.S.C. 5107(b) and wrongly found that he was not entitled to the “benefit of the doubt.” The Federal Circuit affirmed. The benefit of the doubt rule is inapplicable when the preponderance of the evidence is found to be against the claimant. View "Lynch v. McDonough" on Justia Law

The Ninth Circuit affirmed the denial of social security disability benefits to claimant. At issue is whether knowledge of the Social Security Administration's longstanding interpretation of the term "medium work" as requiring standing or walking for approximately six hours out of an eight-hour workday can be imputed to a qualified vocational expert.The panel held that an expert in this field is presumptively aware of the agency's well-established definition of this term of art. Therefore, when the ALJ asked the expert in this case whether jobs existed for a hypothetical individual who was limited to medium work, that question adequately communicated the term's attendant standing and walking limitations. In this case, it follows that the expert's resulting testimony that a significant number of jobs existed in the national economy for an individual with claimant's limitations constituted substantial evidence in support of the ALJ's determination that he was not disabled within the meaning of the Social Security Act. View "Terry v. Saul" on Justia Law

The American Rescue Plan Act of 2021 allocated $29 billion for grants to help restaurant owners. The Small Business Administration (SBA) processed applications and distributed funds on a first-come, first-served basis. During the first 21 days, it gave grants only to priority applicants--restaurants at least 51% owned and controlled by women, veterans, or the “socially and economically disadvantaged,” defined by reference to the Small Business Act, which refers to those who have been “subjected to racial or ethnic prejudice” or “cultural bias” based solely on immutable characteristics, 15 U.S.C. 637(a)(5). A person is considered “economically disadvantaged” if he is socially disadvantaged and he faces “diminished capital and credit opportunities” compared to non-socially disadvantaged people who operate in the same industry. Under a pre-pandemic regulation, the SBA presumes certain applicants are socially disadvantaged including: “Black Americans,” “Hispanic Americans,” “Asian Pacific Americans,” “Native Americans,” and “Subcontinent Asian Americans.” After reviewing evidence, the SBA will consider an applicant a victim of “individual social disadvantage” based on specific findings.Vitolo (white) and his wife (Hispanic) own a restaurant and submitted an application. Vitolo sued, seeking a preliminary injunction to prohibit the government from disbursing grants based on race or sex. The Sixth Circuit ordered the government to fund the plaintiffs’ application, if approved, before all later-filed applications, without regard to processing time or the applicants’ race or sex. The government failed to provide an exceedingly persuasive justification that would allow the classification to stand. The government may continue the preference for veteran-owned restaurants. View "Vitolo v. Guzman" on Justia Law

Appellant N.A. was a nonminor former dependent (NFD). While a minor, she lived with a legal guardian, who received financial aid (aid to families with dependent children-foster care, or AFDC-FC) on N.A.’s behalf. When N.A. was 17 years old, she moved out of the guardian’s home. The San Diego County Health and Human Services Agency was not informed of this circumstance, and AFDC-FC payments to the guardian continued past N.A.’s 18th birthday. The guardian provided some financial support to N.A. after she moved out, but at some point, the guardian stopped providing support altogether. Thereafter, N.A. petitioned to return to juvenile court jurisdiction and foster care, which would provide her with certain services and financial aid, under Welfare & Institutions Code section 388.1. At that time, the Agency became aware of N.A.’s prior living circumstance and determined that she and the guardian became ineligible for AFDC-FC payments when N.A. moved out of the guardian’s home before N.A. turned 18. The Agency sent notice of its decision to the guardian. Based on its determination that N.A. was not actually eligible to receive AFDC-FC payments after she turned 18, the Agency recommended denying her petition for reentry. The juvenile court denied N.A.’s petition for reentry, but ordered the Agency to notify N.A. directly of its eligibility determination so that she could pursue administrative remedies. On appeal, N.A. contended the juvenile court’s order was based on an erroneous interpretation of section 388.1 and related statutes. Alternatively, N.A. argued that the court should have decided the AFDC-FC eligibility issue because exhausting the administrative hearing process would be futile under the circumstances. Finding no reversible error, the Court of Appeal affirmed the order. View "In re N.A." on Justia Law

Kirby received a flu shot in her arm on October 8, 2013. One week later, she complained of persistent arm pain, numbness, and tingling that began immediately after the injection. On October 16, Dr. Henry diagnosed Kirby with radial neuritis and complications due to vaccination. Two weeks later, Kirby reported that her wrist and hand had become “very weak.” On November 12, Kirby began working with a physical therapist. Her physical therapy discharge summary reported that Kirby’s pain was a “0/10,” she had regained full muscle strength except in right thumb extension, and her numbness had decreased by 80%. On December 12, Kirby reported mild right arm pain in the morning, almost normal strength, and occasional tingling, but no numbness in her thumb. Dr. Henry determined she had achieved maximum medical improvement.Kirby visited a nurse practitioner five times in January 2014-July 2015, for reasons unrelated to her vaccine injury and generally reported “feeling fine.” On October 13, 2015, she complained of mild, intermittent pain in her right arm. She had no imitations due to the pain, and no muscle weakness.The Federal Circuit reinstated Kirby’s compensation award under the Vaccine Act, 42 U.S.C. 300aa–1. A finding that Kirby’s vaccine injury lasted more than six months was not arbitrary. A reasonable fact-finder could conclude that Kirby’s testimony is not inconsistent with her medical records from January 2014 through July 2015. The court also rejected an argument concerning causation. View "Kirby v. Secretary of Health & Human Services" on Justia Law

