Justia Government & Administrative Law Opinion Summaries

Relator was injured while working for Employer. Relator began receiving workers’ compensation benefits in 2010. In 2012, Relator began receiving a retirement annuity from the Public Employees Retirement Association (PERA). At some point, Relator began receiving federal social security retirement benefits. While Employer was entitled under Minn. Stat. 176.101(4) to offset Relator’s permanent total disability benefits by the amount of her social security retirement benefits, the parties disagreed as to whether Employer was entitled to apply the offset to Relator’s PERA retirement benefits. A compensation judge granted Employer the offset. The Workers’ Compensation Court of Appeals (WCCA) affirmed, concluding that Relator’s PERA retirement annuity was an “old age and survivor insurance benefit.” The Supreme Court reversed, holding that, under the reasoning in Ekdahl v. Independent School District #213, also decided today, section 176.101(4) does not permit permanent total disability benefits to be offset by public employee pension benefits. Remanded. View "Hartwig v. Traverse Care Ctr." on Justia Law

Relator was injured while working for a School District. Relator eventually sought and was awarded permanent total disability (PTD) benefits. Relying on Minn. Stat. 176.101(4) and claiming that the statute authorizes an offset for “any old age and survivor insurance benefits,” the School District sought to offset its PTD benefit payment by the amount of government-service pension benefits Relator was receiving. A compensation judge concluded that the School District was not entitled to the offset. The Workers’ Compensation Court of Appeals (WCCA) reversed, concluding that government-service pension benefits are included in the phrase “old age and survivor insurance benefits” and therefore can be offset from the School District’s disability-benefit payment. The Supreme Court reversed the WCCA and reinstated the decision of the compensation judge, holding that the phrase “old age and survivor benefits” refers only to federal social security benefits, and therefore, the WCCA erred when it applied section 176.101(4) to Relator’s retirement annuity. View "Ekdahl v. Indep. Sch. Dist. #213" on Justia Law

Because of a 2007 car accident, Glenn suffers from degenerative disc disease, a closed head injury and cerebral concussion that cause dizziness and memory loss, left shoulder tendonitis, and post-traumatic headaches. She also suffers major depression, with slow thought processes, mood swings, agitation, poor concentration, anxiousness, feelings of anger and hopelessness, paranoia, auditory hallucinations, and suicidal and homicidal ideation. She has a chronic skin condition that has caused cysts around the vulva that occasionally prevent her from walking and require frequent bathroom breaks. In 2008, Glenn sought social security benefits. Following her hearing, at which Glenn appeared without counsel, the ALJ denied the application at the fifth step of the required analysis: whether, taking into account age, education, and work experience, the claimant can perform other work. The Appeals Council declined review. The district court remanded, based on five errors, but denied attorney’s fees under the Equal Access to Justice Act, finding that the government’s position on appeal was “substantially justified” because the magistrate rejected three of Glenn’s claims of error. The Sixth Circuit reversed the denial of fees. Regardless of what happens on remand, Glenn had to retain counsel to ensure that her claim would be properly adjudicated.View "Glenn v. Comm'r of Soc. Sec." on Justia Law

Petitioner David Eskeland began work at the New Hampshire Department of Fish and Game in 1990 and, accordingly, became a mandatory member of the New Hampshire Retirement System (NHRS). On October 1, 2010, he retired from the Department of Fish and Game with twenty years and three months of creditable service, at which point he began receiving his service retirement pension. After he retired, a friend told the petitioner that he should have retired on a disability retirement allowance rather than on a service retirement allowance. As a result of this conversation, and three months after he retired, petitioner filed an application for accidental disability retirement based upon work-related injuries he sustained in 2002 and 2004. In December, 2011, the board accepted the hearings examiner's recommendation to deny the petitioner's application for accidental disability retirement. The recommendation was based upon a medical certification that the petitioner was not permanently incapacitated by a work-related injury because he had worked full-time, without accommodation, for six years following his most recently accepted workers' compensation injury. Petitioner moved for reconsideration, and the board referred the request to the hearings examiner. In reviewing the request for reconsideration, the hearings examiner became aware of a potential jurisdictional issue and notified petitioner that, because he "was a beneficiary when he applied for disability retirement, his membership appears to have terminated and the Board of Trustees appears to lack jurisdiction to award him a disability retirement." After a three-day hearing, the hearings examiner recommended that the board find that it did not have jurisdiction to grant accidental disability retirement benefits. The board accepted the recommendation. Finding no reversible error with the Board's decision, the Supreme Court affirmed. View "Petition of David Eskeland" on Justia Law

