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

Articles Posted in Public Benefits

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After appellant successfully litigated her claim to supplemental social security income, she challenged the district court's denial of her application for attorney's fees under 42 U.S.C. 406(b). The Second Circuit affirmed the denial of appellant's attorney's fee application as untimely, because she filed well beyond the 14 days prescribed by Federal Rule of Civil Procedure 54(d)(2)(B). Assuming the court would entertain appellant's argument, it failed on the merits because she provided no factual basis to support a claim that it was reasonable to delay the filing of her section 406(b) application for more than six months after she received notice of the benefits calculation on remand. View "Sinkler v. Berryhill" on Justia Law

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The Second Circuit held that the district court properly deferred to the decision of the New York State Review Officer (SRO), which concluded that student W.E. was not denied a free and appropriate public education (FAPE) for the eighth grade school year and that Northwood School was not an appropriate unilateral private school placement for the ninth grade school year. Accordingly, the court affirmed the district court's November 2016 judgment and order in part. To the extent that the district court failed to accord appropriate deference to the SRO's conclusion that Northwood did not provide W.E. specially designed instruction so as to constitute an appropriate private school placement for the tenth grade school year, the court reversed in part the district court's opinion and vacated the award of tuition reimbursement to plaintiffs for that school year. The court also affirmed a July 2017 opinion and order granting the district court's grant of summary judgment and vacating the award of compensatory education for the eighth grade year. View "W.A.v. Hendrick Hudson Central School District" on Justia Law

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The Second Circuit vacated the district court's decision affirming the Commissioner's denial of social security disability benefits. The court held that the ALJ failed to comply with the procedural mandates of the treating physician rule where it explicitly failed to consider the first Burgess factor before assigning "little weight" to the opinion of plaintiff's treating psychiatrist. Furthermore, there was a lack of other "good reasons" to support that decision. Accordingly, the court remanded for the ALJ to reconsider plaintiff's claim for disability benefits consistent with the procedural mandates of the Social Security Act and this court. View "Estrella v. Berryhill" on Justia Law

Posted in: Public Benefits

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The Coalition filed suit on behalf of its foster parent members, alleging that the State pays foster parents members inadequate rates to cover the costs of caring for their foster children, in violation of the Adoption Assistance and Child Welfare Act of 1980. The Second Circuit affirmed the district court's finding that the Coalition has standing to sue on behalf of its members under Nnebe v. Daus, 644 10 F.3d 147 (2d Cir. 2011) and rejected the State's argument that the Coalition was barred by the third‐party standing rule. However, the court reversed the district court's dismissal of the Coalition's claims and joined the Sixth and Ninth Circuits in holding that the Act creates a specific entitlement for foster parents to receive foster care maintenance payments, and that this entitlement was enforceable through 42 U.S.C. 1983. Accordingly, the court vacated the order dismissing the case and remanded for further proceedings. View "New York State Citizens' Coalition for Children v. Poole" on Justia Law

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The Second Circuit reversed the district court's decision upholding the denial of plaintiff's application for disability insurance benefits. The court held that the Commissioner's decision was not supported by substantial evidence because it relied on testimony from a vocational expert that appeared to be in conflict with the authoritative guidance set out in the Department of Labor's Dictionary of Occupational Titles. In this case, the Commissioner was not entitled to rely on this testimony without first identifying and inquiring into the apparent conflict. Therefore, the district court erred by declining to set aside the Commissioner's benefits decision. View "Lockwood v. Commissioner" on Justia Law

Posted in: Public Benefits

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The Second Circuit granted a petition for review of the Commissioner's decision adopting the Department of Appeals Board's (DAB) decision and imposition of an assessment and penalty for petitioner's failure to report work activity while receiving Social Security disability insurance (SSDI) benefits. Although the court agreed that petitioner's failure to report work activity was "material" and thus authorized the Commissioner to impose an assessment and penalty, the court held that the DAB lacked substantial evidence to support the amounts of the assessment and penalty it imposed. In this case, petitioner's earnings from work activity did not amount to "substantial gainful activity," he remained disabled while failing to report work activity, and the findings of fact on which the DAB relied established only that petitioner's work was "sporadic." Therefore, the court vacated the DAB's decision and remanded for further proceedings. View "Cappetta v. Commissioner of Social Security Administration" on Justia Law

