Justia Government & Administrative Law Opinion Summaries

Roddy, born in 1964, suffers from several serious medical problems, including severe lower back pain attributable to degenerative disc disease. When her pain became unbearable, she stopped working and applied for disability insurance benefits. She was unsuccessful before the Social Security Administration. An administrative law judge found that there were jobs in the national economy within her capabilities, although she no longer could perform her old job as a shift manager at a Taco Bell restaurant. The district court affirmed. The Seventh Circuit vacated and remanded. The ALJ improperly discounted the opinion of a physician and improperly considered Roddy’s testimony about her ability to do housework. View "Roddy v. Astrue" on Justia Law

Diaz, a Michigan Department of Corrections employee, he was diagnosed with heart and abdominal conditions that forced him to take intermittent leave. Diaz alleges he was fired for attendance violations after taking leaves and brought suit under 42 U.S.C. 1983, seeking damages and reinstatement, alleging: interference with Family Medical Leave Act, 29 U.S.C. 2612 (a)(1)(D) rights; retaliation for exercising FMLA rights; and deprivation of a protected federal right. Boden, an employee of the Michigan Department of Human Services, was placed on stress leave by her doctor; she claims that her supervisor dramatically increased her workload and disciplined her for petty infractions because of that leave. She brought suit with the same allegations. The district court dismissed. The Sixth Circuit remanded the claim for reinstatement, but affirmed with respect to claims for damages. The Supreme Court has held that a state employee may recover damages for a state’s failure to comply with family-care provision of the FMLA, but the Sixth Circuit has held that the rationale did not extend to FMLA self-care provision. Suits against the states for damages under 2612(a)(1)(D) are barred by the states’ sovereign immunity and public employers cannot be held individually liable under the FMLA.View "Boden v. MI Dep't of Human Servs." on Justia Law

In the four cases giving rise to these eleven consolidated appeals, the Secretary of the Department of Health and Human Services (HHS) and the Director of the California Department of Health Care Services (DHCS), appealed the district court's grant of preliminary injunctions to plaintiffs, various providers and beneficiaries of California's Medicaid program (Medi-Cal). At issue was the implementation of Medi-Cal reimbursement rate reductions. The court held that Orthopaedic Hospital v. Belshe did not control the outcome in these cases because it did not consider the key issue here - the Secretary's interpretation of 42 U.S.C. 1396a(a)(30)(A); the Secretary's approval of California's requested reimbursement rates were entitled to Chevron deference; and the Secretary's approval complied with the Administrative Procedures Act, 5 U.S.C. 500 et seq. The court further held that plaintiffs were unlikely to succeed on the merits on their Supremacy Clause claims against the Director because the Secretary had reasonably determined that the State's reimbursement rates complied with section 30(A). The court finally held that none of the plaintiffs had a viable takings claim because Medicaid, as a voluntary program, did not create property rights. View "Managed Pharmacy Care, et al v. Sebelius, et al" on Justia Law

A VA regional office awarded King disability compensation for residuals of a left knee surgery and right knee arthritis. King later sought disability compensation for disabilities of the back and hips on a direct basis and as secondary to his service-connected knee disabilities. Records revealed no treatment for back or hip problems during King's active duty service 1973-1974. King underwent a VA spine examination in 2000. The examiner diagnosed minimal degenerative joint disease of both hips and lumbosacral spine, related to age. A private physician disagreed. In 2007, the Board of Veterans denied King's appeal. The Veterans Court remanded. Additional evidence was developed and, in 2008, the Board obtained an opinion from a Veterans Hospital Administration orthopedist that it was not likely that King’s back and bilateral hip disabilities were directly caused or permanently worsened by the service-connected knee disabilities. The Board and Court of Appeals for Veterans Claims affirmed the denial. The Federal Circuit affirmed, rejecting an argument that the Veterans Court erred by discounting lay testimony offered by King and his wife. The Veterans Court did not fail to consider the proffered lay evidence, so King’s appeal was merely a challenge to the weight given his evidence.View "King v. Shinseki" on Justia Law

Ruppel sued CBS in Illinois alleging CBS’s predecessor, Westinghouse, caused the mesothelioma from which he suffers. Westinghouse had included asbestos in the turbines it supplied to the U.S. Navy, and Ruppel was allegedly exposed to it during his Naval service and later when he worked on an aircraft carrier as a civilian. CBS removed the case under the federal officer removal statute, which permits removal of certain suits where a defendant that acted under a federal officer has a colorable federal defense, 28 U.S.C. 1442(a)(1). Ruppel moved to remand and, without allowing response, the district court granted the motion. The district court concluded Ruppel only sued CBS for failing to warn about the dangers of asbestos for which there is no federal defense. The Seventh Circuit reversed. CBS’s relationship with Ruppel arises solely out of CBS’s duties to the Navy. It also has a colorable argument for the government contractor defense, which immunizes government contractors when they supply products with specifications approved by the government. View "Ruppel v. CBS Corp." on Justia Law

