Justia Public Benefits Opinion Summaries

The plaintiffs sought Social Security disability and/or supplemental security income benefits. In each case, the application was denied, and an ALJ upheld the denial. The Appeals Council denied relief. The plaintiffs sought judicial review. While the appeals were pending, the plaintiffs moved to raise an issue they had not raised during administrative hearings--a challenge to the ALJs’ appointments, citing the Supreme Court’s 2018 "Lucia" decision that SEC ALJs had not been appointed in a constitutionally legitimate manner and that remand for a de novo hearing before a different ALJ was required. The district courts agreed that the Appointments Clause challenges were forfeited and affirmed the denials of benefits.The Sixth Circuit vacated and remanded for new hearings before constitutionally appointed ALJs other than the ALJs who presided over the first hearings. There is no question that Social Security ALJs are inferior officers who were required to be, but were not, appointed consistently with the Appointments Clause. There are no statutory or regulatory exhaustion requirements governing Social Security proceedings and, while a court may still impose an implied exhaustion rule, such a requirement is inappropriate because the regulations provide no notice to claimants that their failure to raise an Appointments Clause challenge at the ALJ level will preclude them from later seeking a judicial decision on the issue. View "Flack v. Commissioner of Social Security" on Justia Law

Graham served in the Marine Corps from 1967-1970 and has been receiving disability compensation benefits since 2001. The VA regional office (RO) informed Graham in 2009 that authorities had identified him as a fugitive felon and the subject of an outstanding warrant issued in 1992. That warrant was withdrawn in February 2009. In May 2009, the RO issued a rating decision that retroactively discontinued Graham’s compensation from December 2001 through February 2009, due to his then-fugitive felon status, and informed Graham that he had been improperly paid $199,158.70 and that his monthly compensation would be partially withheld to pay back the debt.Graham appointed Gumpenberger as his representative on appeal and signed a direct-pay agreement stating that Gumpenberger’s fee would be “20 percent of all past-due benefits awarded … as a result of winning … as provided in 38 C.F.R. 14.636.” In 2013, the Board reversed the RO’s debt ruling, finding that Graham was not a fugitive felon for VA purposes because he had never been aware of the outstanding warrant. The VA had recouped $65,464 from Graham’s monthly benefits. The Veterans Court and Federal Circuit affirmed the RO’s determination that Gumpenberger was entitled to a fee of $13,092.80. Although the total debt invalidated was $199,158.70, the past-due benefit, per 38 U.S.C. 5904(d)(1), being awarded was $65,464. View "Gumpenberger v. Wilkie" on Justia Law

The Supreme Court held that a Section 8 beneficiary's compensation for providing in-home care for a severely disabled adult daughter should be excluded from income in calculating the rental subsidy.Plaintiff had an adult daughter who was severally disabled and required constant supervision. Plaintiff and her daughters received housing assistance through Section 8 of the United States Housing Act, 42 U.S.C. 1437 et seq., and Plaintiff received compensation to provide in-home supportive care for her disabled daughter through the In-Home Supportive Services (IHSS) program. Plaintiff asked that the Marine Housing Authority (MHA) exclude her IHSS compensation from "income" under the federal regulations. MHA did not respond to the request and then terminated Plaintiff's housing voucher. Plaintiff filed a petition for writ of mandate seeking an order requiring MHA to reinstitute her Section 8 voucher. The trial court sustained MHA's demurrer, and the court of appeals affirmed. The Supreme Court reversed, concluding that a parent's IHSS compensation to provide care to keep a developmentally disabled child at home is excluded from income under 24 Code of Federal Regulations part 5.609(c)(16). View "Reilly v. Marin Housing Authority" on Justia Law

