Justia Government & Administrative Law Opinion Summaries

The North Dakota Department of Human Services ("the Department") appealed a district court judgment reversing the Department's order determining Edward Ennis was ineligible for continued Supplemental Nutrition Assistance Program ("SNAP") benefits. Ennis cross-appealed, challenging the district court's denial of his motion for costs. Ennis, self-employed, purchased a truck for $5,238 for use in his business. He paid for the truck in full and thus did not make ongoing payments. In March 2011, the County conducted a periodic recertification review to determine Ennis's continued eligibility for SNAP benefits. The County calculated his anticipated 2011 self-employment income based upon his actual 2010 self-employment income, without deducting the $5,238 expense for the truck. Based on this calculation, the County determined Ennis's anticipated 2011 income exceeded the income limit for SNAP benefits and issued a denial of benefits. Ennis appealed to the Department and requested a hearing. An administrative law judge ("ALJ") issued recommended findings of fact, conclusions of law and order determining that the purchase price of the truck should have been deducted from Ennis's anticipated 2011 self-employment income and recommending that the County's denial of further benefits be reversed. The executive director of the Department disagreed with the ALJ's recommendation and issued amended findings, conclusions and final order affirming the County's determination that Ennis was not entitled to further SNAP benefits. Ennis appealed to the district court, which reversed the Department's final order and reinstated the recommended findings of the ALJ. Upon review, the Supreme Court reversed the judgment and reinstated the Department's final order denying further benefits. View "Ennis v. N.D. Dep't of Human Services" on Justia Law

Wilfred Dahly appealed a district court judgment which affirmed a final order of the North Dakota Department of Human Services ("Department") which determined he was ineligible for Medicaid benefits. Upon review, the Supreme Court reversed and remanded, concluding the Department erred when it concluded the proceeds of the sale of Wilfred Dahly's home were an available asset which exceeded the asset limit for Medicaid eligibility. View "Dahly v. Anderson" on Justia Law

Claiming anxiety, depression, suicidal tendencies, insomnia, vertigo, migraine headaches, fibromyalgia, carpal tunnel syndrome, and plantar fasciitis, Farrell, then 33 year old, applied for disability insurance benefits. Her initial application was denied, but the Social Security Administration Appeals Council remanded. The Administrative Law Judge again ruled against her, in part because of her failure to establish definitively that she suffered from fibromyalgia. The Appeals Council summarily affirmed this decision, despite new evidence before it that confirmed the fibromyalgia. The district court affirmed. The Seventh Circuit reversed. The Social Security Administration’s regulations require the Appeals Council to consider “new and material evidence.” The ALJ did not adequately deal with competing expert opinions. View "Farrell v. Astrue" on Justia Law

Hillyard suffered a head injury and was hospitalized for two weeks while serving in the U.S. Army. Hillyard filed a single claim for service connection for a mental condition, which he attributed to his in-service head injury. The Veterans Administration denied his claim and the Board affirmed and subsequently denied Hillyard’s request for revision. The Veterans Court affirmed. Hillyard later filed a second request for revision alleging clear and unmistakable error (CUE) by the Board in failing to consider and apply 38 U.S.C. 105(a) and 1111, a different CUE allegation from the one he made in his first request. The Board dismissed the second request for revision with prejudice, concluding 38 C.F.R. 20.1409(c) permitted only one request for revision to be filed. The Veterans Court affirmed. The Federal Circuit affirmed. The interpretation of Rule 1409(c) proffered by the VA is consistent with the language of the regulation and is in harmony with the VA’s description of the regulation in its notice of rule-making. View "Hillyard v. Shinseki" on Justia Law

Applicants for and recipients of Medicaid home health Services claimed that the New York State Office of Temporary and Disability Assistance and the New York State Department of Health, violated their statutory right, enforceable under 42 U.S.C.1983, to an opportunity for Medicaid fair hearings. They claimed that this right, as construed by federal regulation, entitles them to “final administrative action” within 90 days of their fair hearing requests. The district court declared that “final administrative action” includes the holding of Medicaid fair hearings, the issuance of fair hearing decisions, and the implementation of any relief ordered in those decisions and permanently enjoined the state agencies to ensure that “final administrative action” implemented within 90 days of fair hearing requests. The Second Circuit affirmed in part, holding that the plaintiffs have a right to a Medicaid hearing and decision ordinarily within 90 days of their fair hearing requests, and that such right is enforceable under section 1983. The permanent injunction was, however, overbroad because “final administrative action” refers not to the implementation of relief ordered in fair hearing decisions, but to the holding of fair hearings and to the issuance of fair hearing decisions.

