Justia U.S. 2nd Circuit Court of Appeals Opinion Summaries

A neurologist submitted a Freedom of Information Act (FOIA) request to the United States Social Security Administration (SSA) seeking documents about how the SSA evaluates disability claims for migraines and other headache disorders. The SSA determined that this request was not directly related to the administration of any of its benefit programs. Relying on a provision in the Social Security Act (42 U.S.C. § 1306(c)), the SSA required the requester to pay the full cost of processing the request, which totaled $2,908. The requester paid the fee but later objected because the SSA did not respond within the statutory deadline set by FOIA.The United States District Court for the District of Vermont found in favor of the requester. The district court concluded that FOIA’s provision prohibiting fees when the agency fails to respond on time superseded the Social Security Act’s cost-reimbursement clause. As a result, the court ordered the SSA to refund the fee and awarded the requester attorneys’ fees and costs. The court reasoned that allowing the SSA to charge fees despite late responses would undermine the FOIA amendments designed to ensure agency timeliness.On appeal, the United States Court of Appeals for the Second Circuit considered whether the Social Security Act’s cost-reimbursement provision or FOIA’s fee-preclusion provision controlled. The Second Circuit held that the plain language of § 1306(c), which begins with a “notwithstanding” clause, explicitly exempts the SSA from FOIA’s fee rules for requests not directly related to program administration. The court agreed with the SSA’s determination that the request was not program-related and found the statute unambiguous. Therefore, the court reversed the district court’s judgment and vacated the award of attorneys’ fees and costs. View "Shapiro v. U.S. Soc. Sec. Admin." on Justia Law

The plaintiff, a former security guard, began experiencing panic attacks and anxiety, particularly when using public transportation, which ultimately led to the loss of his job. He was treated with medication, but continued to suffer from symptoms that interfered with his ability to work consistently. He applied for Supplemental Security Income and Social Security Disability Insurance, claiming disability from the time he was terminated due to his condition. The record included testimony from the plaintiff, a vocational expert, and five medical professionals, all of whom opined that he had at least moderate limitations in maintaining concentration, staying on task, and regular work attendance.After an initial denial by the Social Security Administration, the plaintiff requested a hearing before an Administrative Law Judge (ALJ). The ALJ found that the plaintiff had severe impairments but did not meet the criteria for a listed disability. Relying on some aspects of one consultative psychiatrist's opinion, and discounting others, the ALJ concluded that the plaintiff retained the residual functional capacity (RFC) to perform unskilled work in a goal-oriented setting, without finding any specific limitations on his ability to stay on task or maintain regular attendance. The vocational expert testified that an individual who was off task more than 10% of the workday or absent more than one day per month would be unable to maintain employment. The ALJ nonetheless found the plaintiff not disabled. The Appeals Council denied review, making the ALJ's decision final. The United States District Court for the Southern District of New York affirmed the denial.The United States Court of Appeals for the Second Circuit reviewed the administrative record de novo and concluded that the ALJ’s RFC finding was not supported by substantial evidence, particularly given the unanimous medical opinions regarding the plaintiff's limitations and the vocational expert’s testimony. The Second Circuit vacated the district court’s judgment and remanded the case to the Commissioner for further development of the record and reconsideration of the plaintiff’s application. View "Nunez v. Commissioner of Social Security" on Justia Law

Plaintiff-Appellant Mollie Marie Flinton applied for Social Security disability insurance and supplemental security income benefits in August 2015, citing mental health disabilities. Her application was initially denied, and she requested an administrative hearing. ALJ Mark Solomon, who was not properly appointed at the time, conducted the hearing and denied her benefits in March 2018. Flinton appealed, and the United States District Court for the Southern District of New York remanded the case for a new hearing in 2020. Despite the remand, Flinton appeared again before ALJ Solomon in August 2021, whose appointment had been ratified by then.The United States District Court for the Southern District of New York, presided over by Magistrate Judge Gary R. Jones, granted a motion for judgment on the pleadings in favor of the Commissioner of Social Security in September 2023. The court found that the ALJ’s decision was supported by substantial evidence and that remanding the case to a new ALJ was unnecessary, despite acknowledging the Appointments Clause challenge.The United States Court of Appeals for the Second Circuit reviewed the case and held that, pursuant to Lucia v. SEC, Flinton was entitled to a new hearing before a different, properly appointed ALJ. The court found that ALJ Solomon’s initial decision was invalid due to his improper appointment and that the subsequent hearing before the same ALJ did not cure the constitutional violation. The court vacated the district court’s decision and remanded the case to the Commissioner for a de novo hearing before a different, validly appointed ALJ. View "Flinton v. Comm'r of Soc. Sec." on Justia Law

