Justia Public Benefits Opinion Summaries

The Eighth Circuit affirmed the district court's order upholding the Social Security Administration's denial of plaintiff's benefits claim, because substantial evidence supports the finding that the SSA has met its burden. The court concluded that the Vocational Expert relied on sufficient evidence, such as plaintiff's own testimony, when he formed his expert opinion. The court also concluded that the evidence supports the ALJ's finding that plaintiff can transfer her job skills to new sedentary positions, such as the suggested positions of order clerk, receptionist, or appointment clerk. Furthermore, there is sufficient evidence in the record to show that plaintiff possessed job skills that would transfer to other sedentary occupations. View "Swedberg v. Saul" on Justia Law

The statutory presumption of soundness states: [E]very veteran shall be taken to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time ... or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service, 38 U.S.C. 1111. The VA’s prior section 1111 implementing regulation did not require clear and unmistakable evidence of lack of aggravation by service for rebuttal but required only clear and unmistakable evidence that the disorder “existed prior [to service].” In 2003, the VA invalidated the regulation for conflicting with the statutory language and amended the regulation to require evidence of both preexisting condition and no aggravation, 70 Fed. Reg. 23,027, 23,028. The Federal Circuit affirmed.Veterans, whose claims for disability benefits were denied decades ago, sought revision of the denial decisions, alleging that the VA had committed clear and unmistakable error (CUE). The Veterans Court affirmed the Board of Veterans’ Appeals’ denials of the motions, reasoning that the VA did not commit a clear and unmistakable legal error when it faithfully applied the version of the presumption of soundness regulation that existed at the time. The Federal Circuit affirmed. A legal-based CUE requires a misapplication of the law as it was understood at that time, and cannot arise from a subsequent change in interpretation in the law. View "George v. McDonough" on Justia Law

In these consolidated appeals, the Supreme Court affirmed the district court's dismissal of separate actions challenging the Nebraska Department of Health and Human Services' (DHHS) denial of an administrative appeal hearing, holding that the district court correctly determined that the hearing request was untimely submitted to DHHS under the governing regulation.Robert Colwell, DDS, P.C., was a Nebraska corporation through which Colwell (collectively, Colwell) provided medical services. Colwell entered into an agreement with Managed Care of North America (MCNA), which provided managed care services to Nebraska's Medicaid program, agreeing to provide dental services for individuals enrolled in Nebraska Medicaid. When MCNA allegedly failed to compensate Colwell for covered services, Colwell filed one action challenging the MCNA's decision to terminate the Medicaid provider agreement with Colwell. In this action, Colwell filed a request for a fair hearing with DHHS, which DHHS denied and dismissed. Colwell then filed another action challenging the DHHS order of dismissal. The district court dismissed both appeals for lack of subject matter jurisdiction. The Supreme Court affirmed, holding that Colwell's request for a hearing before DHHS was not timely filed within ninety days of the "date of the action." View "Colwell v. Managed Care of North America" on Justia Law

Bailey became partially disabled by pneumoconiosis, caused by the inhalation of coal dust. In 2002, he entered into an agreement with his employer to settle his state workers’ compensation claim; $27,677.50 was designated as Bailey’s take-home amount, representing payments of $135.67 per month, for 17 months beginning in July 2002. In November 2011, Bailey filed a claim under the Black Lung Benefits Act. The Office of Workers’ Compensation Programs (OWCP) granted Bailey’s claim in October 2013, but his benefits entitlement began the month he filed his claim and continued through May 2016—the month preceding the month that he died. At the time of his death, he had received benefits totaling $30,507.70 but was still owed benefits for the months from November 2011 through September 2013, $21,508.90. Bailey’s employer went bankrupt. He sought the remaining benefits from the federal Black Lung Disability Trust Fund. While the OWCP approved that claim, a District Director reevaluated the original award, finding that Bailey’s state workers’ compensation award represented monthly state benefits, some of which ran concurrently with his federal benefits eligibility period, so that the federal benefits must be offset by the state benefits received for that time—$135.67 per month over 55 months ($7,461.85). The OWCP subtracted this amount from the $21,508.90. The Seventh Circuit affirmed. The offset is required by the Act; that Bailey received his state benefits years before he became eligible for federal benefits does not alter the conclusion. View "Bailey v. Director, Office of Workers’ Compensation Programs, United States Department of Labor" on Justia Law

Arnold applied for Social Security disability benefits based on ailments related to her back, heart, and joints, and chronic pain syndrome. Following the initial denial of her claim, Arnold requested a hearing before an ALJ. Arnold testified at the hearing, as did a vocational expert. The ALJ concluded that Arnold was not disabled, finding Arnold had several severe impairments, but that she retained the ability, with certain movement restrictions, to perform her past relevant work as a daycare center director. The district court and Seventh Circuit affirmed the ALJ’s decision, rejecting an argument that the ALJ failed to analyze whether the side effects of her medications impacted Arnold’s ability to work. While there is some evidence of side effects in the record, there is no evidence that the side effects impacted Arnold’s ability to work. On this record, the ALJ was not required to make findings about Arnold’s side effects. View "Arnold v. Saul" on Justia Law

