Justia U.S. 5th Circuit Court of Appeals Opinion Summaries

Ramona Craig applied for Social Security disability benefits and, after her application was denied, she filed suit challenging that denial. The key issue in her case was whether she had properly exhausted her administrative remedies before seeking judicial review. The magistrate judge specifically warned Craig that she needed to present sufficient evidence of exhaustion prior to proceeding with her lawsuit. Despite these warnings, Craig did not provide the necessary evidence before the district court entered final judgment.The United States District Court for the Western District of Texas reviewed Craig’s case and dismissed it without prejudice, finding that she had failed to demonstrate exhaustion of administrative remedies. After the district court entered its final judgment, Craig submitted an additional document intended to establish exhaustion, but this filing occurred after the judgment was entered.On appeal, the United States Court of Appeals for the Fifth Circuit considered whether it could review Craig’s post-judgment filing. The Fifth Circuit held that, under Rule 10(a) of the Federal Rules of Appellate Procedure, the record on appeal does not include documents filed in the district court after the entry of final judgment. The court further declined to exercise its discretion to take judicial notice of the post-judgment filing. The Fifth Circuit affirmed the district court’s dismissal without prejudice, holding that the district court lacked subject matter jurisdiction because Craig failed to establish exhaustion of administrative remedies based on the filings made before final judgment. The court clarified that Craig may file a new case or seek to reopen the existing case if she wishes to pursue her claims. View "Craig v. Bisignano" on Justia Law

The plaintiff, a former machine operator with a high school education, stopped working after a workplace injury and subsequently experienced a range of medical issues, including spinal stenosis, degenerative joint disease, carpal tunnel syndrome, arthritis, depression, and anxiety. In November 2018, she applied for disability insurance benefits, claiming her disability began in March of that year. Her application was denied at multiple stages within the Social Security Administration (SSA), including after a hearing before an administrative law judge (ALJ). The SSA Appeals Council denied her request for review, prompting her to seek judicial review.The United States District Court for the Northern District of Mississippi reversed and remanded the ALJ’s decision, instructing the ALJ to specifically evaluate certain medical opinions, including that of Dr. William Booker, in accordance with relevant regulations. On remand, the ALJ held another hearing, considered extensive medical evidence and testimony, and again found that while the plaintiff had several severe impairments and could not perform her past work, she retained the residual functional capacity to perform light work with certain restrictions. The ALJ concluded that jobs existed in significant numbers in the national economy that she could perform, and thus she was not disabled. The Appeals Council adopted this as the final decision of the Commissioner. The district court, with the consent of both parties, affirmed the Commissioner’s decision, and the plaintiff appealed to the United States Court of Appeals for the Fifth Circuit.The Fifth Circuit reviewed whether the Commissioner’s decision was supported by substantial evidence and whether proper legal standards were applied. The court held that the ALJ’s decision was supported by substantial evidence and that any alleged errors did not prejudice the plaintiff’s substantial rights. The court affirmed the judgment of the district court. View "Madkins v. Bisignano" on Justia Law

William Dexter Lucas was involved in schemes to fraudulently obtain small-business loans from the government and vehicle loans from private institutions. He pleaded guilty to conspiracy to commit bank and wire fraud and waived his right to appeal. His presentence investigation report (PSR) included details of his fraudulent activities and mentioned allegedly fraudulent social security benefits he had been receiving. At sentencing, the district court ordered Lucas to pay restitution to both the private institutions and the Social Security Administration (SSA). Lucas appealed his sentence, challenging the restitution orders for the vehicle loans and social security benefits.The United States District Court for the Southern District of Texas initially handled the case. Lucas objected to the PSR's restitution calculations, arguing that the vehicle loans restitution was ordered to the wrong victim and incorrectly calculated, and that the social security benefits restitution was improper because he was entitled to the benefits and the alleged fraud was not part of the same scheme as the offenses in his indictment. The district court recalculated the vehicle loans restitution but upheld the SSA restitution, finding that Lucas's statement to the SSA was fraudulent and that the SSA fraud was part of the same conduct as the fraud alleged in the indictment.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court held that the SSA restitution was erroneous because the SSA fraud was not part of the same scheme or conspiracy as the offenses in the indictment. The court affirmed the vehicle loans restitution, finding that Lucas's challenge to the calculation was barred by his appeal waiver and that the dealerships were proper victims. The court affirmed the vehicle loans restitution but vacated the SSA restitution award. View "United States v. Lucas" on Justia Law

