Justia Government & Administrative Law Opinion Summaries
Articles Posted in Public Benefits
Petition of Kelly Hagenbuch
Petitioner Kelly Hagenbuch challenged the termination of her food stamp benefits by the New Hampshire Department of Health and Human Services (department). The department terminated the benefits because it found that her income exceeded the maximum amount permitted by the program. In calculating petitioner’s income, the department included distributions from an irrevocable trust, of which petitioner was the sole beneficiary, that had been made by the trustee to third parties. These distributions included payments for trust expenses and for legal fees that the petitioner had incurred to obtain public benefits. This case presented an issue of first impression in New Hampshire: whether a distribution made by the trustee of an irrevocable trust to third parties counted as income to the trust beneficiary for the purpose of determining food stamp benefits. The narrow question before the New Hampshire Supreme Court was whether the trust distributions were “owed” to the petitioner. The Court did not decide the validity of the premise underlying the department’s argument—that because the money used to establish the Trust was derived from the settlement of the petitioner’s personal injury lawsuit, the Trust was established with the petitioner’s “own funds.” Even assuming that the premise was correct, the Court concluded that the vendor payment exclusion applied to the trust distributions because the regulations do not recognize the distinction that the department attempts to draw regarding trusts originally funded by the household. In this case, given that the distributions made by the trustee to third parties were not owed to the petitioner—and therefore, were excluded vendor payments—the department should have excluded the trust distributions from the petitioner’s income. Accordingly, the Court reversed the presiding officer’s decision that the department properly counted the trust distributions as income. View "Petition of Kelly Hagenbuch" on Justia Law
Childress v. Colvin
Childress unsuccessfully sought Social Security Administration disability benefits in 2008, at age 35. He appealed to the district court, which remanded for reevaluation of the medical opinions in the record and reconsideration of the plaintiff’s credibility. After a second hearing, in 2013, the same ALJ again ruled that Childress was not disabled. The district court affirmed. The Seventh Circuit reversed. The ALJ did not give proper weight to medical evidence presented by Childress’s treating physicians, which was extensive and indicated that Childress suffers from congestive heart failure, cardiomyopathy, severe asthma, COPD (chronic obstructive pulmonary disease), occasional chest pain, obesity, hypertension, and dyspnea (difficult or uncomfortable breathing, resulting in shortness of breath). He was prescribed Advair, Benazepril, Coreg, Diovan, Lanoxin, Lasix, Norvasc, Proventil, and Spiriva, but the cardiologist estimated that in an eight‐hour workday Childress would be able to stand or walk for no more than one hour and to sit for no more than two hours. The court characterized the ALJ’s conclusion as “absurd,” noting that the vocational expert admitted that an employee who misses three or more days of work a month is unemployable. The court also noted the ALJ’s reference to Childress’s history of smoking. View "Childress v. Colvin" on Justia Law
Brown v. Colvin
Brown applied for disability benefits on the ground that her bad back and obesity left her in too much pain to work. The Social Security Administration denied Brown’s application; an administrative law judge upheld the denial, concluding that Brown could perform sedentary work associated with six jobs identified by a vocational expert. The Seventh Circuit vacated and remanded, holding that the ALJ violated the Treating Physician Rule when he rejected certain opinions proffered by Brown’s doctor regarding Brown’s ability to sit and stand for prolonged periods of time. In substituting his own opinions for the doctor’s, the ALJ focused on facts that did not directly pertain to sitting or standing and misrepresented multiple statements Brown made to treatment providers and others. The court rejected arguments that the ALJ insufficiently considered her obesity and improperly relied on the vocational expert’s testimony from the administrative hearing, claiming that the expert failed to provide enough information to justify her departure from the Dictionary of Occupational Titles and failed to verify the source of the data on which her jobs-related opinions were based. View "Brown v. Colvin" on Justia Law
Concerned Pastors for Social Action v. Khouri
