Justia Public Benefits Opinion Summaries

As part of its response to the COVID-19 pandemic, Congress enacted the Families First Coronavirus Response Act (Families First Act), which provides for emergency assistance to households participating in the Supplemental Nutrition Assistance Program (SNAP).The Ninth Circuit affirmed the district court's order denying a motion for a preliminary injunction brought by a putative class of Californians, who normally receive the maximum monthly allotment of SNAP benefits, seeking to bar the USDA from denying California's request under section 2302(a)(1) of the Families First Act to issue emergency allotments to households already receiving maximum SNAP benefits. After determining that plaintiffs had Article III standing, the panel held that the USDA, which administers SNAP, correctly interpreted the statute by concluding that it allows households receiving less than the maximum monthly allotment of SNAP benefits to be brought up to the maximum but does not permit those already receiving the maximum to be given any additional benefits. When the panel examined the Families First Act as a whole, as well as other statutes addressing emergency SNAP benefits, three considerations lead it to conclude that the government's reading of section 2302(a)(1) is more consistent with the overall statutory scheme. Therefore, because plaintiffs were unlikely to succeed on the merits of their claims, the district court did not abuse its discretion in denying a preliminary injunction. View "Hall v. United States Department of Agriculture" on Justia Law

O’Donnell, represented by attorney Horn, challenged the Social Security Administration’s (SSA) denial of her application for disability insurance benefits. A magistrate remanded the case, awarding O’Donnell $7,493.06 in Equal Access to Justice Act (EAJA), 28 U.S.C. 2412(b), fees, paid to Horn. On remand, an ALJ found that O’Donnell was disabled. SSA determined that she was eligible for benefits dating back several months and withheld 25% of O’Donnell’s past-due benefits, $14,515.37, for possible future payment of fees under 42 U.S.C. 406(a), which authorizes SSA to award a “reasonable fee” to persons who successfully represent claimants in administrative proceedings.Horn filed an unopposed motion for authorization to collect $14,515.37 in section 406(b) fees; having already received the $7,493.06 EAJA award, Horn proposed to keep the EAJA fee, with SSA to pay the balance ($7,022.31), leaving $7,493.06 with SSA for future payment of section 406(a) fees. The magistrate’s order stated that Horn was awarded $14,515.37 under section 406(b), payable by the SSA from the past-due benefits and that “Horn will refund" to O'Donnell $7,493.06, equal to the EAJA award, so that Horn would have to look to O’Donnell, not SSA, to satisfy any future section 406(a) fees. An ALJ subsequently awarded Horn $4,925.21 under section 406(a); he had to seek that amount from O’Donnell. The Seventh Circuit affirmed. No statute requires that the court order netting; the Savings Provision contemplates a refund by the attorney. View "O'Donnell v. Saul" on Justia Law

Plaintiff filed suit alleging that DCPS failed to provide her son with a free appropriate public education (FAPE) based on his 2017 individualized education program (IEP). The DC Circuit affirmed the district court's dismissal of the claim as moot, holding that the case presents a fact-specific challenge to particular provisions in an inoperative IEP. Furthermore, the parties agreed to a subsequent IEP and plaintiff does not seek retrospective relief. The court also held that an exception to mootness does not apply where the voluntary cessation doctrine is inapplicable and plaintiff's claim fails to meet the capable of repetition prong because the challenge focuses on a fact-specific inquiry rather than a recurring legal question. View "J. T. v. District of Columbia" on Justia Law

The Ninth Circuit vacated the district court's judgment dismissing as time-barred plaintiff's challenge to the Appeals Council's decision affirming the denial of social security disability benefits. The district court found that declarations from plaintiff and her attorney were insufficient to rebut the presumption that she received notice five days after the denial, triggering a 60-day deadline to file a challenge in federal court.The panel held that plaintiff has made a sufficient "reasonable showing" to rebut the presumption that notice was received within five days of its issuance. In this case, the combination of circumstances—including unrebutted declarations from both plaintiff and her attorney, an officer of the court, that neither received the notice, where the face of the notice indicates that both were supposed to have been mailed copies—is sufficient to rebut the presumption and shift the burden of proving actual receipt to the government. Because the district court did not perform this burden-shifting analysis, the panel remanded for further proceedings. View "Ashe v. Saul" on Justia Law

Dual-status military technicians are “Federal civilian employees” but must maintain National Guard membership and wear the appropriate military uniform while performing civilian technician duties. They must meet certain military requirements.Newton worked as a National Guard dual-status technician, 1980-2013, also serving as a New Jersey Army National Guard member, receiving separate military pay. In 2013, Newton retired from both. He received a pension from the Defense Finance and Accounting Service for his National Guard service and an annuity paid by the Office of Personnel Management for his dual-status technician service. The Social Security Administration (SSA) notified Newton that he qualified for retirement benefits, subject to a reduction under the Windfall Elimination Provision (WEP), 42 U.S.C. 415(a)(7)(A), because he received a separate pension payment “based in whole or in part upon" earnings not subject to Social Security tax, his civil service annuity. Newton argued that his civil service pension triggered an exception to the WEP for uniformed service.The Third Circuit held that Newton’s benefits are subject to a WEP reduction. Newton has always received two separate salaries and now receives two separate pensions. At most, Newton’s OPM civil service pension is based on service he provided while also serving in the National Guard, but not for “service as a member of a uniformed service.” View "Newton v. Commissioner Social Security" on Justia Law