Joshua Jones applied for disability insurance benefits (DIB) and supplemental security income (SSI) on October 1, 2019, citing various medical conditions including disc herniation, diabetes, and high blood pressure. His applications were denied initially and upon reconsideration. Jones then requested a hearing before an administrative law judge (ALJ), which took place on August 5, 2021. The ALJ denied his claims on October 6, 2021. Jones appealed to the Appeals Council, which denied review. Subsequently, he sought judicial review in the United States District Court for the Eastern District of Louisiana, which upheld the Commissioner’s decision.The district court reviewed cross-motions for summary judgment and adopted the magistrate judge’s recommendation to deny Jones’ motion and grant the Commissioner’s motion. The court found that the ALJ had applied the correct legal standards and that substantial evidence supported the decision. Jones then appealed to the United States Court of Appeals for the Fifth Circuit.The Fifth Circuit affirmed the district court’s judgment. The court held that the ALJ correctly applied Listing 1.15, which became effective on April 2, 2021, rather than the older Listing 1.04, to evaluate Jones’ claims. The court found that applying the new listing to pending claims did not constitute impermissible retroactivity. Additionally, the court determined that the ALJ’s decision was supported by substantial evidence, including the finding that Jones did not meet the criteria for medical equivalency under Listing 1.15. The court also concluded that the ALJ properly considered the impact of Jones’ medical treatments on his ability to maintain employment, finding no evidence that his treatment regimen significantly interrupted his ability to work. View "Jones v. O'Malley" on Justia Law

This case arose from an appeal against the grant of summary judgment by a district court on a claim related to disability benefits. The appellant, Emily Seago, had contended that Nancy Berryhill was unlawfully serving as the acting Social Security Commissioner in July 2018 when she ratified the appointment of the Administrative Law Judge who later denied Seago’s claim.The United States Court of Appeals for the Fifth Circuit rejected Seago's argument and affirmed the district court’s grant of summary judgment. The court held that Berryhill was lawfully serving as Acting SSA Commissioner under 5 U.S.C. § 3346(a)(2) when she ratified the appointments of all SSA Administrative Law Judges in July 2018.The court noted that 5 U.S.C. § 3346(a) provides for two independent periods of acting service, during the 210-day period following a vacancy, and for the duration of a nomination's pendency in the Senate. The court found that these periods can operate independently, as indicated by the use of the word "or" to separate the two subsections. The court noted that the statutory text does not suggest that service under one subsection excludes someone from also serving under the other.The court also found that this interpretation aligned with the statutory purpose, providing an incentive for the President to submit timely nominations without denying vital public services to the American people due to delays in the Senate confirmation process. View "Seago v. O'Malley" on Justia Law

Plaintiff, proceeding pro se, filed suit against multiple private entities and government officials, including, as relevant to the instant appeal, the Social Security Commissioner, a Social Security claims representative, the Secretary of the Treasury, and the Secretary of Education (the “Federal Defendants”), asserting a number of claims relating to the Social Security Administration’s (SSA) allegedly improper withholding of his disability benefits.   The Fifth Circuit affirmed. The court concluded that it did not have subject matter jurisdiction over Mr. Chambers’ claims against the Social Security Administration representatives concerning his Social Security benefits and that Plaintiff has failed to state a claim as to its remaining claims against the Federal Defendants. The court explained that while the lack of jurisdiction is a sufficient basis on which to affirm the district court, Plaintiff’s broad challenges to “any of [the court’s] holdings dismissing the federal government defendants” warrant but a brief note. The court found no error in the district court’s dismissal of the Treasury Secretary, given its purely ministerial role in administering the offset for Plaintiff’s outstanding loan, or its dismissal of the Secretary of Education, given Plaintiff’s similar failure to exhaust administrative remedies with that department and failure to advance a colorable constitutional violation. View "Chambers v. Kijakazi" on Justia Law

