Justia Government & Administrative Law Opinion Summaries

In 2009, D. was delivered at Sharon Hospital by Dr. Gallagher and sustained an injury, allegedly causing her shoulder and arm permanent damage. In 2010-2011, preparing to file D.’s malpractice case, counsel requested records from Sharon and Gallagher, limited temporally to the delivery. Counsel believed that Gallagher was privately employed. Sharon was private; Gallagher was listed on the Sharon website. Counsel did not discover that Gallagher was employed by Primary Health, a “deemed” federal entity eligible for Federal Tort Claims Act (FTCA), 28 U.S.C. 1346(b), malpractice coverage. D.'s mother had been Gallagher's patient for 10 years and had visited the Primary office. In contracting Gallagher, counsel used the Primary office street address. Gallagher’s responses included the words “Primary Health.” The lawsuit was filed in 2016; Pennsylvania law tolls a minor plaintiff’s action until she turns 18.The government removed the suit to federal court and substituted the government for Gallagher. The district court dismissed the suit against the government for failure to exhaust administrative remedies under the FTCA. The case against Sharon returned to state court. After exhausting administrative remedies, counsel refiled the FTCA suit. The Third Circuit affirmed the dismissal of the suit as untimely, rejecting a claim that D. was entitled to equitable tolling of the limitations period because counsel had no reason to know that Gallagher was a deemed federal employee or that further inquiry was required. D. failed to show that she diligently pursued her rights and that extraordinary circumstances prevented her from timely filing. View "D.J.S.-W. v. United States" on Justia Law

In August 2015, Kiel Cavitt was working for D&D Services, repairing a motor home’s windshield, when he fell from a scaffold onto concrete and fractured his right elbow. He suffered what was known as a “terrible triad” fracture, which had three components: dislocation of the elbow (which can result in ligament injury), fracture of the radial head, and fracture of the ulnar coronoid process. Cavitt had surgery which included an implanted prosthesis for the radial head. The surgeon testified that "typical" complications following terrible triad fracture surgery include pain, decreased range of motion, infection and the "need for further surgery." Cavitt appeared to recover from the surgery, but several months later, he began to experience "shooting electrical pain" in his elbow. Doctors could not determine specifically what was causing the pain, and attempted to manage the pain with medication. Cavitt was unable to return to his former work as a glazier because of restrictions on his use of the arm, and he started a new job delivering pizza. Cavitt sought an order from the Alaska Workers' Compensation Board requiring his employer to pay for medical care for the ongoing elbow issues for the rest of his life. The Board ordered only that the employer “pay future medical costs in accordance with the [Alaska Workers’ Compensation] Act,” and the Alaska Workers’ Compensation Appeals Commission affirmed the Board’s decision. The Alaska Supreme Court construed the Commission’s decision as requiring the employer to provide periodic surveillance examinations until another cause displaces the work injury as the substantial cause of the need for this continuing treatment, and with that construction - consistent with the medical testimony - the Court affirmed. View "Cavitt v. D&D Services, LLC d/b/a Novus Auto Glass" on Justia Law

Joseph Traugott suffered from with diabetes and a related foot condition, and developed an infection in his foot while working at a remote site. He required extensive medical treatment for his foot and did not work since developing the infection. The Alaska Workers’ Compensation Board decided the worker’s disability and need for medical treatment were compensable based on an expert opinion that work was the sole cause of the condition’s acceleration even if work was not the most significant cause of the worker’s overall condition. The Alaska Workers’ Compensation Appeals Commission reversed, because in its' view, the Board had asked the expert misleading questions. The Commission then concluded, based on a different opinion by the same expert, that the worker had not provided sufficient evidence to support his claim. Traugott appealed, raising issues about the interpretation of the new causation standard adopted in the 2005 amendments to the Alaska Workers’ Compensation Act (Act) and its application to his case. After review, the Alaska Supreme Court reversed the Commission’s decision and remanded for reinstatement of the Board’s award. View "Traugott v ARCTEC Alaska" on Justia Law

