Justia Government & Administrative Law Opinion Summaries

The former miner sued in 1992 and an administrative law judge determined that he was not medically qualified for benefits under the Black Lung Benefits Act, 30 U.S.C. 901 and indicated that Arkansas Coals was not the “responsible operator” required to pay benefits. About 17 years later, the miner filed a second claim. After finding that his medical condition had worsened and that he was now disabled, an ALJ awarded benefits and determined that Arkansas Coals was the responsible operator. The Benefits Review Board and the Sixth Circuit affirmed, rejecting the company’s finality, waiver, and collateral estoppel arguments; the miner was entitled to bring a second claim under 20 C.F.R. 725.309(d)(4) and the determination that Arkansas Coals was the responsible operator was not “necessary” to the resolution of the initial claim. Substantial evidence supports the determination that Arkansas Coals is the responsible operator. View "Arkansas Coals, Inc. v. Lawson" on Justia Law

Maynes, a miner who developed pneumoconiosis after working in Consolidated’s coal mine for 25 years, received benefits under the Black Lung Benefits Act, 30 U.S.C. 901-944, from 1997 until he died of respiratory failure in 2003. His widow sought survivors’ benefits. The then-current version of the BLBA conditioned her eligibility for benefits on proof that pneumoconiosis either caused or hastened her husband’s death. Her 2003 claim was denied. The Benefits Review Board and Sixth Circuit affirmed. In 2010, Congress passed the Affordable Care Act, which amended the law so that survivors are automatically entitled to benefits if the miner received BLBA benefits during his lifetime. Congress specified that the changes would apply to claims filed after January 2005, but did not address whether persons whose claims had been denied under the previous eligibility framework, could receive benefits by filing a subsequent claim. The issue was answered in the affirmative by the Benefits Review Board and affirmed by the Third and Fourth Circuits. Although the Department of Labor, an administrative law judge, and the Benefits Review Board agreed Maynes was entitled to benefits, they disagreed about the appropriate commencement date for benefits. The Sixth Circuit rejected Consolidated’s appeal, upholding the 2009 commencement date. View "Consolidation Coal Co. v. Maynes" on Justia Law

Rebecca Mays appealed the denial of her application for disability benefits. After careful consideration of the Social Security Administration's decision and the district court order affirming the Administration's decision, the Tenth Circuit found no reversible error. View "Mays v. Colvin" on Justia Law

On October 11, 2013, the Ohio Department of Medicaid (Department) submitted an application to the Ohio Controlling Board (Board) for an increase in its appropriation authority from the accounts holding federal Medicaid funds. The Board approved the Department's request on October 21, 2013, the effect of which was to provide medical services to Group VIII members under the Patient Protection and Affordable Care Act. The following day, Relators filed a request for writ of mandamus. Relators claimed that the Board violated Ohio Rev. Code 127.17, which provides that the Board shall take no action which does not carry out the legislative intent of the general assembly, by approving the Department's request for increased appropriation authority for the Hospital Care Assurance Match Fund. The Supreme Court denied the writ, concluding that Relators failed to establish a clear legal right to the requested relief and a clear legal duty on the part of the Board to undo the authorization of the expenditure of additional federal funds to provide medical insurance for Group VIII members. View "State ex rel. Cleveland Right to Life v. State of Ohio Controlling Bd." on Justia Law

Two Chicago firefighters suffered duty-related injuries in the 1980s and later died. Their widows each received an ordinary widow’s pension from the Retirement Board of the Firemen’s Annuity and Retirement Benefit Fund of Chicago. The two widows were later awarded annuities available to widows of firemen who died in the line of duty, retroactive to the date of death of each spouse, with interest, because the injuries were permanent and had prevented them from ever returning to active duty. The widows claimed that the calculation of their annuities (based on the current salary of the position last held by the deceased) should include duty availability pay, which is generally intended to compensate firefighters for being available for duty. This type of compensation was created in the 1990s, after these firemen’s accidents, and neither ever received it. Their argument, based on Pension Code language added in 2004, was rejected by the Board and the trial court. The appellate court reversed. The Illinois Supreme Court reinstated the denial. If duty availability pay may be used for pension calculation, it must be pay that was actually received by the firemen. View "Hooker v. Ret. Bd. of the Firemen's Annuity & Benefit Fund of Chicago" on Justia Law

