Justia Government & Administrative Law Opinion Summaries

Appellant, a severely disabled child whose congenital abnormalities were undetected during his mother’s pregnancy, sued various medical providers for wrongful life. The California Department of Health Care Services (“DHCS”) asserted a lien on Appellant’s settlement to recover what DHCS paid for his medical care through the state’s Medi-Cal program, and the trial court awarded DHCS the full amount of the lien.   The Second Appellate District reversed, rejecting Appellant’s contentions that DHCS’s lien is preempted by federal law and that there is no substantial evidence that Appellant’s settlement included payments for past medical expenses. However, the court held that the trial court erred by failing to distinguish between past medical expenses and other damages.   The court concluded that the provisions of the Medi-Cal Act permitting DHCS to impose a lien on Appellant’s tort recovery are not preempted by federal law. Further, the court concluded that the trial court did not err by concluding that Appellant’s settlement included past medical expenses. The court reasoned that the Welfare and Institutions Code provides that DHCS “shall have a right to recover . . . the reasonable value of benefits” provided to a MediCal beneficiary, and it further provides that the court, not the Medi-Cal beneficiary, determines what portion of a settlement is fairly allocated to satisfy DHCS’s lien.  However, it does not appear that the trial court determined which portion of Appellant’s settlement was attributable to past medical expenses, thus the court remanded the trial court to apportion the settlement accordingly. View "Daniel C. v. White Memorial Medical Center" on Justia Law

Daniel Sharp suffered an injury to his lower back from an accident at work in 2015. After surgery, he was repeatedly advised to lose weight by the medical providers treating his injury. However, Sharp gained considerable weight instead. The Industrial Commission found that Sharp’s functional ability had diminished between 2016, when he reached maximal medical improvement (MMI) after surgery, and 2019, when his permanent disability hearing was held. The Commission attributed the worsening of Sharp’s condition to his weight gain, which it held to be a superseding cause of any increase in Sharp’s disability post-MMI. Accordingly, the Commission evaluated Sharp’s disability based on his condition at MMI, despite the Idaho Supreme Court's opinion in Brown v. Home Depot, 272 P.3d 577 (2012), requiring that a claimant’s disability be evaluated based on circumstances at time of the hearing. After review in this case, the Supreme Court held that the Commission erred by departing from "Brown," by applying an incorrect standard to determine that Sharp was not entitled to compensation due to the aggravation of his injury, and by reaching certain factual conclusions not supported by substantial and competent evidence. Therefore, the Commission’s decision was vacated and the matter remanded for further proceedings. View "Sharp v. Thomas Bros Plumbing" on Justia Law

The mother of a child injured while visiting a cemetery when a headstone fell sued the Town of Granite, the operator of the cemetery, for negligence. The district court granted Town's motion for summary judgment, holding that Town did not owe a duty to the child. The mother appealed. The Oklahoma Court of Civil Appeals reversed the district court's judgment, holding Town owed a duty to the child regarding dangerous defects. After certiorari review, the Oklahoma Supreme Court concluded the Town did not own or control the headstone, and therefore owed no duty to the child regarding the maintenance of the headstone. View "Kamphaus v. Town of Granite" on Justia Law

The Supreme Court affirmed the decision of the court of appeals reversing the opinion and award of the North Carolina Industrial Commission denying Plaintiff relief on her claim for disability compensation from Defendants, holding that there was no error.On appeal, the court of appeals held that Plaintiff's claim was not time-barred under N.C. Gen. Stat. 97-24 and thus reversed the Commission's dismissal of Plaintiff's claim based on a 2014 injury. The court remanded the case to the Commission for a determination as to whether Plaintiff suffered a compensable injury under the Workers' Compensation Act. The Supreme Court affirmed, holding that Plaintiff's claim was not barred by section 97-24. View "Cunningham v. Goodyear Tire & Rubber Co." on Justia Law

Plaintiffs did not purchase flood insurance for their house after the sellers told them that the property was not in a FEMA flood zone. Within weeks the area flooded, the home was destroyed and Plaintiffs sued the property sellers, the Federal Emergency Management Agency, and private contractors.   Plaintiffs alleged that either FEMA or the Strategic Alliance for Risk Reduction (“STARR”) made the 2010 Change to the 100-year flood-line estimate and SFHA designation. They alleged that STARR is a joint venture by Defendants Stantec Consulting Services, Inc., Dewberry Engineers, Inc., and Atkins North America, Inc., but do not name STARR itself as a defendant. Atkins and Stantec filed a Motion to Dismiss under Federal Rule of Civil Procedure 12(b)(6), extending the federal-contractor defense. The district court granted the motion.   The Eighth Circuit affirmed the district court’s decision granting Defendant’s motion to dismiss. The court held that Plaintiffs fail to state a claim because their complaint does not contain sufficient factual matter to show they are entitled to relief from Defendants. The court reasoned that Plaintiff’s complaint does not state how Atkins, Stantec and Dewberry work within STARR or which entity was responsible for any acts through STARR. Further, the complaint fails to state a claim for negligent misrepresentation against Atkins, Dewberry, and Stantec because the Plaintiffs provide “only naked assertions devoid of further factual enhancement” for three elements. Finally, the complaint similarly failed to state a claim for fraudulent misrepresentation because it does not plead which defendant made what representation. View "Derek Christopherson v. Robert Bushner" on Justia Law