Murphy served in the Army, 1971-1974. In 2003, he sought disability benefits for PTSD; the VA regional office (RO) denied this claim because Murphy lacked a PTSD diagnosis. A private doctor had diagnosed Murphy with schizophrenia in 1982. In 2006, Murphy submitted another claim for disabilities, including schizophrenia. He requested that the RO reopen his PTSD claim. The RO denied the claim for schizophrenia for failure to show service connection and declined to reopen the PTSD claim for lack of material evidence. In 2007-2012, the RO denied multiple requests to reopen both claims.A 2012 request to reopen listed only PTSD. The VA physician found no PTSD but noted the schizophrenia diagnosis. The RO denied Murphy’s request to reopen his PTSD claim. Murphy filed a Notice of Disagreement. The cover page referred to PTSD; a handwritten attachment mentions “schizophrenia” and “PTSD” multiple times. His Form 9 included numerous mentions of both “PTSD” and “schizophrenia.” The RO determined that Murphy was also seeking to reopen his schizophrenia claim but denied that request for lack of new and material evidence. Murphy did not appeal. The Board remanded the PTSD claim; the RO maintained its denial.The Veterans Court determined that the Board correctly found it lacked jurisdiction over the schizophrenia claim, which was a request to reopen, not an initial claim. The Federal Circuit affirmed. Murphy’s request to reopen cannot be construed as seeking to reopen his schizophrenia claim. Although the lenient-claim-scope rule applies to requests to reopen, Murphy demonstrated an understanding that the conditions would be addressed separately. View "Murphy v. Wilkie" on Justia Law

Perry served in the Wisconsin Army National Guard from January 1977 to March 1977, with active duty for training in February-March 1977. Active duty for training is “full-time duty in the Armed Forces performed by Reserves for training purposes,” 38 U.S.C. 101(22). Medical Board examiners at his March 1977 separation opined that enuresis and incontinence existed prior to service. Perry died in 2014. There was no claim for service-connected disability during his lifetime.The Board of Veterans’ Appeals held that Mrs. Perry was not eligible for nonservice-connected death pension benefits because Perry did not have active duty service during a period of war nor did he have a service-connected disability, as required by 38 U.S.C. 1541, that Mr. Perry did not attain veteran status, and that he “was not service-connected for any disability at the time of his death, and there is no evidence that his death was in any way related to" his 1977 military service. The Veterans Court and Federal Circuit affirmed. Service in the state National Guard including a period of active duty for training, without disability incurred or aggravated in line of duty, does not achieve “veteran” status for these purposes. View "Perry v. Wilkie" on Justia Law

The Fourth Circuit reversed the district court's order affirming the SSA's denial of plaintiff's application for disability insurance benefits, holding that the ALJ erred by determining that plaintiff was not disabled during the relevant period.The court concluded that the ALJ erred in discrediting plaintiff's subjective complaints by applying the wrong legal standard by effectively requiring plaintiff to provide objective medical evidence of her symptoms; improperly cherry-picking, misstating, and mischaracterizing facts from the record; and drawing various conclusions unsupported by substantial evidence and failing to explain them adequately. Furthermore, the ALJ's decision exhibits a pervasive misunderstanding of fibromyalgia. Applying its discretion to review the issue, the court concluded that the ALJ erred by according little weight to plaintiff's treating physician's opinion. In this case, the ALJ's treatment of the doctor's opinion contains several errors and is not supported by substantial evidence. The court held that the record as a whole clearly establishes plaintiff's disability and thus her legal entitlement to disability benefits. The court remanded to the Commissioner for calculation of disability benefits. View "Arakas v. Commissioner" on Justia Law

The National Organization of Veterans’ Advocates (NOVA), sought review under 38 U.S.C. 502. The Knee Joint Stability Rule, promulgated in 2018 and set forth in the Veterans Affairs Adjudication Procedures Manual, assigns a joint instability rating under Diagnostic Code (DC) 5257, 38 C.F.R. 4.71a, based on the amount of movement that occurs within the joint. The Knee Replacement Rule provides that evaluation under DC 5055, 38 C.F.R. 4.71a, is not available for partial knee replacement claims. The Replacement Rule was published in the Federal Register in 2015, stating that section 4.71a was amended to explain that “‘prosthetic replacement’ means a total, not a partial, joint replacement.” It was published in a 2016 Manual provision, which informs regional office staff that evaluation under DC 5055 is not available for partial knee replacement claims filed on or after July 16, 2015.The Federal Circuit referred the case for adjudication on the merits. NOVA has standing because it has veteran members who are adversely affected by the Rules. The Manual provision is an interpretive rule reviewable under 38 U.S.C. 502 and constitutes final agency action. The Knee Replacement Rule is a final agency action. The merits panel will determine whether the Manual provision or the Federal Register publication constitutes the reviewable agency action. The challenge is timely under the six-year statute of limitations, 28 U.S.C. 2401(a); Federal Circuit Rule 15(f), establishing a 60-day time limit for bringing section 502 petitions, is invalid. View "National Organization of Veterans’ Advocates, Inc. v. Secretary of Veterans' Affairs" on Justia Law

The First Circuit dismissed these consolidated appeals, and a companion appeal, arising out of long-running litigation between Puerto Rico and several Federally Qualified Health Centers (FQHCs) over the Commonwealth's failure to make payments to the FQHCs, holding that the orders appealed from were void.Here, the FQHCs asserted new claims that the Commonwealth failed fully to pay the statutorily required reimbursement amounts for the services they provided to underserved patients under the Medicaid Act. The First Circuit dismissed the appeals, holding that the Court lacked jurisdiction to resolve the merits of the underlying orders because they were void. View "HealthproMed Foundation, Inc. v. Department of Health And Human Services" on Justia Law