The Eleventh Circuit affirmed the Commissioner's denial of plaintiff's application for disability insurance benefits pursuant to 42 U.S.C. 405(g). The court held that there is no apparent conflict between one's limitation to following simple instructions and positions that require the ability to follow "detailed but uninvolved" instructions. The court concluded that the decision to deny benefits is otherwise supported by substantial evidence. View "Buckwalter v. Acting Commissioner of Social Security" on Justia Law

The Court of Appeal reversed the superior court's decision reversing the ALJ's finding that A.V. met the statutory criteria for developmental disability: he had a qualifying condition of autism, i.e., ASD; his ASD was substantially disabling; and the condition originated before age 18. The ALJ rejected the Regional Center's argument that a qualifying condition must not only originate but must also become "substantially disabling" before age 18. Although the superior court agreed with the ALJ's decision to the extent it found a claimant's qualifying condition need not become substantially disabling before age 18, it found that the ALJ erred by weighing the parties' evidence "on an even playing field" rather than deferring to the Regional Center's opinions about A.V.'s eligibility for services under the Lanterman Developmental Disabilities Services Act.The court concluded that the superior court erred when it deferred to the Regional Center's eligibility determinations. The court explained that a fair hearing under the Act is just that – an even playing field on which the participants present their evidence to an impartial hearing officer. In this case, the superior court owed deference not to the Regional Center's evaluators but to the administrative process created to fairly resolve disputes over eligibility for services. Accordingly, the court directed the superior court to review the petition under the appropriate standard on remand. View "Tri-Counties Ass'n v. Ventura County Public Guardian" on Justia Law

Flores-Vazquez served on active duty in the Navy, 1984-1988. In 1998, he sought service connection for depression for which he received treatment while onboard the U.S.S. Kitty Hawk. Flores-Vazquez claimed that he had witnessed several accidental deaths during service, including “a man being sucked inside the nose of an airplane.” Flores-Vazquez did not then submit service department records verifying the incidents. Flores-Vazquez did not appeal the denial of his claim. In 2005, Flores-Vazquez sought to reopen his claim. A medical examiner diagnosed bipolar disorder with depression and determined that the condition was “due to or the result of in[-]service illness.” The regional office denied service connection, reasoning that the medical opinion was “appeared to be based on the veteran’s unsupported report.”In 2008-2009, while Flores-Vazquez’s appeal to the Board of Veterans’ Appeals was pending, the VA received the 1986-1987 command histories of the Kitty Hawk. In 2010, the Board decided that, while the evidence was not compelling, service connection was warranted. The Board relied primarily on the 2005 medical report, not the command histories, and granted an effective date of January 2005. On remand from the Veterans Court, the Board found that 38 C.F.R. 3.156(c) did not apply because the Board’s 2010 award of benefits “was not based on” the new service department records. The Federal Circuit affirmed. The command histories submitted in 2008 played no role in the grant of service connection; the favorable resolution turned on a 2005 VA opinion that was based on service medical records that were always part of the claims file. View "Flores-Vazquez v. McDonough" on Justia Law

The Equal Access to Justice Act (EAJA), 28 U.S.C. 2412, requires that if statutory requirements are met, the federal government must reimburse attorneys’ fees of a party who prevails in a lawsuit against the government. Smith, dissatisfied with the VA’s decision regarding his claims for veterans’ benefits, took an appeal to the Veterans Court. He was successful on the merits in part of his case and requested an EAJA award for his appellate counsel. The Veterans Court agreed to an award which included fees for 18 hours the attorney spent on an initial review of the 9,389-page agency record. The court imposed a reduction in that part of the award because Smith prevailed on some but not all of the issues that were litigated. The Veterans Court reasoned that this reduction was required as a matter of law by the EAJA.The Federal Circuit reversed in part. The Veterans Court undervalued the importance of the initial review of the case, a review that is necessary before appellate counsel could determine what bases existed for an appeal. That decision was contrary to the purpose and law of the EAJA. The court noted that if Smith had brought only the successful claim, the hours would have been fully compensated. View "Smith v. McDonough" on Justia Law

Gedatus, born in 1976, sought social security disability benefits, alleging many medical conditions, including lumbar degenerative disc disease, sciatica, leg pain, knee pain, wrist difficulties, tremors, and residual effects from a head hemorrhage. She graduated from high school. By 2003, she worked at a bar. Over the years, she underwent multiple surgeries and other treatments.After a hearing, the Administrative Law Judge agreed with Gedatus about several issues, but concluded she could perform light work with some limits, so she was not disabled. No doctor opined she needed more limits than the ALJ determined. The district judge affirmed. The Seventh Circuit affirmed the denial as supported by substantial evidence, rejecting claims that errors permeated the ALJ’s symptom evaluation and that the ALJ erred by not setting forth an assessment of her limited sitting tolerance or tremors. View "Gedatus v. Saul" on Justia Law