Justia Government & Administrative Law Opinion Summaries

A participant in the federal Section 8 housing assistance program received notice from the local housing authority that her benefits would be terminated based on several alleged violations, including a recent eviction for serious lease violations, untimely submission of eligibility documentation, failure to allow an inspection, and failure to maintain her unit. The participant contested the termination, explaining that her appeal of the eviction was still pending and that she ultimately complied with inspection and paperwork requirements.At the administrative hearing, the hearing officer concluded that because a court-ordered eviction had occurred and, according to the officer, had been upheld on appeal, termination of assistance was mandatory under federal regulations. The participant then petitioned the Superior Court of Riverside County for a writ of administrative mandamus, arguing that the finding regarding her eviction was factually incorrect, as the appeal was still pending. Soon after, the appellate division of the Riverside County Superior Court reversed the eviction judgment for insufficient evidence. The trial court acknowledged that the hearing officer’s findings regarding the eviction were not supported by the record. However, it proceeded to independently review the evidence and found other violations of program obligations, upholding the housing authority’s discretionary decision to terminate benefits.The California Court of Appeal, Fourth Appellate District, Division Two, found that the trial court misunderstood the scope of judicial review under Code of Civil Procedure section 1094.5. The appellate court held that the trial court was required to review whether the administrative agency’s factual findings—not any alternative grounds—were supported by the record. Since the hearing officer’s findings were unsupported and the court could not uphold termination based on new grounds not adjudicated at the administrative hearing, the judgment was reversed with instructions to grant the petition and vacate the termination of assistance. View "Harrington v. Housing Authority of Riverside County" on Justia Law

A former employee of the County of San Diego pleaded guilty to a felony charge for violating a state conflict-of-interest law, which prohibits public employees from having a financial interest in contracts made in their official capacity. After the guilty plea, but before sentencing, the San Diego County Employees Retirement Association (SDCERA) notified him that a portion of his accrued pension benefits would be forfeited under Government Code section 7522.74, as he had been “convicted” of a job-related felony. At sentencing, the criminal court reduced the offense to a misdemeanor under Penal Code section 17, subdivision (b)(3). The employee then requested reinstatement of his pension benefits, which SDCERA denied.The employee challenged SDCERA’s denial through administrative appeals, including to its chief executive officer and Board of Retirement, but both appeals were denied. He subsequently petitioned the Superior Court of San Diego County for a writ of administrative mandate to set aside SDCERA’s decision. The court denied the petition, finding that section 7522.74 precluded reinstatement of the forfeited pension benefits. The employee timely appealed the judgment.The California Court of Appeal, Fourth Appellate District, Division One, reviewed the case. The court held that a public employee is “convicted” for purposes of Government Code section 7522.74 upon an adjudication of guilt—whether by plea or jury verdict—and not only upon entry of judgment. The reduction of the felony to a misdemeanor at sentencing under Penal Code section 17, subdivision (b)(3), did not retroactively affect the forfeiture. The court affirmed the judgment, concluding that the employee’s pension benefits remained forfeited, and SDCERA properly denied reinstatement. View "Bishop v. San Diego County Employees Retirement Assn." on Justia Law

