Justia Government & Administrative Law Opinion Summaries

The case involves Alam & Sarker, LLC, a convenience store in New Bedford, Massachusetts, which was disqualified from participating in the federal Supplemental Nutrition Assistance Program (SNAP) by the United States Department of Agriculture's Food and Nutrition Service (FNS). The FNS's decision was based on data indicating irregular SNAP transactions at the store, including a high number of back-to-back transactions and unusually large purchases, which suggested trafficking in SNAP benefits.The United States District Court for the District of Massachusetts granted summary judgment in favor of the FNS. The court found that the transaction data provided sufficient evidence of trafficking and that the store failed to rebut this inference with significantly probative evidence. The Market's opposition, which included customer statements and inventory records, was deemed insufficient to create a genuine issue of material fact.The United States Court of Appeals for the First Circuit reviewed the case de novo and affirmed the district court's decision. The appellate court held that the FNS's reliance on SNAP transaction data was appropriate and that the Market did not provide adequate evidence to counter the strong inference of trafficking. The court also rejected the Market's procedural due process claim, noting that the de novo hearing in the district court cured any potential procedural deficiencies at the administrative level. The court concluded that the Market received all the process that was due and upheld the permanent disqualification from SNAP. View "Alam & Sarker, LLC v. US" on Justia Law

Harold Grimes, a coal miner for 34 years, developed black lung disease and later died of lung cancer in 2018. His widow, Susan Grimes, is eligible for survivor’s benefits under the Black Lung Benefits Act. The dispute centers on whether Apogee Coal Company, Grimes’s last employer, or the Black Lung Disability Trust Fund should pay these benefits. The Department of Labor’s administrative law judge (ALJ) and the Benefits Review Board assigned financial responsibility to Apogee, with Arch Resources Inc., Apogee’s former parent corporation, bearing the liability. Arch contested this, arguing that the Trust Fund should pay.The district director initially identified Apogee as a potentially liable operator and notified Arch as Apogee’s “Insurance Carrier.” Despite Apogee’s bankruptcy in 2015, the district director and ALJ concluded that Arch, as Apogee’s self-insuring parent, was responsible for the benefits. The ALJ’s decision was based on the premise that Arch’s self-insurance umbrella covered Apogee’s liabilities. The Benefits Review Board affirmed this decision, referencing its prior cases, including Howard v. Apogee Coal Co., which supported the Department’s theory of liability for self-insuring parents.The United States Court of Appeals for the Seventh Circuit reviewed the case and found no statutory or regulatory basis for holding Arch liable for Apogee’s obligations. The court emphasized that neither the ALJ nor the Board identified a specific provision in the Act or its regulations that justified this liability. The court vacated the Board’s decision and remanded the case with instructions to assign Mrs. Grimes’s benefits to the Black Lung Disability Trust Fund. The court noted that future cases might provide additional arguments for such liability, but in this instance, the Trust Fund must pay. View "Apogee Coal Co. v. Office of Workers' Compensation Programs" on Justia Law

In 2013, Ronald Fossat, a coal miner, filed a claim for benefits under the Black Lung Benefits Act (BLBA). Fossat had worked in coal mines for 24 years, with 10 years underground and 14 years above ground. He suffered from severe respiratory issues and was on oxygen therapy. After filing his claim, he underwent medical evaluations, including those by Dr. Gagon (OWCP-sponsored) and Drs. Farney and Rosenberg (requested by his employer, Sunnyside Coal Company). The evaluations produced mixed results regarding the cause and extent of his respiratory impairment.An Administrative Law Judge (ALJ) awarded Fossat benefits in 2021, concluding that he was totally disabled based on arterial blood gas studies and medical opinions. Sunnyside appealed to the U.S. Department of Labor Benefits Review Board, which affirmed the ALJ’s decision. Sunnyside then petitioned the United States Court of Appeals for the Tenth Circuit for review, arguing that the agency’s interpretation of the BLBA was erroneous and that the ALJ’s medical merits analysis was flawed.The Tenth Circuit reviewed the case and rejected Sunnyside’s arguments. The court held that Fossat’s employment qualified him for the rebuttable presumption under the BLBA, as he had worked for more than 15 years in an underground coal mine, including above-ground work at the same mine. The court also found that the ALJ correctly applied the burden of proof and that substantial evidence supported the ALJ’s conclusion that Fossat was totally disabled. The court further determined that any error in admitting a supplemental medical report was harmless, as the ALJ’s conclusions were supportable without it. Consequently, the Tenth Circuit denied Sunnyside’s petition for review. View "Sunnyside Coal Company v. Office of Workers' Compensation Programs" on Justia Law