The Sixth Circuit declined to stay a preliminary injunction requiring the delivery of bottled water households served by the Flint water system that lack properly installed water filters. For many homes without a proper filter, safe drinking water is inaccessible due to the limited hours of the points of distribution and transportation issues. The cost of verifying and maintaining water filters and delivering bottled water to residents that are not part of the allegedly 96% of homes that have a functioning filter is "nowhere near $10.5 million" claimed by the defendants. There is still $100 million left of the $212 million that Michigan allocated to respond to the Flint water crisis. The court rejected an argument that delivering bottled water will slow down the recovery of Flint’s water system by decreasing the amount of water moving through the delivery lines. The defendants did not demonstrate a strong likelihood of success on their arguments, nor have they shown that portions of the preliminary injunction, including the provisions requiring the delivery of bottled water to non-exempt households, are overbroad. A stay would not support the public interest. Flint residents continue to suffer irreparable harm from the lack of reliable access to safe drinking water. View "Concerned Pastors for Social Action v. Khouri" on Justia Law
Hardaway v. District of Columbia Housing Authority
Under the Department of Housing and Urban Development’s (HUD) Housing Choice Voucher Program, 42 U.S.C. 1437f, housing agencies use HUD funds to issue housing subsidy vouchers based on family size. The Montgomery County, Maryland Housing determined, based on a medical form, that Angelene has a disability and requires a live-in aide. HUD regulations mandate that any approved live-in aide must be counted in determining family size. The Commission issued Angelene a two-bedroom voucher. Angelene’s sister was Angelene’s live-in aide. Angelene decided to move to the District of Columbia. Program vouchers are portable. Angelene obtained a two-bedroom voucher from the D.C. Housing Authority. The sisters moved into a two-bedroom District apartment. Within weeks, they received a letter revoking Angelene’s right to a live-in aide and her legal entitlement to a two-bedroom voucher. They sued, citing the Americans with Disabilities Act, 42 U.S.C. 12132, Rehabilitation Act, 29 U.S.C. 794, and Fair Housing Act, 42 U.S.C. 3604(f)(1). The court denied motions for a temporary restraining order and to seal their complaint, medical records, and “nondispositive materials.” While the case was pending, the Authority sent another letter reaffirming that Angelene’s request for a live-in aide was denied, but stating that the decision did not reverse the two-bedroom voucher. The court dismissed, finding no allegation of injury-in-fact. The D.C. Circuit reversed with respect to the motion to seal and the dismissal. At the pleadings stage, plaintiff’s allegation that the government denied or revoked a benefit suffices to show injury-in-fact. Angelene’s loss of a statutory entitlement traces directly to the Authority’s letter and would be redressed by a court order to approve her aide request. View "Hardaway v. District of Columbia Housing Authority" on Justia Law
State ex rel. Pressley Ridge v. W. Va. Department of Health & Human Resources
Seven entities under contract to provide residential services to youth in the state (collectively, Petitioners) filed a petition for writ of mandamus requiring the West Virginia Department of Health and Human Services (DHHR), its Cabinet Secretary, the West Virginia Bureau for Medical Services (BMS), its Acting Commissioner, the Bureau for Children and Families (BCF), and its Commissioner (collectively, Respondents) to promulgate new or amended legislative rules prior to implementing changes to existing residential child care services policies. The Supreme Court granted a writ as moulded, finding it most appropriate to order this matter to be docketed in this circuit court as if it were an original proceeding in mandamus in that court. Remanded for further proceedings. View "State ex rel. Pressley Ridge v. W. Va. Department of Health & Human Resources" on Justia Law
Barr v. CitiCorp Credit Svc
Jessica Barr appealed an Idaho Industrial Commission (Commission) decision finding her ineligible for unemployment benefits and affirming the decision of an Appeals Examiner for the Idaho Department of Labor’s (IDOL) Appeals Bureau. The Commission found that Barr was discharged by her employer, Citicorp Credit Services, Inc. USA (Citicorp), for misconduct in connection with employment and determined that Barr was not eligible for benefits pursuant to Idaho Code section 72-1366(5). Barr argued that Citicorp representatives provided false information to the Appeals Examiner and her unemployment benefits should have been restored. Finding that the Commission's decision was supported by substantial and competent evidence, the Supreme Court affirmed the IDOL Appeals Examiner's decision. View "Barr v. CitiCorp Credit Svc" on Justia Law
Maine Medical Center v. Burwell
