Justia Government & Administrative Law Opinion Summaries

Paul was driving his daughter Kelly’s vehicle when it was struck by a United States Postal Service (USPS) vehicle. Kelly was a passenger. Days later, Kelly filed her SF 95, for a claim under Federal Tort Claims Act (FTCA), 28 U.S.C. 2671–80. Use of the form is not required to present an FTCA claim. Kelly listed herself as the claimant, noted Paul’s involvement, and indicated that the extent of their injuries was unknown. Kelly alone signed the form and provided only her contact information. The form requests a total amount of damages and states: “[f]ailure to specify may cause forfeiture of your rights.” Kelly wrote: “I do not have ... a total on medical.” Kelly sent USPS the final car repair bill, which USPS paid. Later, USPS received a representation letter from counsel for Kelly that did not mention Paul. USPS responded, stating: “A claim must be for a specific dollar amount.” USPS states that it did not receive any further information concerning the amount of personal injury damages.Paul and Kelly filed suit, seeking $25,000 in personal injury damages. The district court dismissed for lack of jurisdiction. The Sixth Circuit remanded. While the sum certain requirement in the FTCA is not jurisdictional, Kelly never provided a sum certain so, her personal injury claim is not cognizable. The agency had adequate notice of Paul’s claim but he also failed to satisfy the statutory “sum certain” requirement. View "Copen v. United States" on Justia Law

In a workers’ compensation case, the issue presented for the Oregon Supreme Court's review centered on the scope of an employer’s obligation under ORS 656.262(7)(c) to reopen a closed claim for processing if a “condition is found compensable after claim closure.” The closed claim at issue here was claimant Randy Simi's accepted right rotator cuff tear, and the conditions giving rise to the dispute were supraspinatus and infraspinatus tendon tears, which claimant asked employer to accept as “new or omitted” conditions. Employer issued a denial specifying that the conditions were not compensable, but, without withdrawing the denial, employer later took the position that the tendon tears were “encompassed” within the originally accepted rotator cuff tear. That change of position caused an administrative law judge (ALJ) to determine that the tendon conditions were compensable and to set aside employer’s denial. According to claimant, that ALJ order triggered employer’s obligation under ORS 656.262(7)(c) to reopen the claim. Employer contended, however, that the legislature did not require reopening if the compensable condition at issue was “encompassed within” the already-accepted conditions, even if the employer also had denied that the condition was compensable. A majority of the Workers’ Compensation Board and a majority of the Court of Appeals panel agreed with employer, and the Supreme Court allowed review to consider this disputed question of statutory interpretation. Based on its examination of the statutory text and context, the Supreme Court concluded the legislature intended employers to reopen compensable claims for processing when a compensability denial was set aside after claim closure, including under the circumstances of this case. Accordingly, the Court of Appeals' decision was reversed. View "Simi v. LTI Inc. - Lynden Inc." on Justia Law

In June 2008, Scot Decker sustained work related injuries while he was working for Cyclone Drilling, Inc. in Mountrail County, North Dakota. WSI accepted liability and Decker received more than $1,250,000 in benefits from WSI. In June 2014, Decker signed a third party notice of legal representation advising WSI that he retained an attorney and planned to bring an action against a third party for the work related injuries. The notice stated Decker would act as a trustee for WSI’s subrogated interest. The notice also included a lien notice, advising that WSI had a lien in the full amount it paid in all benefits for Decker’s claim and that WSI could sue if Decker received any money related to the claim from a third party and WSI did not receive payment of its lien within 30 days of the third party’s payment to Decker. Decker brought an action against I.E. Miller Services, Inc., received a favorable verdict, and was awarded $2,045,972.60 in damages. In December 2018, WSI issued a subrogation order, finding it paid Decker for his work related injury and Decker failed to pay WSI’s subrogation interest and lien within 30 days. Decker requested a hearing before an ALJ. Decker alleged WSI incorrectly applied the law, it inappropriately included in the subrogation order benefits paid related to medical negligence which is the subject of a separate third-party action, and it did not properly determine the amount of its lien. Decker also argued WSI did not have a right to recovery of its lien before attorney’s fees and litigation expenses were paid. The ALJ ruled in favor of WSI, and Decker appealed. Decker argued the district court erred in concluding it does not have jurisdiction and dismissing his appeal. The North Dakota Supreme Court found Decker brought his appeal in Burleigh County District Court, and it was undisputed that Decker did not reside in Burleigh County and that his injuries did not occur in Burleigh County. Because N.D.C.C. 65-10-01 applied and required Decker to bring the appeal in the county where he resided or the county where the injury was inflicted, the Burleigh County district court did not have jurisdiction over the appeal. Dismissal was affirmed. View "Decker v. WSI" on Justia Law