John Doe, a recipient of vocational rehabilitation services from the California Department of Rehabilitation, sought to have his rent covered while attending a law school outside commuting distance from his home. The Department agreed to cover his tuition and other expenses but refused to pay his rent, classifying it as a non-covered "long-term everyday living expense." Doe argued that rent should be considered "maintenance" under the Rehabilitation Act of 1973 and related California law, which the Department disputed.An administrative law judge (ALJ) upheld the Department's decision, interpreting the law to allow rent as "maintenance" only for short-term shelter, not for the three-year duration Doe required. The Superior Court of Orange County denied Doe's petition for a writ of mandate, agreeing with the ALJ that three years of rent did not qualify as "short-term shelter."The California Court of Appeal, Fourth Appellate District, Division Three, reviewed the case. The court found that the term "maintenance" under the Rehabilitation Act and California law includes costs incurred in excess of normal expenses while receiving vocational rehabilitation services, without distinguishing between short-term and long-term costs. The court held that the Department's categorical refusal to cover long-term rent as "maintenance" was incorrect. The court reversed the lower court's decision and remanded the case, directing the Department to reconsider Doe's request for rental assistance based on his individual circumstances, rather than a blanket policy against long-term expenses. View "Doe v. Dept. of Rehabilitation" on Justia Law

James Morell, a retired research attorney for the Orange County Superior Court, was entitled to a pension under the County Employees Retirement Law of 1937 (CERL). The dispute arose over whether the $3,500 Optional Benefit Program (OBP) payments he received should be included in the calculation of his pension. The OBP allowed attorneys to allocate the $3,500 benefit to various options, including taxable cash or a healthcare reimbursement account. Morell allocated portions of the OBP to both cash and healthcare reimbursement in the years leading up to his retirement.The Superior Court of Los Angeles County initially ruled in favor of Morell, ordering the Board of Retirement for the Orange County Employees’ Retirement System (OCERS) to reconsider its decision excluding the OBP payments from Morell’s pension calculation. The court found that the board had improperly relied on a settlement agreement and a repealed statute, Government Code section 31460.1, which had excluded such payments from the definition of "compensation."The California Court of Appeal, Second Appellate District, reviewed the case. The court concluded that Resolution 90-1551, adopted by the Orange County Board of Supervisors, which excluded OBP payments from the definition of "compensation," remained valid despite the repeal of section 31460.1. The court found that Morell had elected to participate in the OBP by allocating the $3,500 benefit, and these payments reflected amounts that exceeded his salary. Therefore, the exclusion of the OBP payments from the pension calculation was proper.The Court of Appeal reversed the trial court’s judgment and remanded the case with directions to deny Morell’s petition. The court held that Resolution 90-1551 was still valid and that the OBP payments were correctly excluded from Morell’s pension calculation. View "Morell v. Board of Retirement for the Orange County Employees’ Retirement System" on Justia Law

Joshua Jones applied for disability insurance benefits (DIB) and supplemental security income (SSI) on October 1, 2019, citing various medical conditions including disc herniation, diabetes, and high blood pressure. His applications were denied initially and upon reconsideration. Jones then requested a hearing before an administrative law judge (ALJ), which took place on August 5, 2021. The ALJ denied his claims on October 6, 2021. Jones appealed to the Appeals Council, which denied review. Subsequently, he sought judicial review in the United States District Court for the Eastern District of Louisiana, which upheld the Commissioner’s decision.The district court reviewed cross-motions for summary judgment and adopted the magistrate judge’s recommendation to deny Jones’ motion and grant the Commissioner’s motion. The court found that the ALJ had applied the correct legal standards and that substantial evidence supported the decision. Jones then appealed to the United States Court of Appeals for the Fifth Circuit.The Fifth Circuit affirmed the district court’s judgment. The court held that the ALJ correctly applied Listing 1.15, which became effective on April 2, 2021, rather than the older Listing 1.04, to evaluate Jones’ claims. The court found that applying the new listing to pending claims did not constitute impermissible retroactivity. Additionally, the court determined that the ALJ’s decision was supported by substantial evidence, including the finding that Jones did not meet the criteria for medical equivalency under Listing 1.15. The court also concluded that the ALJ properly considered the impact of Jones’ medical treatments on his ability to maintain employment, finding no evidence that his treatment regimen significantly interrupted his ability to work. View "Jones v. O'Malley" on Justia Law

James Morell, a retired research attorney for the Orange County Superior Court, was entitled to a pension under the County Employees Retirement Law of 1937 (CERL). The dispute arose over whether the $3,500 Optional Benefit Program (OBP) payments he received should be included in the calculation of his pension. The OBP allowed attorneys to allocate the $3,500 to various benefits or receive it as taxable cash. Morell allocated portions to a healthcare reimbursement account and cash. The Orange County Employees’ Retirement System (OCERS) excluded these payments from his pension calculation, leading to prolonged litigation.The Los Angeles County Superior Court initially ruled in favor of Morell, ordering OCERS to reconsider its decision without relying on Resolution 90-1551, which OCERS argued required the exclusion of OBP payments. The court found that the resolution had been invalidated and that Morell could not waive his argument that OCERS’ calculation contravened CERL through a settlement agreement.The California Court of Appeal, Second Appellate District, Division One, reviewed the case. The court concluded that Resolution 90-1551, which adopted the provisions of the now-repealed Government Code section 31460.1, remained valid due to a savings clause in Senate Bill 193. This clause preserved actions taken by counties under section 31460.1 before its repeal. The court found that Morell had elected to participate in the OBP and that the payments reflected amounts exceeding his salary.The Court of Appeal reversed the trial court’s judgment and remanded the case with directions to deny Morell’s petition. The court held that Resolution 90-1551 was still valid and that OCERS correctly excluded the OBP payments from Morell’s pension calculation. View "Morell v. Board of Retirement of the Orange County Employees' Retirement System" on Justia Law