Gregory Weaver worked at remote sites for ARCTEC Alaska1 off and on for several years as a relief station mechanic. His job involved heavy labor, and he filed several reports of injury during the times he worked for ARCTEC. He reported in December 2010 that he had “pulled something in the lower spinal area” while adjusting tire chains on a dump truck. He filed another injury report related to his back in early 2012, after he experienced back pain while installing garage door panels. Weaver passed “fit for duty” physical examinations after both of these injuries. In 2013, however, he woke up one morning with back pain that made it hard for him to walk. He said his back pain “had been building up for several months,” but he could not identify a specific task related to the onset of pain. He said “the majority of the heavy lifting” he did that summer had been at Indian Mountain, but he described work at Barter Island as including significant shoveling and pushing wheelbarrows of rocks over difficult surfaces. He thought the camp bed provided inadequate back support. He asked to be flown out because of his back pain and has not worked since. Weaver began receiving About six months later his employer controverted all benefits based on a medical opinion that the work caused only workers’ compensation benefits after experiencing severe low back pain at a remote job site. About six months later his employer controverted all benefits based on a medical opinion that the work caused only a temporary aggravation of a preexisting condition. Weaver the Alaska Workers’ Compensation Board to join a prior back injury claim against the same employer. Following a lengthy and complex administrative process, the Board denied the worker’s claim for additional benefits, and the Alaska Workers’ Compensation Appeals Commission affirmed the Board’s decision. Finding no reversible error, the Alaska Supreme Court affirmed the Board's and Commission's decisions. View "Weaver v. ASRC Federal Holding Co." on Justia Law

The Supreme Court affirmed the decision of the Medical Commission upholding that decision of the Wyoming Workers' Safety and Compensation Division denying workers' compensation benefits because Appellant failed to establish a causal connection between his injury and employment, holding that the Commission's decision was not contrary to the overwhelming weight of the evidence.The Division denied benefits because Appellant did not submit evidence establishing a causal connection between his injury and employment as required by Wyo. Stat. Ann. 27-14-603(a). The Commission upheld the denial of benefits after rejecting the opinions of Appellant's medical experts. The Supreme Court affirmed, holding that the Commission's determination that Appellant failed to meet his burden under section 27-14-603(a) for an injury occurring over a substantial period of time was not contrary to the overwhelming weight of the evidence. View "McMillan v. State, ex rel. Department of Workforce Services, Workers' Compensation Division" on Justia Law

Susan Burren was injured at work, and she received temporary workers’ compensation benefits after her employer admitted liability. Many months passed, with many efforts to treat her injuries, but none of her authorized treating physicians (“ATPs”) placed her at “Maximum medical improvement” (“MMI”). Her employer and her employer’s insurer sought a second opinion regarding Burren’s MMI status, and Burren subsequently underwent a Division Independent Medical Examination (“DIME”). The DIME doctor who examined Burren also declined to place her at MMI. The employer and insurer then challenged the DIME doctor’s opinion under section 8-42-107(8)(b)(III), C.R.S. (2019), of the Workers’ Compensation Act (“Act”). An administrative law judge (“ALJ”) concluded that the employer and insurer had overcome the DIME doctor’s finding. The ALJ then placed Burren at MMI with a finding of no permanent impairment, making Burren ineligible to receive permanent disability benefits. An administrative panel agreed with the ALJ. Burren appealed. A division of the court of appeals concluded that the ALJ had no authority to place Burren at MMI. Instead, Burren should have been allowed to resume treatment with her ATPs until either an ATP or a DIME doctor placed her at MMI. The employer and its insurer petitioned the Colorado Supreme Court for review, and the Supreme Court reversed: once an ALJ concludes that an employer or an employer’s insurer has overcome a DIME doctor’s MMI opinion under section 8-42-107(8)(b)(III), the ALJ may determine the claimant’s MMI status and permanent impairment rating as questions of fact. View "Destination Maternity v. Burren" on Justia Law

In 2012, Lozano gave birth to a baby. While still hospitalized, Lozano received a tetanus-diphtheria-acellular-pertussis (Tdap) vaccination. Two weeks later, Lozano reported a low-grade fever, body aches, and breast tenderness. Lozano’s symptoms persisted through visits to her physician and the emergency room. She developed abdominal pain, difficulty urinating, weakness, loss of balance, vision changes, neck pain, headache, vomiting, and dizziness. A brain MRI suggested that Lozano possibly had multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), or vasculitis. Lozano’s symptoms improved with steroid treatment, following a working diagnosis of MS. After several months, a repeat MRI “showed dramatic improvement, suggesting that ADEM was a more likely etiology, which was confirmed through later serological findings.” Lozano’s doctors opine that ADEM is the likely explanation for her symptoms.Lozano sought compensation under the National Childhood Vaccine Injury Act, 42 U.S.C. 300aa. Lozano’s expert opined that Lozano’s ADEM was the result of her receipt of the Tdap vaccine. The special master granted Lozano’s petition, finding that her expert’s testimony and the supporting medical literature demonstrated that the Tdap vaccine can cause autoimmune diseases such as ADEM and that Lozano offered preponderant evidence of a proximate temporal relationship between the vaccine and her injury. The Claims Court and Federal Circuit upheld the award of a lump-sum payment of $1,199,216.86, finding that the decision was neither an abuse of discretion nor contrary to law and that the fact-findings were neither arbitrary nor capricious. View "Lozano v. Secretary of Health and Human Services" on Justia Law