Plaintiff Michelle Rubin applied for Social Security Disability Insurance benefits in 2019, citing major depressive disorder as her disabling condition. An administrative law judge (ALJ) denied her claim, concluding that Rubin was not disabled under the Social Security Act. Rubin exhausted the administrative appeals process and subsequently challenged the final decision in the United States District Court for the Southern District of New York, which affirmed the denial of benefits.The ALJ found that Rubin had not engaged in substantial gainful activity since her alleged onset date and had a severe impairment of major depressive disorder. However, the ALJ determined that Rubin did not meet the criteria for a listed impairment and had the residual functional capacity (RFC) to perform a full range of work with certain nonexertional limitations. The ALJ partially discounted the opinion of Rubin’s treating psychiatrist, Dr. Paul, who had opined that Rubin met the criteria for a listed impairment and was unable to work full-time. The ALJ also found that Rubin could not perform her past relevant work but could perform other jobs existing in significant numbers in the national economy.The United States Court of Appeals for the Second Circuit reviewed the case and found that the ALJ’s decision was not supported by substantial evidence. The court noted that the ALJ had misinterpreted the medical and lay evidence, failing to appreciate the consistent narrative that supported Dr. Paul’s opinion. The court concluded that the ALJ erred in determining that Rubin did not meet the criteria for a listed impairment, particularly the paragraph C criteria of Listed Impairment 12.04. The court vacated the district court’s judgment and remanded the case to the agency for further proceedings, including a fuller consideration of the existing evidence and the results of a consultative examination. View "Rubin v. O'Malley" on Justia Law

Plaintiff, MSP Recovery Claims, Series LLC (“MSP”) appealed from the district court’s judgment dismissing for lack of standing its putative class action against Defendant Hereford Insurance Company (“Hereford”) and denying leave to amend. MSP has brought several lawsuits around the country seeking to recover from insurance companies that allegedly owe payments to Medicare Advantage Organizations (“MAOs”) under the Medicare Secondary Payer Act (the “MSP Act”). In the putative class action brought here, MSP charges Hereford with “deliberate and systematic avoidance” of Hereford’s reimbursement obligations under the MSP Act.   The Second Circuit affirmed. The court concluded that MSP lacked standing because its allegations do not support an inference that it has suffered a cognizable injury or that the injury it claims is traceable to Hereford. The court also concluded that the district court did not abuse its discretion when it denied MSP leave to amend based on MSP’s repeated failures to cure. The court explained that the plain language of Section 111 provides that when a no-fault insurance provider such as Hereford reports a claim pursuant to Section 111, it does not thereby admit that it is liable for the claim. The statutory context of the section’s reporting obligation and the purpose of the reporting obligation confirms the correctness of this interpretation. Because MSP’s argument that the payments made by EmblemHealth are reimbursable by Hereford rests entirely on its proposed interpretation of Section 111, MSP has not adequately alleged a “concrete” or “actual” injury or that the injury it alleges is fairly traceable to Hereford. View "MSP v. Hereford" on Justia Law

Plaintiff filed for Social Security benefits, but her application was denied by the Social Security Commissioner. The Appeals Council denied review, which made the Commissioner’s decision final. Plaintiff appealed that decision to the district court, which denied her motion and granted the Commissioner’s motion for judgment on the pleadings. Plaintiff appealed that judgment.   The Second Circuit affirmed in part and remanded in part. The court held the district court failed to properly assess Plaintiff’s Residual Functional Capacity (RFC) with regard to her ability to work consistently as well as her limitations regarding social interactions, and that substantial evidence accordingly does not support the determination that Plaintiff’s psychological impairments do not render her disabled. By contrast, the court held that substantial evidence does support the determination that Plaintiff’s physical impairments do not render her disabled. View "Rucker v. Kijakazi" on Justia Law