Louisiana Fair Housing Action Center (LaFHAC) sued Azalea Garden Properties, LLC (Azalea Garden), alleging that Azalea Garden discriminated on the basis of race and disability at its apartment complex in Jefferson, Louisiana, in violation of the Fair Housing Act (FHA). The district court dismissed LaFHAC’s disability claim but allowed its disparate impact race claim to proceed, subject to one caveat: The district court certified a permissive interlocutory appeal on the issue of whether the “predictably will cause” standard for FHA disparate-impact claims remains viable after Inclusive Communities Project Inc. v. Lincoln Property Co., 920 F.3d 890 (5th Cir. 2019).   The Fifth Circuit remanded the case with instructions to dismiss LaFHAC’s claims without prejudice. The court held that the district court lacked jurisdiction over this case. Along the same lines, the court wrote that it cannot consider the district court’s certified question. The court explained that LaFHAC has plausibly alleged a diversion of resources, as it shifted efforts away from planned projects like its annual conference toward counteracting Azalea Garden’s alleged discrimination. But “an organization does not automatically suffer a cognizable injury in fact by diverting resources in response to a defendant’s conduct.” The court wrote that LaFHAC failed to plead an injury because it failed to allege how its diversion of resources impaired its ability to achieve its mission. Thus, the court held that because LaFHAC has not alleged a cognizable injury, it lacks standing to bring the claims it alleges in this action. View "LA Fair Housing Action v. Azalea Garden" on Justia Law

This dispute is about whether Texas must provide around-the-clock nursing services to a disabled individuals even though the expense of doing so exceeds the cost cap in the state’s Medicaid program. Plaintiff contends that the Americans with Disabilities Act and Rehabilitation Act require this service because the alternative of institutionalization would amount to discrimination. The district court issued a preliminary injunction requiring Texas to provide the nursing services.   The Fifth Circuit vacated the injunction. The court explained that with the scorecard lopsided in favor of exercising jurisdiction, it is unlikely the district court abused its discretion in declining to abstain. Further, although Plaintiff has shown that the district court should hear her claims, we conclude she is unlikely to succeed on one of them: her due process claim. The court found that because it is unlikely that Plaintiff has a property interest in the treatment she is seeking, a preliminary injunction was not warranted on her due process claim. Finally, on the current record, Plaintiff has not shown that she can prevail on an Olmstead claim seeking services that exceed the cost cap in Texas’s Medicaid waiver program. View "Harrison v. Young" on Justia Law

D&G, a Medicare service provider for nursing homes and homebound individuals, filed suit against the H.H.S. Secretary in federal court seeking repayment of recouped funds, which then amounted to $4,136,258.19 in principal and $593,294.54 in accrued interest. The district court dismissed D&G's case for lack of subject matter jurisdiction, holding that there was no federal court jurisdiction pursuant to 42 U.S.C. 405(g), as applied to Medicare appeals by 42 U.S.C. 1395ff(b)(1)(A).The Fifth Circuit held that "effectuations" of final agency decisions when sought to liquidate the amount of repayment owed, are reviewable under 42 U.S.C. 405(g) as continuous aspects of the initial, properly exhausted, administrative decision. The court concluded that the district court had jurisdiction under section 405(g) to resolve this dispute because "effectuations" are inextricably intertwined with the initial exhausted agency action. Therefore, the district court committed reversible error when it granted the Secretary' motion to dismiss. Furthermore, the Secretary's attempted reopening of the "effectuation" was untimely and the purported reopening was void ab initio. The court reversed and remanded for further proceedings. View "D&G Holdings, LLC v. Becerra" on Justia Law

The Fifth Circuit affirmed the denial of social security disability benefits to plaintiff, concluding that the ALJ's residual function capacity (RFC) determination was supported by substantial evidence. The court also concluded that a consultive exam was not required where the ALJ's decision was based upon substantial evidence in a sufficiently developed record. Finally, the court concluded that plaintiff's remaining arguments were waived because he failed to raise them in the district court. View "Webster v. Kijakazi" on Justia Law