The consolidated appeals in this case involved a dispute between the Secretary of Health and Human Services and a group of Maine hospitals about certain payments - called disproportionate share payments (DSH payments) - the hospitals had received in reimbursement from the federal government for charity care for fiscal years dating as far back as 1993. Generally speaking, the more low-income patients a hospital services, the higher the hospital’s DSH payment. In this case, the Secretary maintained that the Hospitals were overinclusive in their DSH payment calculations. An intermediary reassessed the DSH payments and recouped from the Hospitals approximately $22 million in alleged overpayments. The Provider Reimbursement Review Board, in turn, ordered the intermediary to restore approximately $17 million to the Hospitals. The Secretary reversed. The Hospitals sought judicial review, but neither side was satisfied with the district court’s ruling. On appeal, the First Circuit reversed in part and affirmed in part, holding (1) the Secretary properly reopened the disputed years and adequately demonstrated that the Hospitals had received substantial overpayments of DSH funds; and (2) the Hospitals’ defenses to repayment were unavailing. View "Maine Medical Center v. Burwell" on Justia Law
Moro v. Oregon
In the underlying litigation to this appeal, claimants were petitioners or represented petitioners who challenged legislation passed in 2013 that changed the pension benefits paid to certain members of the Public Employee Retirement System (PERS) by limiting the statutory cost-of-living adjustment (COLA) and eliminating a PERS income-tax offset for out-of-state retirees. In "Moro v. Oregon," (351 P.3d 1 (2015) (Moro I)), the Oregon Supreme Court largely agreed with petitioners’ argument that modifications to the COLA formula impaired petitioners’ contractual rights, thus violating Article I, section 21, of the Oregon Constitution. But the Court rejected petitioners’ similar challenge to the elimination of the income-tax offset. Petitioners, who were active and retired members of PERS, were the prevailing parties. Following the decision in Moro I, claimants petitioned for attorney fees and costs. State respondents and county/school district respondents filed objections. The Supreme Court referred those petitions to a special master for recommended findings of fact and conclusions of law. The special master reported his recommendations, and the parties subsequently filed objections and responses to those recommendations. The issues raised in those filings included which legal doctrines justified an award of attorney fees in this case; whether self-represented attorneys were eligible to receive an award of attorney fees; whether the fees sought by claimants were reasonable; and how to pay for an award of fees and costs. After review, the Oregon Supreme Court concluded that fees should be awarded based on the common-fund and substantial-benefit doctrines; that the self-represented attorneys were eligible to receive a fee award under those doctrines; that a reasonable fee award under the lodestar approach had to be based on reasonable hourly rates and reflect reductions to account for duplicative work and work on unsuccessful claims; and that an award in this case should be paid for as determined by the Public Employees Retirement Board (PERB) in a manner that was consistent with its statutory authority and fiduciary obligations. View "Moro v. Oregon" on Justia Law
Israel v. Colvin
In 2001, Israel injured his back while digging posts for a porch. He worked while receiving treatments but his pain worsened; he stopped working in February 2003. He underwent a lumbar laminectomy and diskectomy, which did not resolve his pain Two surgeons determined that further surgery was not an option. Under the care of various doctors, Israel tried physical therapy, transcutaneous electrical nerve stimulation (TENS), a dorsal column stimulator, epidural injections, narcotic pain medications including Methadone and morphine, lidocaine patches, a muscle relaxer, an anti‐depressant, and drugs for nerve pain. Diagnosed with lumbar radiculopathy and post‐laminectomy pain syndrome, Israel continues to experience severely limiting pain. His doctor sought approval to implement an “intrathecal drug delivery system,” a pain pump that delivers medication directly to the spinal cord. Israel’s insurer refused to cover the cost. Israel sought Disability Insurance Benefits and Supplemental Security Income benefits in 2007. On remand, the Social Security Administration repeatedly denied benefits.The Commissioner conceded in the district court that her decision was not supported by substantial evidence and requested remand. Israel, frustrated with years of delay, sought a direct award of benefits. The district court remanded. The Seventh Circuit affirmed, finding that the district court did not abuse its discretion in ordering a remand; the agency should expedite proceedings so that the matter may be resolved. View "Israel v. Colvin" on Justia Law