Essintial Enterprise Solutions, LLC, a staffing and services company, received a $7 million Paycheck Protection Program (PPP) loan during the COVID-19 pandemic. The company calculated its loan amount based on its reported payroll costs, which included payments made to both employees and independent contractors. After the loan was issued and the company applied for forgiveness, its bank approved forgiveness of the full amount. However, the Small Business Administration (SBA) reviewed the forgiveness request and determined that payments made to independent contractors were not eligible as “payroll costs” under the CARES Act, resulting in only partial forgiveness. The SBA forgave approximately $3.7 million and denied forgiveness for the remainder that was based on contractor payments.Essintial challenged the SBA’s decision by filing suit in the United States District Court for the Middle District of Pennsylvania. The company argued that the SBA’s interpretation of “payroll costs” was erroneous and violated the Administrative Procedure Act (APA). The District Court agreed with Essintial, granting summary judgment in its favor. It held that the SBA’s exclusion of independent contractor payments from payroll costs was arbitrary and capricious, and ordered full loan forgiveness for Essintial.On appeal, the United States Court of Appeals for the Third Circuit reviewed the statutory definition of “payroll costs” in the CARES Act de novo. The Third Circuit held that the SBA’s interpretation was correct: payments to independent contractors by a business are not included as “payroll costs” for PPP loan forgiveness purposes. The court concluded that the CARES Act provides two separate definitions of “payroll costs” depending on the borrower’s type, and Essintial’s payments to independent contractors did not qualify. The Third Circuit reversed the District Court’s judgment and remanded for further proceedings. View "Essintial Enterprise Solutions LLC v. SBA" on Justia Law

A veteran who suffered a traumatic brain injury from an improvised explosive device while deployed sought financial assistance under the Traumatic Servicemembers’ Group Life Insurance (TSGLI) program after experiencing a stroke within two years of the injury. The Army denied his claim, determining the stroke was a physical illness or disease, not a qualifying traumatic injury as defined by the relevant statute and regulations. The veteran then petitioned the Department of Veterans Affairs (VA) to amend its rules to include coverage for illnesses or diseases caused by explosive ordnance, arguing these conditions are analogous to those already covered under existing exceptions for injuries resulting from chemical, biological, or radiological weapons.The VA initially denied the rulemaking petition but agreed to further review as part of a program-wide assessment. After several years, extensive consultation with medical experts, and consideration of the petition and supporting materials, the VA issued a final denial. It concluded that expanding coverage to delayed illnesses or diseases linked to explosive ordnance would be inconsistent with TSGLI’s purpose, which focuses on immediate injuries, would deviate from the insurance model underlying the program, and could threaten its financial stability. The VA also found insufficient evidence of a direct causal relationship between explosive ordnance, traumatic brain injury, and downstream illnesses like stroke.The United States Court of Appeals for the Federal Circuit reviewed the VA’s denial under the highly deferential “arbitrary and capricious” standard of the Administrative Procedure Act. The court held that the VA provided a reasoned explanation addressing the petitioner’s arguments and the record, and did not act arbitrarily or capriciously. The petition for review was therefore denied. View "MCKINNEY v. SECRETARY OF VETERANS AFFAIRS " on Justia Law

James Young, a veteran who served in the military during the mid-1980s, initially filed a claim for service-connected disability benefits in 1988, alleging head injuries from an in-service car accident. The Department of Veterans Affairs (VA) regional office denied his claim in 1991, and after several years of proceedings, the Board of Veterans’ Appeals denied the claim in 1999, citing Young’s failure to appear for scheduled medical examinations. Young did not appeal the Board’s 1999 denial. Years later, in 2017, following a new claim and medical examinations, the VA granted service connection for his head injuries effective August 17, 2012.Seeking an earlier effective date linked to his original 1988 claim, Young filed a motion in 2022 with the Board to vacate its 1999 denial, alleging due process violations because the Board had failed to ensure the regional office complied with orders to search for certain records. The Board denied the motion, characterizing the alleged error as a “duty to assist error” rather than a due process error. Young appealed this denial to the United States Court of Appeals for Veterans Claims, which dismissed the appeal. The Veterans Court found that while the appeal was timely regarding the denial of the motion to vacate, such a denial was not an appealable decision under its jurisdictional statute.Upon review, the United States Court of Appeals for the Federal Circuit affirmed the Veterans Court’s dismissal. The Federal Circuit held that the Board’s denial of a motion to vacate under 38 C.F.R. § 20.1000(a), when based solely on alleged material error known at the time of the original decision, does not constitute an appealable “decision” under 38 U.S.C. § 7252. The court determined that allowing appeals from such procedural denials would undermine the statutory time bar and permit indefinite judicial review of Board decisions. View "YOUNG v. COLLINS " on Justia Law