Sterling, a former coal miner, received a favorable decision from an administrative law judge (ALJ) declaring him eligible for benefits under the Black Lung Benefits Act, 30 U.S.C. 901. The Department of Labor’s Benefits Review Board affirmed. The Sixth Circuit denied a petition by Sterling’s employer that argued that the ALJ wrongly applied the statutory presumption of pneumoconiosis, improperly discredited certain medical opinions disputing Sterling’s pneumoconiosis diagnosis, and failed to explain his resolution of conflicting evidence about the extent of Sterling’s past cigarette smoking. View "Central OH Coal Co. v. Dir.r, Office of Workers' Comp. Programs" on Justia Law

Johnson served in the U.S. Army, 1970-197171. Years after leaving the service, he filed a claim for increased disability ratings for his service-connected disabilities, including rheumatic heart disease (then rated 10% disabling), and degenerative changes of the right and left knees (each knee rated 10% disabling). A VA regional office (RO) denied the claims, finding that he was not entitled to a rating of total disability based on individual unemployability. The Board of Veterans’ Appeals affirmed and denied his claim for extra-schedular consideration of the combined impact of his service-connected rheumatic heart disease and right knee disability under 38 CFR 3.321(b)(1). The Veterans Court affirmed, finding the CFR language ambiguous and deferring to the VA’s interpretation. The Federal Circuit reversed, citing plain language. Section 3.321(b)(1) entitles a veteran to consideration for referral for extraschedular evaluation based on an individual disability not adequately captured by the schedular evaluations; it also entitles a veteran to consideration for referral for extra-schedular evaluation based on multiple disabilities, the combined effect of which is exceptional and not captured by scheduler evaluations.View "Johnson v. McDonald" on Justia Law

Boley sought Social Security disability benefits. The agency denied her request initially and on reconsideration. A person dissatisfied with such a decision has 60 days to request a hearing. Boley took about nine months because SSA had notified Boley but not her lawyer (as required by 20 C.F.R.404.1715(a)). Boley was ill at the time, preparing for a double mastectomy, and did not know, until it was too late, that her lawyer was unaware of the decision. An ALJ dismissed an untimely hearing request, finding that Boley lacked “good cause” because she had received notice and could have filed a request herself. A district judge dismissed her petition for judicial review, based on 42 U.S.C. 05(g), which authorizes review of the agency’s final decisions made “after a hearing.” The Seventh Circuit vacated and remanded, with instructions to decide whether substantial evidence, and appropriate procedures, underlie the decision that Boley lacks “good cause” for her delay in seeking intra-agency review. In doing so, the court overruled its own precedent and noted a divide among the circuits. View "Boley v. Colvin" on Justia Law