The case involves the Sandpiper Residents Association and other residents of Sandpiper Cove, a privately owned apartment complex in Texas, subsidized by the U.S. Department of Housing and Urban Development (HUD) under its Section 8 project-based rental assistance program. The residents sued HUD, alleging that the agency failed to ensure that Sandpiper Cove was maintained in a habitable condition. They sought to compel HUD to issue Tenant Protection Vouchers, which would allow them to receive rental payment assistance for use at other properties.The District Court dismissed the residents' claims for lack of subject-matter jurisdiction, reasoning that their claims had been mooted by the sale of Sandpiper Cove to a new owner who had not received a Notice of Default. The residents appealed this decision.The United States Court of Appeals for the District of Columbia Circuit held that the District Court erred in dismissing the residents' claims as moot. The court found that the question of whether the residents were legally entitled to relief after the sale of Sandpiper Cove went to the merits of their case, not mootness. However, the court affirmed the District Court’s dismissal of the residents' complaint because they failed to state a claim upon which relief could be granted. The court held that the residents had not shown that the new owner of Sandpiper Cove had received a Notice of Default, a condition necessary for the issuance of Tenant Protection Vouchers under the relevant statute. View "Sandpiper Residents Association v. Housing and Urban Development" on Justia Law

Catherine Bradford applied for Social Security disability insurance benefits and supplemental security income, claiming she became unable to work due to multiple ailments. Her disability insurance coverage expired on September 30, 2018, and to receive benefits, she had to establish that her period of disability began between April 24, 2015, and September 30, 2018. Bradford also sought supplemental security income payments for the period between April 24, 2015, and April 8, 2020. Bradford's medical records included opinions from a nurse practitioner, three state-agency physicians, and a family medicine practitioner.The administrative law judge (ALJ) determined that Bradford had not performed substantial gainful activity since the date of her alleged disability and that she was severely impaired by multiple ailments. However, the ALJ found that none of these impairments, either individually or in combination, met or medically equaled the severity of any impairment listed in the relevant regulation. The ALJ assessed Bradford’s residual functional capacity before April 9, 2020, and concluded that she was capable of performing light work, subject to certain limitations. The ALJ determined that Bradford’s limitations did not preclude her from performing her past work as a housekeeper, laundry aide, or factory cleaner. The ALJ gave Nurse Ash’s opinion little weight and gave great weight to the opinions of the state-agency physicians and Dr. Keown.The Appeals Council denied review, and the district court granted judgment for the Commissioner. Bradford appealed, arguing that the ALJ committed legal error by disregarding a prior remand order of the district court and disputing the ALJ’s conclusion that she could perform light work. The United States Court of Appeals for the Eighth Circuit affirmed the district court's decision, concluding that the ALJ permissibly weighed the evidence and committed no legal error. The court found that the ALJ's determination that Bradford could stand for six hours and perform light work was supported by substantial evidence. View "Bradford v. Kijakazi" on Justia Law

The case involves Melissa Palmer, who applied for Pandemic Unemployment Assistance (PUA) benefits due to loss of income from her self-employment as a sign-language interpreter during the COVID-19 pandemic. Despite continuing to work her second job at Woofs and Waves, she did not report this income in her weekly requests for benefits. The South Dakota Department of Labor and Regulation, Reemployment Assistance Division (Department) determined that she had misrepresented her income and was therefore ineligible for the benefits she had received. The Department ordered her to repay the benefits and assessed a mandatory penalty.The administrative law judge (ALJ) upheld the Department's decision, finding that Palmer had willfully misrepresented her income. The circuit court affirmed the ALJ’s decision. Palmer appealed, arguing that she had not willfully misrepresented her income because she believed she only needed to report her self-employment income.The Supreme Court of the State of South Dakota reversed the lower courts' decisions. The Court found that the ALJ's finding that Palmer believed she only needed to report her self-employment income was inconsistent with the conclusion that she had willfully misrepresented her income. The Court held that a willful misrepresentation requires evidence of intentional misrepresentation, not merely knowledge of the falsity of the representation. The Court remanded the case for the ALJ to reconsider whether Palmer was at fault for the overpayment and whether she was eligible for a waiver. View "Palmer V. Dep’t Of Labor & Regulation" on Justia Law