The Supreme Court quashed the decree of the Appellate Division of the Workers' Compensation Court (WCC) awarding attorneys' fees and costs to Petitioner, holding that the WCC's Appellate Division acted in excess of its statutory authority in concluding that R.I. Gen. Laws 45-21.2-9 conferred authority to award attorneys' fees in this case.Petitioner, a firefighter with the City of Woonsocket, sustained a work-related injury and applied for accidental disability retirement (ADR) benefits with Respondent, Municipal Employees' Retirement System of Rhode Island. Respondent denied Petitioner's ADR application, finding that Petitioner had failed to prove that is injury arose out of and in the course of his duties as a firefighter. On appeal, the trial judge granted Petitioner's petition seeking ADR benefits and awarded a counsel fee to Petitioner's counsel. The Appellate Division upheld the fee award and imposed an additional fee for counsel's work before the Appellate Division. The Supreme Court reversed, holding that the General Assembly has not conveyed specific statutory authority upon the WCC to award attorneys' fees and costs in successful ADR appeal claims. View "Koback v. Municipal Employees' Retirement System of R.I." on Justia Law

In December 2014, Steve Tenny sustained a right-sided lumbar disc herniation injury during the course of his employment with Loomis Armored US (Loomis). He immediately began treatment, receiving a series of right-sided steroid injections in his back. At some point shortly after the second injection, Tenny began to complain of increasing left hip and groin pain and underwent testing and treatment for these symptoms. However, the worker’s compensation insurance surety, Ace American Insurance Co., ultimately denied payment for treatment related to the left-side groin pain. Following the matter going to hearing, the Referee recommended that the Industrial Commission find that the left-sided symptoms were causally related to Tenny’s December 2014 industrial accident. The Industrial Commission adopted the Referee’s findings, and after unsuccessfully moving for reconsideration, the employer and surety (collectively, "Defendants") appealed to the Idaho Supreme Court. At issue before the Supreme Court was the question of causation: Was the left-side groin pain experienced by Tenny causally related to his industrial accident? Finding no reversible error, the Idaho Supreme Court affirmed the Industrial Commission's decision. View "Tenny v. Loomis Armored US, LLC" on Justia Law

Michael and Katherine Gatto filed suit against the City of Statesboro and City Clerk Sue Starling, alleging negligence and maintenance of a nuisance, after their son, Michael, died following an altercation at a bar in the University Plaza area of the City. The trial court granted summary judgment to both defendants, based in part on sovereign immunity. The Court of Appeals affirmed as to the City, solely on the ground of sovereign immunity. The Georgia Supreme Court granted certiorari to address municipal immunity in the context of a nuisance claim. The Court held that the Citywasis immune from liability for the conduct alleged here, because municipalities never faced liability for a nuisance claim based on alleged conduct related to property they neither owned nor controlled, and "nothing in our Constitution alters that principle." Accordingly, judgment was affirmed. View "Gatto et al. v. City of Statesboro et al." on Justia Law

Claimant John West appealed a Vermont Department of Labor decision concluding that the 2014 amendment to 21 V.S.A. 644(a)(6) did not apply retroactively. In March 2013, West fell fifteen to twenty feet while working in the course of his employment for North Branch Fire District. He was transported to the hospital and treated for extensive injuries. In September 2014, West relocated to Florida, and at some point thereafter, began working at the Freedom Boat Club. Between 2014 and 2016, several different physicians provided conflicting opinions on the level of West’s permanent impairment. In February 2016, Dr. Joseph Kandel conducted an independent medical examination (IME) at North Branch’s request. At a deposition in September 2018, Dr. Kandel testified that it would be accurate to say that “West suffered an injury to the skull resulting in [a] severe traumatic brain injury causing permanent and severe cognitive, physical, or psychiatric disabilities.” West filed a request for a formal hearing, asserting that he was permanently and totally disabled under section 644(a)(6). Between the date of West’s injury and his request for a formal hearing, the Vermont Legislature amended section 644(a)(6). In January 2019, North Branch filed a motion for summary judgment arguing that the pre-amendment version of 644(a)(6), which defined total and permanent disability as “an injury to the skull resulting in incurable imbecility or insanity,” applied to West’s claim because that was the law on the date of his injury in March 2013. Further, North Branch argued that the 2014 amendment did not apply retroactively because despite the Legislature’s stated purpose, the amendment created a substantive change in the law. In any event, because West was employed, North Branch maintained that he was not totally and permanently disabled under either version of 644(a)(6). West argued that, contrary to the Commissioner’s conclusion, the 2014 amendment to 644(a)(6) applied retroactively because it did not create any new substantive rights. The Vermont Supreme Court concluded the 2014 amendment applied retroactively and therefore reversed and remanded. View "West v. North Branch Fire District #1" on Justia Law