Kathy Inwards was injured while employed as an assembler by Bobcat. WSI accepted liability for her claim and awarded Inwards vocational rehabilitation benefits to assist her in returning to work. In early June 2011, WSI issued a notice of intention to discontinue benefits ("NOID") stating her disability benefits would end then convert to retraining benefits. She had 30 days to request reconsideration of the decision. WSI issued a formal order requiring Inwards to "enter into training at Hutchinson Community College, Hutchinson, Kansas, in the Business Management & Entrepreneurship AAS program." Inwards requested reconsideration of the vocational rehabilitation plan, but attended two college courses during the summer of 2011 in accordance with the plan. Inwards complained to her physician that she was having increased pain as a result of her course work. Although Inwards registered for fall courses at the college, she withdrew from them. In October 2011, WSI issued a NOID to Inwards stating "[t]here is no medical evidence that supports your professed inability to attend the classes as outlined in the administrative order dated June 27, 2011. You are now considered to be in non-compliance with vocational rehab." Inwards timely requested reconsideration of this NOID, and on January 13, 2012, WSI issued a formal order suspending Inwards' rehabilitation benefits based on her noncompliance with the rehabilitation plan. Inwards timely requested a hearing to challenge WSI's finding of noncompliance and suspension of benefits. The ALJ reversed WSI's January 13, 2012 order suspending benefits for noncompliance with the vocational rehabilitation plan. WSI appealed to district court and Inwards moved to dismiss the appeal, claiming the court lacked subject matter jurisdiction because WSI failed to serve the notice of appeal and specification of errors on Inwards and her employer. The court denied the motion to dismiss, concluding Inwards had no standing to object to defective service on her employer and there was good cause to excuse WSI's mistake about recently mandated court electronic filing requirements. The court reversed the ALJ's decision, concluding the finding of good cause was "not supported by law," and reinstated WSI's January 13, 2012 order of noncompliance. The Supreme Court concluded the ALJ erred as a matter of law in ruling Inwards had good cause for failing to comply with a retraining program because WSI's previous order requiring Inwards to participate in the retraining program had been appealed and had not been finally resolved at the time she withdrew from the retraining program. The Court affirmed the district court judgment reversing the ALJ's decision and reinstating WSI's order of noncompliance. View "Inwards v. WSI" on Justia Law

Plaintiff, a former laborer, applied for social security disability benefits, claiming he was unable to work a full 40-hour week because of acute lower back pain that radiates into his right leg. He has had various treatments and takes several medications such as oxycodone and percocet. His application was denied; the Appeals Council and district court affirmed. The Seventh Circuit reversed and remanded, reasoning that the administrative law judge was likely mistaken in believing that one physician’s report refuted the findings of the other physician. What was relevant was not the cause of the pain and numbness but the severity of these symptoms and whether they disabled plaintiff from working full time. Both physicians diagnosed radiculopathy. If the administrative law judge remains skeptical of the claim, he can order a further examination of the plaintiff by a qualified physician instructed to offer a medical opinion (if possible) on the plaintiff’s physical ability to engage in full-time work. The court stated references to the credibility of the applicant are “a recurrent feature of the government’s defense of denials of social security disability benefits” that constitutes “professional misconduct and if it continues we’ll have to impose sanctions.” View "Hanson v. Colvin" on Justia Law

In this case, the Georgia Department of Human Services, Family and Children Services (DFCS) granted appellee Jerry Glover's application for Medicaid benefits but imposed a multi-month asset transfer penalty on him pursuant to section 2339 of DFCS's Georgia Economic Support Services Manual due to his refusal to name the State as the remainder beneficiary on an annuity. Glover appealed the penalty to an Office of State Administrative Hearings Administrative Law Judge (ALJ) who issued an initial decision reversing the penalty. DFCS then filed a request for agency review by the Georgia Department of Community Health (DCH). DCH issued a final decision upholding the penalty. Pursuant to OCGA 50-13-19 of the Administrative Procedures Act, Glover then sought judicial review from the Superior Court which affirmed the final agency decision. The Court of Appeals granted Glover’s application for discretionary appeal and reversed the superior court, concluding that section 2339 of the Eligibility Manual as applied to Glover was inconsistent with the plain language of the federal Medicaid statute and that pursuant to 42 U. S. C. sections 1396p (c) (1) (F) and (G), Glover's annuity was not an asset to which the asset transfer penalty would apply. Appellants, David Cook in his official capacity as Commissioner of DCH and Clyde Reese in his official capacity as Commissioner of DFCS, appealed to the Georgia Supreme Court arguing that the Court of Appeals improperly interpreted the annuity section of the Medicaid Act and erred in holding that sec. 2339 as applied to Glover violated federal law. Asserting that the statutory provisions at issue was ambiguous, appellants contended that the Court of Appeals was required to defer to CMS's interpretation of the federal statute. Because the Supreme Court found that the federal statutory provisions at issue were ambiguous and the relevant administrative agencies’ interpretations of them were based on a permissible construction of the statutory language, it reversed the Court of Appeals’ decision in this case. View "Cook v. Glover" on Justia Law