Articles Posted in Public Benefits

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After the Department of Education issued a proposed determination that Texas was ineligible for $33.3 million of future grants because of the shortfall in both aggregate and per capita state funding, the state argued that it had complied with the "maintenance of state financial support" (MFS) requirement because funding under a weighted-student model had remained constant. The Fifth Circuit denied Texas' petition for review and held that the weighted-student model contravenes the plain meaning of the MFS clause. The court explained that, under the weighted-student model, Texas may reduce the amount of funding for special education if it determines that the needs of children with disabilities have changed. In this case, Texas violated the plain requirements of the MFS clause by doing so and was therefore ineligible for the corresponding amount of future Individuals and Disabilities Education Act Part B grants. Finally, the MFS clause did not exceed Congress's spending power by failing to provide sufficiently clear notice of its requirements. View "Texas Education Agency v. United States Department of Education" on Justia Law

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A social security disability claimant does not have an absolute right to question medical consultants. The Fifth Circuit affirmed the denial of disability benefits to plaintiff, holding that disability claimants' interest in accurate disability decisions was adequately protected by the qualified right to question medical consultants they already enjoyed. The type of case-by-case assessment of need was common for procedural issues in disability cases. In this case, the ALJ did not abuse his discretion by refusing to issue the subpoena or interrogatories at issue. Accordingly, the court affirmed the denial of benefits. View "Barrett v. Berryhill" on Justia Law

Posted in: Public Benefits

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The Fifth Circuit affirmed the district court's denial of attorneys' fees for plaintiff under the Individuals with Disabilities Education Act (IDEA). The court held that the hearing officer's decision did not make plaintiff a prevailing party under the IDEA and thus she was not entitled to attorneys' fees. In this case, the officer's decision effected no change to plaintiff's educational plan, which the officer agreed was entirely appropriate despite lacking a prior autism diagnosis. Furthermore, the IDEA focuses, not on a student's diagnostic label, but on whether the student received appropriate education services, which the officer found plaintiff had received from the school district. View "Lauren C. v. Lewisville Independent School District" on Justia Law

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The Fifth Circuit affirmed the district court's judgment upholding a hearing officer's decision that the school district deprived plaintiff, a high school student with a disability, of a free and appropriate public education (FAPE) by failing to fulfill its Child Find duty in a timely manner. The court held that the district court did not reversibly err by concluding that taken together, the student's academic decline, hospitalization, and incidents of theft should have led the district to suspect her need for special education services by October 2014, at the latest. Therefore, the school district violated the Individuals with Disabilities Education Act's Child Find requirements by failing to identify, locate, and evaluate students with suspected disabilities within a reasonable time. The court also held that the student was a prevailing party entitled to attorneys' fees because she received a FAPE and thus achieved some of the benefit she sought in requesting the due process hearing. View "Krawietz v. Galveston Independent School District" on Justia Law

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The Fifth Circuit reversed the denial of social security benefits for plaintiff, a former physician and army veteran, who was diagnosed with post traumatic stress disorder (PTSD), depression, and bipolar disorder. The court held that the ALJ's decision was not supported by substantial evidence where the ALJ erred in finding for step two of the five-step approach that plaintiff's impairments were not severe. Accordingly, the court remanded for further consideration. View "Salmond v. Berryhill" on Justia Law

Posted in: Public Benefits

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The Fifth Circuit affirmed the district court's denial of social security disability benefits to plaintiff. The court held that the ALJ's decision not to follow the VA's 100% disability rating determination was supported by substantial evidence where the court considered, but ultimately rejected the VA's findings, in part because the VA relied heavily on a one-time evaluation by a doctor who had not formed a treating relationship with plaintiff. The court explained that reports by two state-agency consultants cut against the VA's determination, and it was emphatically the ALJ's province to weigh the evidence and decide among these competing accounts. The court rejected plaintiff's remaining claims. View "Garcia v. Berryhill" on Justia Law

Posted in: Public Benefits

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Plaintiff filed suit under the Individuals with Disabilities Education Act (IDEA), alleging that the school district did not offer her daughter a free appropriate public education (FAPE). On appeal, the school district challenged an award in favor of plaintiff. The Fifth Circuit held, without adopting the characterization that the district court created a new category of IDEA private school student, that the district court's order could not be supported based on a requirement of temporary services for transfer students; plaintiff took a financial gamble of not being reimbursed when she placed her daughter in a private school without first allowing the school district to seek to comply with its obligations under IDEA; and, although the district court failed to recognize the proper private school placement, that failure did not create a penalty beyond what otherwise would be owed. Because the district court erred by holding that the school district was obligated to provide temporary services and by ordering reimbursement of the costs associated with such services, the court reversed in part. The court affirmed the district court's holding that the school district failed to make a timely offer of FAPE, thereby making reimbursement an appropriate form of relief. The court remanded for the district court to determine the amount of reimbursement owed from April 24, 2014, to the end of the school year. View "Dallas Independent School District v. Woody" on Justia Law

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Claimants appealed the denial of civil claims under the Settlement Program that was established following the Deepwater Horizon oil spill. Claimants submitted Individual Economic Loss (IEL) claims for lost wages as employees of their architectural firm. The firm had already received a Business and Economic Loss (BEL) award under the Settlement Program. The Fifth Circuit held that the BEL framework, by compensating the business for the owners' lost wages through the fixed-cost designation of their wages, precluded compensating those same owners for the same wages through an IEL claim. Because the Settlement Program did not contemplate the requested compensation, the court affirmed the judgment. View "In Re: Deepwater Horizon" on Justia Law

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Maxmed sought judicial review of the Secretary of Health and Human Services' determination that the Medicaid program overpaid Maxmed by almost $800,000 for home health care services rendered to Medicare beneficiaries. The Fifth Circuit held that the failure to record the random numbers used in the sample did not necessarily invalidate the extrapolation methodology; the Secretary did not act arbitrarily and capriciously in rejecting the challenge to the independence of the sampling units; Congress clearly envisioned extrapolation in overpayment determinations involving home health agencies like Maxmed, and the Secretary's reliance on extrapolation as a tool was justified; the district court did not abuse its discretion in denying Maxmed's motion to amend or alter the judgment; and the district court properly rejected Maxmed's due process claim. Accordingly, the court affirmed the district court's grant of summary judgment to the Secretary. View "Maxmed Healthcare, Inc. v. Price" on Justia Law

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Plaintiff suffers from physical, cognitive, and psychological impairments. In this appeal, plaintiff challenged the denial of her social security disability benefits. The court concluded that the ALJ legally erred by rejecting an examining physician's opinion without explanation. In this case, the physician opined that plaintiff could not work any job that entailed standing for longer than 30 minutes or walking farther than 50 years. Accordingly, the court vacated and remanded for the ALJ to consider plaintiff's impairments, taking into account the examining physician's opinion. View "Kneeland v. Berryhill" on Justia Law

Posted in: Public Benefits