Ramage, born in 1933, worked for Island Creek for 28 years, five years underground and 23 years on the surface. In 2007 he sought black lung benefits. While the claim was pending, Congress revived a statutory rebuttable presumption that a coal miner who worked in an underground coal mine for 15 years and suffers from a total respiratory or pulmonary disability is presumed to be totally disabled due to pneumoconiosis, 30 U.S.C. 921(c)(4), applicable to pending claims filed after January 1, 2005. The ALJ noted that x-rays did not show pneumoconiosis, that Ramage could not complete a pulmonary function test due to a tracheostomy, and that arterial blood-gas studies were qualifying under the federal standards. The ALJ summarized the medical opinions of five doctors, including one who emphasized that it was impossible to distinguish between the damage due to coal dust as opposed to the damage due to smoking. The ALJ awarded benefits and the Benefits Review Board affirmed. The Sixth Circuit denied a petition for review, holding that the ALJ’s determinations were reasoned and reasonable and that the legislative provisions creating the presumption are self-executing.View "Island Creek KY Mining v. Ramage" on Justia Law

The Jackson County Board of Supervisors terminated June Seaman, and she applied to the Mississippi Employment Security Commission (MESC) for unemployment benefits. A claims examiner, an administrative-law judge, and the Board of Review all determined that Seaman was entitled to unemployment benefits because Jackson County had failed to prove by clear and convincing, substantial evidence that Seaman had been terminated for misconduct. The circuit court affirmed the agency’s decision, but the Court of Appeals reversed, finding that the employer had proven misconduct by substantial evidence. After its review, the Supreme Court concluded the Court of Appeals improperly reweighed the evidence before the MESC. Therefore, the Supreme Court reversed the Court of Appeals and reinstated and affirmed the circuit court's judgment. View "Jackson County Board of Supervisors v. Mississippi Employment Security Commission" on Justia Law

A member of the military moved to a new post in Alaska in 2005. Two months later, he was deployed to Iraq. After 16 months of service in Iraq, he returned to Alaska in December of 2006. Shortly thereafter, he applied for the 2007 Permanent Fund Dividend (PFD), for his eligibility for 2006. The Department of Revenue denied his application. The service member filed an informal appeal and later a formal appeal with the Department, both of which were denied. The superior court affirmed the denial, concluding that the relevant statute required him to reside in Alaska for six months before claiming an allowable absence for military service and that the statute did not violate equal protection under the U.S. and Alaska Constitutions. After its review, the Supreme Court concluded that because the service member was not eligible for the 2007 PFD, the Court affirmed the superior court's judgment. View "Heller v. Alaska Dept. of Revenue" on Justia Law

Parents who adopted special needs children challenged decision by the Department of Human Services (DHS) to provide a lower assistance subsidy for the children than the assistance subsidy that would be paid if the children were in a foster placement. The decision was upheld upon administrative review by DHS and sustained by the district court and Court of Civil Appeals. Parents filed a petition for certiorari, seeking review of the Court of Civil Appeals' decision. The Supreme Court concluded DHS was attempting to apply a predetermined fixed amount of subsidy without allowing adoptive parents to show greater need up to the amount provided for special needs children in foster care. This was contrary to the policy and purpose of the statutory law providing and regulating financial assistance to people who undertake parental responsibility and care of special needs children. The opinion of the Court of Civil Appeals was therefore vacated and the district court order sustaining the decision of the Department of Human Services was reversed. The case was remanded to the Department of Human Services for redetermination of the monthly subsidy amount. View "Troxell v. Oklahoma Dept. of Human Services" on Justia Law

Beckley Appalachian Regional Hospital (Beckley ARH) was a voluntary provider of medical services through the Medicaid program pursuant to an agreement executed between it and the West Virginia Bureau for Medical Services (BMS). Beckley ARH filed a lawsuit against the West Virginia Department of Health and Human Resources and its secretary and the BMS and its commissioner (collectively, Respondents), seeking a remedy for inadequate Medicaid reimbursement rates. The circuit court dismissed the complaint for failure to state a claim upon which relief could be granted. The Supreme Court affirmed, holding that W. Va. Code 9-15-16 and 16-29B-20 do not provide for an express or implied private cause of action by a Medicaid provider for judicial review of reimbursement rates for medical services. View "Appalachian Reg'l Healthcare v. W. Va. Dep't of Health & Human Res." on Justia Law