Plaintiff filed a claim for Social Security benefits. In support of her disability claims, she presented the opinions of two of her treating physicians. After a hearing, an ALJ assigned partial weight to the treating physicians’ opinions, ultimately concluding that the plaintiff was not disabled. Congress has authorized federal courts to engage in a limited review of final SSA disability benefit decisions.Plaintiff argued that the ALF’s residual functional capacity (“RFC”) finding was not supported by substantial evidence. The court reasoned that in this instance, the ALJ had complete records such as medical opinions, treatment notes, and relevant test results. The court found that the plaintiff failed to identify any missing medical records, and therefore the ALJ did not err in failing to supplement the administrative record. Similarly, the ALJ found notable inconsistencies between the plaintiff's treating doctors' conclusions and the longitudinal records of the plaintiff’s physical health.Thus, the court concluded that substantial evidence supports the ALJ’s ultimate RFC determination. Finally, although the ALJ committed procedural error by failing to explicitly apply each of the factors listed in 20 C.F.R. Sec. 404.1527(c), the error was harmless because substantial evidence supported the ALJ's determinations. View "Schillo v. Saul" on Justia Law

The Second Circuit reversed the district court's denial in part of the law firm's motion for attorney's fees in a Social Security disability case. The court held that for a court to find an attorney's agreed-upon contingency fee unreasonable under 42 U.S.C. 406(b) on the sole ground that it constitutes a windfall, it must be truly clear that the high fee represents a sum unearned by counsel. In this case, the requested fee was not such a windfall and there is no other reason to think that the fee requested is unreasonable. Therefore, the court remanded with instructions to order the Social Security Administration to release the requested fee to the law firm. View "Fields v. Kijakazi" on Justia Law

Colgan, a teacher at a special education high school, attempted to break up a fight between students but either fell or was pushed into a wall, leading to serious injuries. Colgan’s injuries and symptoms persisted despite treatment from several medical sources. Her treating physician, Dr. Ward, a concussion specialist, found that Colgan satisfied the medical criteria for mild traumatic brain injury and post-concussion syndrome with persistent cognitive defects and fatigue, chronic post-traumatic headaches, sleep disturbance, and dizziness; Colgan's debilitating headaches severely hampered her ability to carry out activities of daily living and basic job-related functions.Colgan successfully applied for workers’ compensation benefits. In 2016, Colgan sought social security disability insurance benefits. An ALJ denied Colgan’s claim, concluding that she had the residual functional capacity (RFC) to perform sedentary work, subject to physical and cognitive limitations (42 U.S.C. 423(d)(1)(A)). The district court affirmed. The Second Circuit vacated. The ALJ’s factual determination with respect to Colgan’s RFC was not supported by substantial evidence. The ALJ misapplied the treating physician rule to Dr. Ward’s “check-box” medical opinion, which was supported by voluminous treatment notes gathered over almost three years of clinical treatment View "Colgan v. Kijakazi" on Justia Law

The Second Circuit affirmed the district court's judgment, which (A) declared the Board to be in violation of the Individuals with Disabilities Education Act (IDEA) for denying a free appropriate public education (FAPE) to disabled students between the ages of 21 and 22 while providing a free public education to nondisabled students in the same age range, and (B) permanently enjoined the Board and its successors, employees, and agents, etc., from terminating, on the basis of age, FAPEs for plaintiff class members who have not received a regular high school diploma before they reach the age of 22.The court concluded that the original plaintiff, D.J., had standing to bring the action where D.J. received ten months less of special education than he would have if not for the Board's enforcement of the challenged state regulation, thereby demonstrating injury for purposes of Article III standing. Furthermore, D.J.'s standing was entirely traceable to the Board's enforcement of the regulations at issue and the injury could be redressed by judicial action. On the merits, the court concluded that the district court did not abuse its discretion in interpreting the IDEA term "public education" to encompass free adult education programs offered by the State of Connecticut. The court considered all of the Board's arguments on appeal and found them to be without merit. View "A.R. v. Connecticut State Board of Education" on Justia Law