Posted in: Public Benefits

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New York's intestacy law, as it existed in 2013 at the time of the agency's final determination, did not permit children conceived posthumously to inherit via intestacy. In this case, plaintiff had conceived twins via in vitro fertilization eleven years after her husband, the donor spouse, died. Plaintiff filed applications for child's survivors' benefits, based on her husband's earnings history, with the Social Security Administration. The Second Circuit held that, under the applicable provisions of New York's Estates, Powers and Trusts Law (EPTL) in effect at and prior to the time of the agency's final decision, the twins were not entitled to inherit from the decedent in intestacy. Accordingly, the court affirmed the district court's denial of benefits. View "MacNeil v. Berryhill" on Justia Law

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Plaintiffs Chorches and Fabula filed a qui taim suit under the False Claims Act (FCA), 31 U.S.C. 3729 et seq., against AMR, alleging that AMR made false statements and submitted false Medicare and Medicaid claims. Plaintiff Fabula also alleged a retaliation claim. The Second Circuit vacated the district court's dismissal of the claims and held that Chorches has pled the submission of false claims with sufficient particularity under Fed. R. Civ. P. 9(b), as applied in the qui tam context, and that Fabula's refusal to falsify a patient report, under the circumstances of this case, qualified as protected activity. Accordingly, the court remanded for further proceedings. View "Fabula v. American Medical Response, Inc." on Justia Law

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Plaintiff, on behalf of herself and her son, K.T., filed suit under the Individuals with Disabilities Education Act (IDEA), 20 U.S.C. 1400 et seq., against the DOE. At issue is the adequacy of three individualized education programs (IEP), which were characterized by a pattern of procedural violations of the IDEA committed by the DOE, and whether these errors deprived K.T. of a free appropriate public education (FAPE) for a period of three consecutive years. The court concluded that the procedural violations in formulating each IEP, when taken together, deprived K.T. of a FAPE for each school year. The DOE displayed a pattern of indifference to the procedural requirements of the IDEA and carelessness in formulating K.T.’s IEPs over the period of many years, repeatedly violating its obligations under the statute, which consequently resulted in the deprivation of important educational benefits to which K.T. was entitled by law. Accordingly, the court reversed the judgment of the district court and remanded for further proceedings. On remand, the district court is directed to consider, in the first instance, what, if any, relief plaintiff is entitled to as an award for K.T.'s FAPE deprivations. View "L.O. ex rel. K.T. v. N.Y.C. Dep’t of Educ." on Justia Law

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Plaintiff filed a class action against the Commissioner, challenging New York’s coverage restrictions on certain medical services provided under its Medicaid plan. Plaintiffs argued that New York’s 2011 plan amendments, which restrict coverage of orthopedic footwear and compression stockings to patients with certain enumerated medical conditions, violate the Medicaid Act’s, 42 U.S.C. 1396 et seq., reasonable standards, home health services, due process, and comparability provisions, as well as the anti‐discrimination provision and integration mandate of Title II of the Americans with Disabilities Act (ADA), 42 U.S.C. 12131 et seq., and section 504 of the Rehabilitation Act, 29 U.S.C. 794. Because neither the Medicaid Act nor the Supremacy Clause confers a private cause of action to enforce the reasonable standards provision, the court vacated the district court’s grant of summary judgment to plaintiffs on that claim; the court declined to reach plaintiffs’ unequal treatment claim under the ADA and Rehabilitation Act as largely duplicative of their integration mandate claim; and the court affirmed the summary judgment rulings with respect to the remaining claims. Defendant is entitled to summary judgment on plaintiffs' home health services plan because orthopedic footwear and compression stockings constitute optional “prosthetics” rather than mandatory “home health services” under the Medicaid Act; defendant is entitled to summary judgment on the hearing element and plaintiffs are entitled to summary judgment on the notice element of plaintiffs’ due process claim, because the due process provision required New York to provide plaintiffs with written notice – though not evidentiary hearings – prior to terminating their benefits; plaintiffs are entitled to summary judgment on their comparability provision claim because New York’s coverage restrictions deny some categorically needy individuals access to the same scope of medically necessary services made available to others; and plaintiffs are entitled to summary judgment on their anti‐discrimination claims because New York’s restrictions violate the integration mandate of the ADA and Rehabilitation Act. Finally, the court vacated the injunction and remanded for further consideration on the appropriate relief because the injunction is broader than is warranted by the court's liability conclusions. View "Davis v. Shah" on Justia Law