Justia Government & Administrative Law Opinion Summaries

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.

Gallo served as an FAA air traffic control specialist from 1982 until 1995 when she experienced a job-related injury for which she received OWCP benefits. Gallo recovered enough to return to light duty. In 1996 she lost her medical certification to continue as an operational ATCS. Until 2000 she was assigned to a “non-operational” automation specialist position, which did not provide the same retirement credit or weekend pay. She received OWCP benefits for the differential. Gallo fully recovered in 2000 and received medical clearance; the Agency terminated OWCP benefit. She applied for restoration under 5 U.S.C. 8151(b)(2), which provides the right to priority consideration for restoration to federal employees who have overcome a compensable injury. The Agency assigned Gallo to a supervisory ATCS position. In setting her salary, the Agency did not take into account pay increases granted to operational ATCS employees during while Gallo was working as an automation specialist. The Merit Systems Protection Board denied her claim. The Federal Circuit reversed. The Board erred in interpreting “resumes employment with the Federal Government” under section 8151(a), and any pay increases that Gallo would have received based on her creditable service time with the federal government are “benefits based on length of service.”

Arnaz Crawford was fired from his job in January 2009. Crawford subsequently applied for Social Security disability benefits (SSDI benefits) due to a mental condition, but the social security administration (Administration) denied the claim. Meanwhile, Crawford applied for state unemployment benefits. The division of employment security (Division) awarded unemployment benefits to Crawford until March 20, 2010. On March 2, 2010, the Administration determined Crawford had been disabled and eligible for SSDI benefits since January 29, 2009. The Division subsequently determined (1) Crawford was unable to work from December 20, 2009 to March 20, 2010 and, therefore, was ineligible for unemployment compensation benefits; and (2) Crawford had received $3,080 in benefits that he was ineligible to receive. The labor and industrial relations commission (Commission) affirmed the determination that Crawford was ineligible for unemployment compensation benefits. The Supreme Court (1) reversed the Commission's decisions to the extent they authorized the Division to collect the overpayment from Crawford; but (2) otherwise affirmed the Commission's decision.

The Department of Health and Human Services denied Medicare coverage of the BIO-1000, a piece of durable medical equipment used to treat osteoarthritis of the knee. In four decisions, the Medicare appeals counsel, the highest level of agency adjudication, ruled that the BIO-1000 had not been shown to be reasonable and necessary for the treatment at issue. The supplier of the device challenged those decisions. The district court granted summary judgment for the BIO-1000 supplier. The Ninth Circuit Court of Appeals reversed the district court's judgment and joined the Fourth Circuit in holding that the appeals council's coverage denials for the BIO-1000 were not arbitrary, capricious, or unsupported by substantial evidence, as (1) the appeals council adequately explained its reasons for denying coverage; and (2) the coverage denials were supported by substantial evidence. Remanded.

The Secretary of the Department of Health and Human Services (HHS) imposed a civil money penalty on Greenbrier Nursing and Rehabilitation Center, a skilled nursing facility in Arkansas, for noncompliance with Medicare participation requirements. The Eighth Circuit Court of Appeals denied Greenbrier's petition for review, holding (1) substantial evidence supported HHS's finding that Greenbrier was not in substantial compliance with 42 C.F.R. 483.25; (2) the finding that Greenbrier's noncompliance with section 483.25 rose to the level of immediate jeopardy was not erroneous; and (3) judicial review of two of Greenbrier's objections to the monetary penalty was barred, and Greenbrier received adequate notice of its noncompliance.

Locane, born in 1983, was adopted and does not know her family medical history. She suffered her first symptoms within two weeks of being vaccinated in 1997 and was diagnosed with Crohn’s Disease. She sought compensation under the National Childhood Vaccine Injury Act, 42 U.S.C. 300aa-1 to -34, alleging that she suffered Crohn’s disease as a result of hepatitis B vaccination. A special master denied the claim, finding Locane’s disease began before her vaccination and that Locane failed to prove by a preponderance of the evidence that the vaccine caused or significantly aggravated her disease. The Federal Circuit affirmed.

Plaintiff-Appellant John Dilley appealed the grant of summary judgment in favor of Defendant-Appellee City of Missoula. The district court concluded the City acted within its legal authority when it purchased the Missoula Civic Stadium with tax increment financing (TIF) funds designated for urban renewal. The stadium was originally planned and developed by Play Ball Missoula, Inc. (Play Ball), a volunteer, non-profit corporation organized for the purpose of bringing a minor league baseball team to Missoula. In 2000, Play Ball and the City entered a development agreement that permitted Play Ball to finance and construct a stadium on blighted City property and later convey the facility to the City. Plaintiff, acting pro se, filed suit prior to the City's acquisition of the stadium, alleging the planned purchase using TIF funds was an "illegal payoff of private enterprise debt." On appeal, Plaintiff argued that the district court erroneously failed to specify which provision under Title 7, Chapter 15, Part 42 of the Montana Code that permitted the "payoff." He also argued that the City could not make such an expenditure of TIF funds simply because the practice was not prohibited by statute. Finding that the City's use of TIF money to acquire the stadium was a proper exercise of its urban renewal posers, the Supreme Court affirmed the grant of summary judgment in the City's favor.