Garvey served in the Army, 1966-1970. While posted in Germany, Garvey was punished for “disorderly conduct.” Garvey was posted to Vietnam, where he was convicted by special courts-martial of possessing four pounds of cannabis with intent to sell and of being absent without leave three times. Garvey was discharged as unfit for service with an “Undesirable Discharge.” He waived consideration of his case before a board of officers and acknowledged that he “may be ineligible for many or all benefits as a veteran.” In 1977, under the Special Discharge Review Program for Vietnam-era service members, Garvey’s discharge status was upgraded to “Under Honorable Conditions (General).” In 1978, a Discharge Review Board found that Garvey would not have been entitled to an upgrade under generally applicable standards. Garvey died in 2010.His widow applied for dependency and indemnity compensation and death pension benefits. The Veterans Court and Federal Circuit affirmed the denial of her claim; 38 C.F.R. 3.12(d)(4) is not contrary to 38 U.S.C. 5303, which is not the exclusive test for benefits eligibility. A former service member is ineligible for benefits unless he is a “veteran.” Under 38 U.S.C. 101(2), to be a veteran, a former service member must have been discharged “under conditions other than dishonorable.”The VA was authorized to define a discharge for willful and persistent misconduct as a discharge under “dishonorable conditions.” View "Garvey v. Wilkie" on Justia Law

Plaintiff challenged the denial of her application for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. The ALJ found that plaintiff was not disabled because she could perform two occupations that existed in significant numbers in the economy.The Ninth Circuit held that the ALJ's identification of two occupations is insufficient to satisfy the "significant range of work" requirement of the Medical-Vocation Guidelines. The panel explained that, because plaintiff's skills were readily transferrable to only two occupations, the ALJ erred in concluding that she was not disabled. The panel reversed in part and remanded with instructions for calculation and payment of benefits for the period after plaintiff reached 55 years of age. Finally, the panel affirmed the district court's disability determination as to the time period before plaintiff reached the age of 55. View "Maxwell v. Saul" on Justia Law

Burkhart is the widow of U.S. Army veteran David, who served honorably in the Korean War. He had no service-connected disabilities. In the late 1990s, he was admitted to a VA nursing facility, where he died. Burkhart filed a claim for dependency and indemnity compensation (DIC) benefits under 38 U.S.C. 1151, which provides for compensation related to the death or injury of a veteran in certain circumstances while the veteran was under VA care “as if such additional disability or death were service-connected.” Having determined that David’s death was due to an event “not reasonably foreseeable,” the VA granted DIC benefits.In 2007, Burkhart obtained a certificate of eligibility (COE) for home loan guaranty benefits available under chapter 37 but never finalized a loan. In 2013, she requested a new COE for a guaranty. The VA determined that she was ineligible. The Board of Veterans’ Appeals found that home loan guaranty benefits are available only to “the surviving spouse of any veteran . . . who died from a service-connected disability,” 38 U.S.C. 3701(b)(2). The Veterans Court affirmed, requesting requests for equitable relief. The Veterans Court reasoned that an “incontestability provision” (section 3721) gives only lenders receive the privilege of estoppel with respect to COEs. The Federal Circuit affirmed. Burkhart is not eligible for home loan guaranty benefits under any of the cited statutes and the Veterans Court lacked the power to grant her equitable relief. View "Burkhart v. Wilkie" on Justia Law

After defendant was convicted of wire and securities fraud, he was ordered to pay restitution pursuant to the Mandatory Victims Restitution Act (MVRA). The government sought to enforce the restitution order pursuant to the Federal Debt Collection Procedures Act (FDCPA), and thus applied for a post-judgment writ of garnishment against a bank account that held the Social Security benefits of defendant's wife (the claimant), on the theory that those funds were subject to garnishment pursuant to community property principles of Idaho state law. The district court denied claimant's objections and concluded that the MVRA's enforcement provision, 18 U.S.C. 3613(a), overrides the protections afforded Social Security benefits under the Social Security Act (SSA) so the benefits were garnishable community property.The Ninth Circuit held that it has jurisdiction, following the district court's entry of an order directing the disposition of the funds at issue pursuant to the writ of garnishment. The panel reversed the district court's disposition order and held that claimant's Social Security benefits are not subject to garnishment pursuant to the MVRA in connection with her husband's criminal restitution order. The panel explained that the government was entitled to collect on property only to the same extent defendant had a right to it. In this case, defendant would have no right to his wife's Social Security benefits because the SSA preempts application of Idaho state law community property principles. Accordingly, the panel reversed the order denying claimant's objections, vacated the disposition order, and remanded for further proceedings. View "United States v. Swenson" on Justia Law