In 2016, plaintiff Jennifer Buhl and her husband went to a party store in Oak Park, Michigan. As she was walking, plaintiff saw a raised crack in the sidewalk outside the store and tried to step over it. Because plaintiff did not notice that the sidewalk was uneven on the other side of the crack, she fell and fractured her left ankle. The specific question this case raised for the Michigan Supreme Court’s review was whether an amendment to the governmental tort liability act (GTLA) that went into effect after plaintiff’s claim accrued but before plaintiff filed her complaint could be retroactively applied. The Supreme Court held that the amended provision did not apply retroactively. Accordingly, the Court of Appeals’ judgment was reversed and the matter remanded for further proceedings. View "Buhl v. City of Oak Park" on Justia Law

In the summer of 2016, a large fire, later known as the Dog Head Fire, engulfed Isleta Pueblo and United States Forest Service land in the Manzano Mountains of New Mexico. The fire resulted from forest-thinning work performed by Pueblo crewmembers under an agreement with the Forest Service. Insurance companies and several owners of destroyed property (collectively, “Appellants”) sued the government, alleging negligence under the Federal Tort Claims Act (“FTCA”). The government moved to dismiss, arguing that the court lacked jurisdiction and, alternatively, for summary judgment on that same basis. The district court granted the government summary judgment, concluding: (1) the Pueblo crewmembers had acted as independent contractors of the government, and thus, the government wasn’t subject to FTCA liability based on the Pueblo crewmembers’ negligence; and (2) Appellants’ claims premised on the Forest Service employees’ own negligence, under the FTCA’s discretionary-function exception, were barred. On appeal, Appellants contended the district court erred in ruling that the FTCA jurisdictionally barred their claims. Finding no reversible error, the Tenth Circuit affirmed. View "Ohlsen v. United States" on Justia Law

WSI appealed a judgment ordering payment of death benefits to Gloria Felan. In 2017, Fred Felan was injured when driving a loaded truck that tipped on its side. Julie Schulz of KBO Farms, Fred’s employer, arrived at the scene a short time later. Fred declined an ambulance but agreed to allow Schulz to drive him to the hospital. At the hospital Fred complained of left chest and rib pain. X-rays taken at the hospital did not reveal any fractures. The next morning, Schulz picked Fred up from the hotel. She noted Fred was falling asleep during the meal and expressed concern he should return to the hospital to get checked again. Fred declined. Fred was discovered dead in his hotel room two days after the accident. WSI accepted Fred’s claim for injuries relating to his truck accident for contusion of thorax. WSI also did not believe Fred died from his work-related injury because Fred had multiple health problems including some related to his heart and diabetes. An autopsy confirmed Fred died of congestive cardiomyopathy and arteriosclerotic heart disease. Gloria thereafter filed a claim for death benefits. WSI would deny this claim, but an ALJ reversed the agency’s denial. WSI argued the ALJ and the district court misapplied the law by failing to properly apply N.D.C.C. 65-01-02(11)(a)(3). The North Dakota Supreme Court reversed the ALJ and district court, finding the ALJ was not provided objective evidence of the claimed injury: Fred died of a cardiac arrhythmia caused by blunt force trauma to his chest cavity. However, a medical expert admitted there was no objective medical evidence that an arrhythmia occurred. Rather, the conclusion the expert reached was a result of deductive reasoning. “As our precedent indicates, objective medical evidence may be established by a physician’s medical opinion based on an examination, a patient’s medical history, and the physician’s education and experience. However, objective medical evidence may not be established solely by deductive reasoning. On this record, the ALJ erred in concluding there was objective medical evidence of a cardiac arrhythmia.” View "WSI v. Felan, et al." on Justia Law