In 2004, Illinois enacted Hospital Provider Funding Legislation imposing a tax on hospital providers, except for certain categories of exempt hospitals, for fiscal years 2004 and 2005, 305 ILCS 5/5A-2(a). The Centers for Medicare and Medicaid Services disallowed the reimbursement of Medicare expenses (42 U.S.C. 1395f(b)(1)) to a group of Illinois hospitals, finding that the amount of a tax assessment paid by the hospitals was a reasonable cost, but was subject to offset by any payments those hospitals received from an Illinois State fund. The district court and Seventh Circuit affirmed, finding that the decision was not inconsistent with established policy. The court rejected an argument that the hospitals incurred the full cost of the tax, as they were billed by and wrote checks to the state, reasoning that the argument ignored the real net impact of the tax and of Access Payments by the state.View "Abraham Lincoln Mem'l Hosp. v. Sebelius" on Justia Law

The Mississippi Department of Health (DOH) issued a final order in 2011, approving a certificate-of-need (CON) application filed by Vicksburg Healthcare, LLC, doing business as River Region Health System (River Region), for the purpose of renovating space on River Region's west campus and adding twenty acute-care beds designated for the inpatient care of adolescent psychiatric patients. Diamond Grove Center, LLC, (Diamond Grove), appealed the DOH's decision to the Hinds County Chancery Court, which upheld the CON approval. Diamond Grove then appealed to the Supreme Court, maintaining that the DOH was barred from issuing a CON under Mississippi Code Section 41-7-191(4)(a)(iii) (Rev. 2009) because of a previously approved, but never acted upon, CON granted by the DOH to Brentwood Health Management of Mississippi, LLC (Brentwood). Upon review, the Supreme Court affirmed the chancery court. View "Diamond Grove Center, LLC v. Mississippi State Dept. of Health" on Justia Law

Bontrager filed a putative class action complaint challenging Indiana’s $1,000 annual limit for dental services covered by Medicaid, 42 U.S.C. 1396. The district court granted a preliminary injunction, holding that Indiana is required to cover all medically necessary dental services, irrespective of the monetary cap. The Seventh Circuit affirmed. Bontrager has an enforceable federal right capable of redress through Section 1983. The monetary cap, which excludes medically necessary treatment, is not a utilization control procedure, but allows a state to shirk its primary obligation to cover medically necessary treatments. The court acknowledged that Bontrager’s victory may be short-lived if the state decides to end coverage for all dental services. View "Bontrager v. IN Family & Soc. Servs." on Justia Law

Plaintiff filed a complaint with the department of labor against her employer (Employer), alleging a violation of the Connecticut family and medical leave statute, which applies only to employers that employer seventy-five or more employees. Although Employer employed more than 1,000 employees nationwide, the commissioner of labor dismissed the complaint on the ground that the leave statute does not apply to Employer because it does not employ seventy-five or more employees within the state of Connecticut. The trial court sustained Plaintiff's appeal and rendered judgment in Plaintiff's favor, concluding that all employees of a business are to be counted in determining whether the business is an employer under the leave statute. The Supreme Court reversed, holding that section Conn. Agencies Regs. 31-51qq-42, which has the force and effect of a statute, makes clear that only Connecticut employees are to be counted under the leave statute. View "Velez v. Comm'r of Labor" on Justia Law

Until 2003, Hagans worked as a security guard and as a sanitation worker. At 44 years old, Hagans required open-heart surgery. Hagans claims additional medical problems relating to his cerebrovascular and respiratory systems, hypertension and dysphagia, insomnia, and back pain. He has been diagnosed with depression. Hagans began receiving disability benefits as of January 30, 2003. In September, 2004, pursuant to an updated Residual Function Capacity assessment showing his condition had improved, SSA determined that Hagans was no longer eligible for benefits. The ALJ considered several evaluations of Hagans’s condition, most of which were completed in mid-2004, and found that he was capable of engaging in substantial gainful activity, although he could not perform his past relevant work. The Appeals Council denied review; the district court affirmed. The Third Circuit affirmed, after determining that “relatively high” deference should be afforded to SSA’s Acquiescence Ruling interpreting the cessation provision of 42 U.S.C. 423(f) as referring to the time of the SSA’s initial disability determination. SSA correctly evaluated Hagans’s condition as of the date on which the agency first found that Hagans’s eligibility for disability benefits ceased. Substantial evidence supported the conclusion that Hagans was not fully disabled as of that date. View "Hagans v. Comm'r of Soc. Sec." on Justia Law