Appellant appealed a district court judgment affirming the Social Security Administration's (SSA) decision finding him disabled from September 26, 1997 through December 3, 1998, and concluding that the disability ended on December 4, 1998 due to medical improvement. Appellant contended that the ALJ's medical improvement finding was not supported by substantial evidence because she erred in relying on a single proposed rating decision from the Department of Veterans Affairs (VA) (the 2001 decision). Appellant also claimed that the ALJ erred by failing to mention the opinion of his treating physician. The Ninth Circuit Court of Appeals reversed, holding that the ALJ erred in relying solely on the 2001 decision, as (1) the 2001 only proposed changes while ignoring two other decisions that rejected the proposed changes recommended in the 2001 decision; and (2) the ALJ's misunderstanding led her to inaccurately conclude that her finding that Appellant's disability terminated on December 4, 1998 was consistent with the VA's ratings.

This appeal arose from a claim filed by the Idaho Department of Health and Welfare in the probate proceeding of George D. Perry, the deceased spouse of Medicaid recipient Martha J. Perry. The Department sought to recover funds under I.C. 56-218 from the sale of the couple’s home (their only significant asset) to recoup Medicaid benefits paid to Martha during her lifetime. The magistrate court disallowed the Department’s claim for recovery, finding that Martha had no interest in the real property because George, acting for Martha under a power of attorney, conveyed the property to himself before his death. That decision was upheld on appeal to the district court. The Department appealed to the Supreme Court. Upon review, the Court found that the district court erred in finding that federal law preempted the Department's ability to recover from George's estate what was once Martha's community property during the marriage. The Court reversed the district court and remanded the case for further proceedings.

Plaintiff filed for disability insurance benefits and supplemental security income under Title II and Title XVI of the Social Security Act. The Social Security Administration denied Hill's application. An ALJ also denied Plaintiff's application, and the appeals council denied Plaintiff's request for review. The district court granted summary judgment in favor of the Commissioner of Social Security and affirmed the ALJ's decision. The Ninth Circuit Court of Appeals reversed, holding (1) the ALJ failed to consider evidence favorable to Plaintiff and posed an improper hypothetical question to the vocational expert; and (2) therefore, substantial evidence did not support the ALJ's determination that Plaintiff was not disabled under the Social Security Act.

Perks applied for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. An ALJ denied Perks's application. On appeal to the appeals council, Perks submitted additional evidence. The appeals council noted the receipt of the additional evidence but denied further review of Perks's claim. The district court affirmed. The Eighth Circuit Court of Appeals affirmed, holding (1) substantial evidence supported the ALJ's finding that Perks was not disabled; and (2) the additional evidence submitted to the appeals council did not undermine the ALJ's determination, as the ALJ would not have reached a different result with the additional evidence and the ALJ's decision was supported by substantial evidence in the record as a whole.

Kevin Byes applied for disability insurance benefits and supplemental security income on July 30, 2007, claiming disability since November 1, 2005. The Commissioner of Social Security Administration (Commissioner) denied benefits. An administrative law judge (ALJ) upheld the Commissioner's decision, concluding that Byes was not disabled from November 1, 2005 through the date of the decision. The district court agreed with the ALJ's decision. The Eighth Circuit Court of Appeals affirmed, holding that substantial evidence supported the ALJ's finding of no severe mental impairment; and (2) the district court correctly concluded that the ALJ had applied the incorrect grid rule in order to determine Byes was not disabled but that the error was harmless.