The appellant, a Ventura County Deputy Sheriff, suffered two work-related back injuries in 2014 and 2015. Medical evaluations revealed degenerative disc disease and herniation at the L5-S1 level. Multiple physicians recommended surgical intervention, and the County authorized surgery to address his condition. However, the appellant declined the recommended procedures, citing concerns about surgical outcomes and referencing anecdotal experiences of colleagues. Later, his condition progressed, and more extensive surgery was suggested, but authorization for additional procedures was denied due to insufficient evidence. Despite ongoing pain, the appellant also declined to participate in a recommended home exercise program and a work hardening regimen.After the appellant applied for service-connected disability retirement, his application was challenged by the County and assigned to VCERA’s hearing officer for review. During the administrative hearing, the appellant testified about his refusal of surgery and physical therapy, while medical experts presented conflicting views on his prognosis and ability to return to work. The hearing officer found that the appellant had unreasonably refused recommended medical treatments with a high probability of success, and that his refusal likely worsened his condition, making him ineligible for service-connected disability retirement benefits. The Board adopted these findings and denied his application.The Superior Court of Ventura County denied the appellant’s petition for a writ of administrative mandate, concluding that his unreasonable refusal of authorized surgery and other treatments constituted valid grounds to deny benefits under the doctrine of avoidable consequences/mitigation of damages. The California Court of Appeal, Second Appellate District, Division Six, affirmed this decision. The court held that a disability retirement application may be denied if the disability is caused, continued, or aggravated by an unreasonable refusal to undergo medical treatment, even if the refused treatment is no longer effective due to the passage of time. View "Mendoza v. Bd. of Retirement of the Ventura County" on Justia Law

A longtime deputy sheriff was convicted by a federal jury of mail and wire fraud after she submitted an insurance claim for items stolen during a burglary at her home, some of which she falsely claimed as her own but actually belonged to her employer, the sheriff’s office. She also used her employer’s fax machine and cover sheet in communicating with the insurance company and misrepresented her supervisor’s identity. The criminal conduct arose after a romantic relationship with a former inmate ended badly, leading to the burglary, but the fraud conviction was based on her false insurance claim, not on the relationship or the burglary itself.Following her conviction, the California Public Employees’ Retirement System (CalPERS) determined that her crimes constituted conduct “arising out of or in the performance of her official duties” under Government Code section 7522.72, part of the Public Employees Pension Reform Act, and partially forfeited her pension. The administrative law judge and the San Francisco Superior Court both upheld CalPERS’s decision, reasoning that her actions were sufficiently connected to her employment, particularly in her misuse of employer property and resources and in the context of her relationship with the former inmate.The Court of Appeal of the State of California, First Appellate District, Division One, reversed the trial court’s judgment. The appellate court held that the statute requires a specific causal nexus between the criminal conduct and the employee’s official duties, not merely any job-related connection. The court found that the deputy’s fraudulent insurance claim, although it referenced employer property and resources, did not arise out of or in the performance of her official duties as required by the statute. Accordingly, the pension forfeiture determination was set aside. View "Myres v. Bd. of Admin. for CalPERS" on Justia Law

Florida challenged a federal agency document known as the “Informational Bulletin” that interpreted Medicaid’s hold-harmless rule and threatened to claw back billions in Medicaid funds if certain state practices continued. Florida’s Medicaid funding system relies on a Directed Payment Program, under which local governments assess special fees on private hospitals, pool these fees, and transfer the funds to the state agency, which then uses them to secure additional federal matching funds. The state feared the new federal interpretation could jeopardize its program and moved to preliminarily enjoin the Bulletin’s implementation.The United States District Court for the Southern District of Florida, following a magistrate judge’s recommendation, denied Florida’s motion for a preliminary injunction and dismissed the case for lack of subject matter jurisdiction. The district court held that the Bulletin was not a “final agency action” under the Administrative Procedure Act (APA), and therefore not subject to judicial review.The United States Court of Appeals for the Eleventh Circuit reviewed the case and found that, contrary to the district court’s conclusion, the Bulletin was indeed a final agency action subject to judicial review under the APA. However, the Eleventh Circuit held that Florida was unlikely to succeed on the merits of its challenge, concluding that the Bulletin’s interpretation of the Medicaid hold-harmless rule was consistent with the statutory text, was not arbitrary or capricious, and did not require notice-and-comment rulemaking. The court thus reversed the dismissal of the complaint, affirmed the denial of the preliminary injunction, and remanded the case for further proceedings. View "Florida Agency for Health Care Administration v. Administrator for the Centers for Medicare & Medicaid Services" on Justia Law