Lang served in the Marine Corps in 1966-1968 and was badly injured in Vietnam. Lang sought psychiatric treatment at the Pittsburgh VA Medical Center. In 1995, an examiner explained: [T]he Veteran from a physical standpoint is permanently and totally disabled from any type of gainful employment [and] is also socially handicapped to a severe degree . . . . He has a very severe form of PTSD that he has treated himself with alcohol abuse... not to mention the horrendous physical deformities. Lang was granted a 10% disability rating in 1996. Lang did not appeal but continued to receive treatment.In 2014, Lang moved to revise the 1996 rating, citing clear and unmistakable error (CUE). The Veterans Court affirmed the denial of Lang’s request for an adjustment, stating that Lang failed to prove that the “VA had sufficient knowledge of the VA treatment records . . . to trigger the Board’s duty to make the requested findings.” The Federal Circuit vacated. Lang’s post-decision medical records were constructively received by the VA adjudicator before the expiration of the one-year appeal period. A claim remains open until the VA determines whether post-decision evidence received within the one-year appeal period is “new and material.” The Board made no such determination as to Lang’s post-decision medical records, so the 1996 rating decision was not final and a CUE analysis was not required. View "Lang v. Wilkie" on Justia Law

Brace, now age 40, was injured on the job in 2013 and can no longer perform his past work in health service, food service, and construction. He applied for Social Security disability benefits, claiming persistent back and neck pain and several other conditions. An ALJ found that Brace’s severe impairments from degenerative disc disease, neuropathy in the elbow and forearm, and a history of surgery in his shoulder. did not presumptively establish a disability. The ALJ ruled that Brace could not perform any of his past work. A vocational expert testified that Brace could perform jobs as a callout operator, semiconductor bonder, or registration clerk, or a counter clerk, subject to restrictions and that a significant number of jobs exist across those job categories—an estimated 140,000. Brace’s lawyer asked the vocational expert to explain how he arrived at his job estimates; the answer was inscrutable. The ALJ nonetheless accepted his testimony and rejected Brace’s claim for benefits.The Seventh Circuit reversed. The ALJ’s approach does not satisfy the substantial evidence standard. The court rejected the ALJ’s justifications that Brace’s counsel should have objected to the expert’s qualifications before he testified and that the cited jobs number was so large that “[e]ven if the methodology used create[d] a significant margin of error[,] … a significant number of jobs exist.” View "Brace v. Saul" on Justia Law

Kisor served in the Marine Corps, 1962-1966. In 1982, he sought disability compensation benefits for PTSD. A 1983 psychiatric examination noted Kisor's combat experiences in Vietnam. The examiner expressed his “distinct impression” that Kisor suffered from “a personality disorder as opposed to PTSD,” which cannot be a basis for service connection. Kisor did not pursue an appeal. In 2006, Kisor submitted a request to reopen and presented a 2007 report of a psychiatric evaluation diagnosing PTSD. He was granted a 50% rating. The Veterans Court and Federal Circuit affirmed that Kisor was not entitled to an effective date earlier than 2006.On remand from the Supreme Court, the Federal Circuit again affirmed. In the setting of 38 C.F.R. 3.156(c)(1), for purposes of reconsideration of the 1983 denial, the term “relevant” is not “genuinely ambiguous” and “Auer deference” is not appropriate. In the context of section 3.156(c)(1), “relevant” has only “one reasonable meaning.” As the Board determined, under the regulation, to be “relevant,” a record must speak to a matter in dispute. Service department records received in 2006 and 2007 were not “relevant” under the regulation because they did not pertain to the basis of the 1983 denial of Kisor’s claim, which was the lack of a diagnosis of PTSD. View "Kisor v. Wilkie" on Justia Law