Plaintiff, a retired "dual status technician" with the National Guard, argues that the civil service pension he received in connection with his employment as a dual status technician – a civilian position that requires concurrent National Guard membership – is not subject to reduction under the Social Security Act's Windfall Elimination Provision because the pension falls within an exception applicable to payments based wholly on work performed as a member of a uniformed service. The district court granted summary judgment to plaintiff and the Administration appealed.The Second Circuit reversed the Administration's calculation of plaintiff's Social Security retirement benefits. The court read the plain language of the statute and used traditional tools of statutory interpretation, holding that a civil service pension based on federal civilian employment as a dual status technician does not fall within the uniformed service exception. Therefore, the court remanded for further proceedings consistent with the court's opinion. View "Linza v. Saul" on Justia Law

In March 2020, Congress created the Paycheck Protection Program (PPP), which authorized the SBA to guarantee favorable loans to certain business affected by the COVID-19 pandemic. The SBA Administrator promulgated regulations imposing several longstanding eligibility requirements on PPP loan applicants, including that no SBA guarantee would be given to businesses presenting "live performances of a prurient sexual nature." Pharaohs, a business featuring nude dancing, sought a preliminary injunction directing the SBA to give it a PPP loan guarantee.The Second Circuit affirmed the district court's denial of Pharaoh's motion, holding that the district court did not abuse its discretion in finding that Pharaohs has failed to show that it is substantially likely to succeed on its claims that (1) the SBA exceeded its statutory authority to promulgate eligibility restrictions, and (2) the exclusion of nude-dancing establishments from the Program violates the First or Fifth Amendments. The court need not address the remaining preliminary injunction factors in light of its conclusion. View "Pharaohs GC, Inc. v. United States Small Business Administration" on Justia Law

Euzebio served in the U.S. Navy, 1966-1969, including two tours of duty in Vietnam, where he was exposed to Agent Orange. In 2009, Euzebio began experiencing problems swallowing. In 2011, medical examinations and testing by private physicians indicated that he had benign thyroid nodules. The Veterans Court affirmed the Board of Veterans’ Appeals’ denial of Euzebio’s entitlement to service connection for a thyroid condition due to exposure to Agent Orange. The Board noted that the Agent Orange Act requires that when the Secretary determines that a presumption of service connection based on herbicide exposure is not warranted for certain conditions, he must consider reports of the National Academy of Sciences (NAS), 38 U.S.C. 1116; Euzebio’s thyroid disorder was not among the conditions listed by the Secretary for presumptive service-connection.The Federal Circuit vacated. The Board is required to consider relevant documents within its constructive possession; all relevant and reasonably connected VA-generated documents are part of the record, constructively known by the VA adjudicator. The Veterans Court applied an erroneous legal standard when it concluded the Board did not have constructive possession of the NAS Update 2014. While the VA has not published that Update in the Federal Register, it appears on its website. Update 2014 includes statements that, “thyroid conditions overall showed an indication of increased risk with herbicide exposure” and that “consistent observations of exposures to herbicide agents” indicated that they were “related to perturbations of thyroid function.” View "Euzebio v. McDonough" on Justia Law

The Individuals with Disabilities Education Act (IDEA) does not permit a school district to amend an individualized education program (IEP) unilaterally during the thirty-day resolution period. The Act envisions the resolution period as a time for mediation and agreement, not one-sided action. In this case, the first IEP that the school district prepared for the child and presented to the parents indicated erroneously that the child would be placed in a 12-student classroom, which the parents deemed insufficient. After the parents filed a due process complaint, the school district sought to cure this deficiency by unilaterally amending the original IEP to reflect that the student would be in a 15-student class. The district court found in favor of the parents and ordered the school district to reimburse the parents for the private school tuition.The Second Circuit affirmed and concluded that because the school district argues only that it provided the student with a free appropriate education (FAPE) based on her IEP as unilaterally amended during the resolution period, and does not dispute that the unamended IEP denied the student a FAPE, the school district denied the student a FAPE for her 2016-17 school year. Finally, the district court's other conclusions relevant to the reimbursement order are not challenged on appeal and therefore stand unaltered. View "Board of Education of the Yorktown Central School District v. C.S." on Justia Law

Karr applied for Social Security disability benefits based on her complaints of chronic lower back pain and other ailments. Karr traces the source of her back pain to a car accident in the late 1990s. She has tried multiple forms of treatment for her pain, numbness, and weakness in her lower back and legs.An ALJ concluded that Karr was not disabled because she still could perform sedentary work with some restrictions. The district court and Seventh Circuit affirmed, rejecting Karr’s claim that the ALJ improperly discounted a statement from her treating neurosurgeon that she could not sit, stand, or walk for sustained periods. The ALJ’s decision was supported by substantial evidence Although acknowledging that the neurosurgeon was a treating provider who had examined Karr, the ALJ found “extreme” his notation that Karr could not “sit, stand or walk for any sustained period of time” because the record contained reports of multiple physical examinations showing that Karr had full strength and could walk normally. View "Karr v. Saul" on Justia Law