A neurologist submitted a Freedom of Information Act (FOIA) request to the United States Social Security Administration (SSA) seeking documents about how the SSA evaluates disability claims for migraines and other headache disorders. The SSA determined that this request was not directly related to the administration of any of its benefit programs. Relying on a provision in the Social Security Act (42 U.S.C. § 1306(c)), the SSA required the requester to pay the full cost of processing the request, which totaled $2,908. The requester paid the fee but later objected because the SSA did not respond within the statutory deadline set by FOIA.The United States District Court for the District of Vermont found in favor of the requester. The district court concluded that FOIA’s provision prohibiting fees when the agency fails to respond on time superseded the Social Security Act’s cost-reimbursement clause. As a result, the court ordered the SSA to refund the fee and awarded the requester attorneys’ fees and costs. The court reasoned that allowing the SSA to charge fees despite late responses would undermine the FOIA amendments designed to ensure agency timeliness.On appeal, the United States Court of Appeals for the Second Circuit considered whether the Social Security Act’s cost-reimbursement provision or FOIA’s fee-preclusion provision controlled. The Second Circuit held that the plain language of § 1306(c), which begins with a “notwithstanding” clause, explicitly exempts the SSA from FOIA’s fee rules for requests not directly related to program administration. The court agreed with the SSA’s determination that the request was not program-related and found the statute unambiguous. Therefore, the court reversed the district court’s judgment and vacated the award of attorneys’ fees and costs. View "Shapiro v. U.S. Soc. Sec. Admin." on Justia Law

Rosa A. Camacho, a retired Class II member of the Northern Mariana Islands Retirement Fund, claimed that she was entitled to cost-of-living allowances (COLAs) as part of her retirement benefits. When Camacho entered the Retirement Fund in 1980, COLAs were not part of the retirement package. In 1989, the Commonwealth legislature amended the Retirement Fund Act to provide a two percent COLA. Over the years, this provision was repeatedly modified, suspended, and ultimately repealed in 2011. The Commonwealth’s financial difficulties led to a class action and a subsequent settlement agreement in 2013, which entitled participants to 75% of their “Full Benefits,” as defined by statute or guaranteed by the Commonwealth Constitution.The United States District Court for the Northern Mariana Islands held that Camacho was not entitled to COLAs under the settlement agreement, reasoning that COLAs were not constitutionally protected benefits at the time she joined the Retirement Fund and were discretionary by statute as of 2013. Camacho appealed, arguing that the statutory introduction of COLAs during her membership created a protected right under Article III, section 20(a) of the Commonwealth Constitution.The United States Court of Appeals for the Ninth Circuit certified to the Supreme Court of the Commonwealth of the Northern Mariana Islands the question of whether section 8334(e) of the Retirement Fund Act conferred a constitutionally protected accrued benefit in the form of COLAs for Class II members employed when the Act took effect. The Commonwealth Supreme Court answered in the negative, finding that COLAs were legislative policy adjustments and not protected contractual benefits. In accordance with this interpretation, the Ninth Circuit held that Camacho did not acquire a constitutionally protected right to COLAs under section 8334(e). The district court’s decision was affirmed. View "Camacho v. Northern Mariana Islands Settlement Fund" on Justia Law