After a 21-year career as a firefighter with the City of Pocatello, Richard Nelson was diagnosed with leukemia. Nelson brought a workers’ compensation claim against the City. The Industrial Commission determined that the City failed to rebut a statutory presumption of causation with substantial and competent evidence. The City appealed, arguing there was substantial evidence to rebut the presumption that Nelson’s cancer was caused by his employment. The City also argued Idaho Code section 72-438(14)(b) unconstitutionally discriminated between the employers of firefighters who had cancer and the employers of other employees who claim to have contracted an occupational disease. After review, the Idaho Supreme Court affirmed the Industrial Commission. View "Nelson v. City of Pocatello" on Justia Law

The Supreme Court reversed the judgment of the Board of Review affirming the decision of the Office of Judges denying Appellant's request to add C5-6 spondylosis with C6 radiculopathy as a compensable condition, holding that Appellant was entitled to a permanent partial disability award.Appellant suffered a compensable injury to his shoulder, neck and back while working for Respondent. After the injury, Appellant developed cervical radiculopathy. At issue was whether cervical radiculopathy should be added as a compensable condition of Appellant's claim. The Supreme Court reversed and remanded this case with directions to add cervical radiculopathy as a compensable condition, holding that Appellant proved a causal connection between his compensable injury and his cervical radiculopathy. View "Moore v. ICG Tygart Valley, LLC" on Justia Law

The Supreme Court affirmed the opinion of the court of appeals that affirmed an administrative law judge's (ALJ) award of permanent partial disability benefits to Plaintiff, holding that the court of appeals did not err.Plaintiff worked for Defendant for twenty-three years as a garbage truck driver and loader. After he was injured on two separate occasions, Plaintiff filed two claims for workers' compensation benefits. The ALJ awarded Plaintiff permanent partial disability benefits, applying the three-multiple from Ky. Rev. Stat. 342.730(1)(c)(1) to the benefits for both injuries. The Workers' Compensation Board affirmed. The court of appeals affirmed. The Supreme Court affirmed, holding that the ALJ's award was supported by substantial evidence. View "Apple Valley Sanitation, Inc. v. Stambaugh" on Justia Law

The Supreme Court affirmed the decision of the Labor and Industrial Relations Commission reversing the administrative law judge's (ALJ) award of permanent and total disability (PTD) benefits against the Second Injury Fund, holding that the Commission's findings were supported by substantial and competent evidence.Christopher Klecka suffered a compensable work-related injury to his left shoulder. After settling the primary claim with his employer Klecka brought a claim against the Fund, alleging that his primary injury combined with his prior injuries rendered him permanently and totally disabled (PTD). An ALJ issued an award against the fund for PTD benefits. The Commission reversed. The Supreme Court affirmed, holding that Klecka failed to establish that his primary injury and sole qualifying preexisting disability entitled him to PTD benefits from the Fund under Mo. Rev. Stat. 287.220.3. View "Klecka v. Treasurer of Missouri" on Justia Law

Petitioner State of California (the “State”) is a defendant in an action in which Plaintiffs sought damages for wrongful death and personal injuries suffered in an automobile collision. The superior court ordered the State to produce unredacted accident reports revealing identifying information of the parties and witnesses involved in accidents that occurred in the same area.   The Second Appellate Division denied the State’s petition for a writ of mandate and required the State to reveal the information the Plaintiffs/real parties in interest seek. Petitioner argued the superior court abused its discretion when it ruled that personally identifiable information was not protected under section 20014 of the Vehicle Code. Plaintiffs contended that under section 20012 they have a proper interest in the disclosure of unredacted police reports. The court reasoned that Plaintiffs have shown the accidents are similar in nature and the evidence of the reported accidents “either is itself admissible in evidence or appears reasonably calculated to lead to the discovery of admissible evidence.” Thus, this evidence illustrated that Plaintiffs are persons with a “proper interest” in obtaining the unredacted accident reports they seek. View "State of Cal. v. Super. Ct." on Justia Law