The First Circuit affirmed the order of the district court finding that Plaintiff was disabled as defined under 20 C.F.R. 404.1520 and awarding her benefits, holding that there was very strong evidence of Plaintiff's disability, without any contrary evidence, to justify an award of benefits.At age thirty-four, Plaintiff filed applications for Social Security Disability Benefits and Supplemental Security Income. The Commissioner of Social Security denied Plaintiff's applications. In an independent assessment of her claim, an ALJ agreed with the Commissioner's decision, finding that Plaintiff was not disabled as defined under the Social Security Act. A federal magistrate judge found that substantial evidence did not support the ALJ's denial of benefits and recommended reversing the Commissioner's decision and remanding the case for further development of the facts. The district court agreed with the magistrate judge's findings but bypassed the need for further fact-finding and awarded benefits. The First Circuit affirmed, holding that there was overwhelming evidence to support a finding of disability and an award of benefits and that a remand for further proceedings was unnecessary. View "Sacilowski v. Saul" on Justia Law

In this workers' compensation appeal, the Supreme Court affirmed the order of the district court reversing the decision of the appeals officer denying benefits to Respondent, holding that the plain language of Nev. Rev. Stat. 617.366(1) did not exclude the possibility of benefits for hearing loss when at least part of Respondent's current hearing disability was attributable to some level of hearing loss before he began his job that made the hearing loss worse.While serving as a police officer for the City of Henderson, Respondent suffered progressive hearing loss to the point where he was assigned to desk duty. Respondent sought compensation under Nev. Rev. Stat. 617.430 and .440, which entitle employees to workers' compensation benefits if they suffer a disability caused by an "occupational disease." Because Respondent already had some level of hearing loss, perhaps genetically induced, before his employment as a police officer, the appeals officer denied benefits. The district court reversed. The Supreme Court affirmed, holding that the appeals officer applied the relevant statutes incorrectly as a matter of law. View "City of Henderson v. Spangler" on Justia Law

Plaintiff-appellant Nancy Marks was serving a prison term in Colorado when she obtained entry into a community corrections program operated by Intervention Community Corrections Services (Intervention). To stay in the program, plaintiff needed to remain employed. But while participating in the program, she aggravated a previous disability and Intervention deemed her unable to work. So Intervention terminated plaintiff from the program and returned her to prison. Plaintiff sued, blaming her regression on two Colorado agencies,: the Colorado Department of Corrections (CDOC) and the Colorado Department of Criminal Justice (CDCJ). In the suit, plaintiff sought damages and prospective relief based on: (1) a violation of the Americans with Disabilities Act and the Rehabilitation Act; and (2) a denial of equal protection. The district court dismissed the claims for prospective relief and granted summary judgment to the CDOC and CDCJ on the remaining claims, holding: (1) the Rehabilitation Act did not apply because Intervention had not received federal funding; (2) neither the CDOC nor the CDCJ could incur liability under the Americans with Disabilities Act or Rehabilitation Act for Intervention’s decision to regress plaintiff; and (3) plaintiff did not show the regression decision lacked a rational basis. After review, the Tenth Circuit agreed that (1) claims for prospective relief were moot and (2) neither the CDOC nor CDCJ violated plaintiff's right to equal protection. However, the Court reversed on the award of summary judgment on claims involving the Rehabilitation Act and the Americans with Disabilities Act, finding the trial court mistakenly concluded the Rehabilitation Act did not apply because Intervention had not received federal funding, and mistakenly focused on whether the CDOC and CDCJ could incur liability under the Rehabilitation Act and Americans with Disabilities Act for a regression decision unilaterally made by Intervention, "This focus reflects a misunderstanding of Ms. Marks’s claim and the statutes." The matter was remanded for further proceedings. View "Marks v. Colorado Dept. of Corrections" on Justia Law