Justia U.S. 7th Circuit Court of Appeals Opinion Summaries

Most federal employees receive health benefits through the Federal Employee Health Benefits Program (FEHBP). Until the 2010 enactment of the Patient Protection and Affordable Care Act (ACA), members of the U.S. Senate and House of Representatives, and their staff members, were eligible for FEHBP insurance. The ACA limited their options to plans created under the ACA or offered through a health insurance exchange established under the ACA; they could no longer receive insurance through the FEHBP (42 U.S.C. 18032(d)(3)(D)). The Office of Personnel Management conducted notice-and-comment rulemaking and issued the final rule, 78 Fed. Reg. 60653-01. Senator Johnson and his legislative counsel sought to enjoin implementation of that rule, which, they claimed, was contrary to the ACA and other law because it allows the government to make pre-tax employer contributions to non-FEHBP plans and makes members of Congress and their staffs eligible for an ACA insurance exchange reserved for small businesses. The Seventh Circuit affirmed dismissal, finding that the plaintiffs had not identified a judicially cognizable injury that is traceable to aspects of the OPM regulation that they challenge. The court noted that the challenged regulation creates a benefit for Senator Johnson and that he is free to decline that benefit. View "Johnson v. United States Office of Pers. Mgmt." on Justia Law

Enacted after the attacks of September 11, 2001, the Terrorism Risk Insurance Act (TRIA), authorizes execution, in satisfaction of judgments against terrorists, on blocked assets that are seized or frozen by the United States. The plaintiffs, victims of terror, hold a judgment against al Qaeda for their $2.5 billion subrogation claims. The Seventh Circuit vacated summary judgment in favor of plaintiffs. Although plaintiffs have constitutional and statutory standing and TRIA is a remedial statute, under the statute the only assets subject to execution are blocked assets. Assets that are subject to a United States government license for final payment, transfer, or disposition, among other requirements, do not qualify as blocked assets. By the time plaintiffs filed their initial claims, the Office of Foreign Assets Control had already issued its license and the funds had already been arrested to preserve them for forfeiture; the funds were no longer blocked. View "United States v. Art Ins.Co." on Justia Law

The plaintiff, then age 40, applied to the Social Security Commission in 2009 for benefits, claiming to be disabled from gainful employment as a result of psychiatric disorders (depression and bipolar disorder), chronic back and hip pain, and an anal fissure. He had been trained as a machinist and, until 2002, had worked intermittently as a machinist and an assembly line worker. The administrative law judge denied his claim on the ground that he was capable of performing unskilled sedentary work. The district court upheld the denial of benefits. The Seventh Circuit reversed, noting contradictions and gaps in the ALJ’s reasoning. The court did “not say that Voigt is in fact totally disabled from gainful employment, however— only that he’s entitled to a more careful analysis of his claim by the Social Security Administration.” View "Voigt v. Colvin" on Justia Law

Since 1982 Chicago has provided free or subsidized health care to certain retirees who receive pension benefits. In 2013 the ordinance establishing those benefits expired. After being notified that they would have to pay more for medical coverage in 2014, the retirees filed suit, alleging that any reduction of health care or increase in the retirees’ contribution toward it violated Art. XIII 5 of the Illinois Constitution, which says that “[m]embership in any pension or retirement system of … any unit of local government … shall be an enforceable contractual relationship, the benefits of which shall not be diminished or impaired” and the Contracts Clause of the U.S. Constitution. Following removal, the district court dismissed the suit, ruling that the Illinois Pensions Clause does not apply to health care. While the case was on appeal, the Supreme Court of Illinois held that the Pensions Clause applies to health benefits. The Seventh Circuit vacated, noting that the Illinois case did not address the exact issue in this case. Because the Supreme Court of Illinois has granted review of a similar case and because this suit began in state court, relinquishing supplemental jurisdiction is preferable to certifying questions to the state judiciary. View "Underwood v. City of Chicago" on Justia Law

Hall, an aviation mechanic, was discharged in 2001 by the military because of pain from an ankle injury. He was deemed by the Department of Veterans Affairs to be 70 percent disabled and to be “unemployable” in “a substantially gainful occupation” and totally disabled, 38 C.F.R. 4.16. In 2010 he applied for social security disability benefits on the ground that pain from his ankle injury, plus back and knee pain and other ailments, had worsened and rendered him totally disabled under Social Security Act standards. From 2005-2011 he underwent physical examinations and diagnostic tests. Some results were normal but many were not, revealing torn ligaments, obesity, possible arthritis, an “alignment problem” in his back, and fibromyalgia. Hall testified about his pain and inability to perform normal functions. The Seventh Circuit reversed the denial of benefits. Several doctors noted that Hall had been in pain when examined, which was some corroboration of his testimony. The ALJ could have resolved her doubts by ordering an MRI or directing a further examination by a medical expert. In addition, her failure to analyze and weigh the VA determination that Hall is totally disabled was a further oversight. View "Hall v. Colvin" on Justia Law

When the applicant was 15 years old, “Harrington rods” were inserted into his spine to correct a 57-degree curvature of the spine. He then developed chronic back pains. He also has cognitive difficulties. At age 20 he was determined to be eligible for social security disability benefits, but he later obtained a job at a nonprofit organization, driving disabled clients, helping with cooking and cleaning, and performing clerical tasks. The Social Security Administration determined in 1999 (when the applicant was 32) that he was not disabled and tried to recover the $65,000 in benefits. He declared bankruptcy. Three years later, he was fired because he could not keep up with the demands of the job. Two years later he reapplied for social security disability benefits. Several physicians and mental-health professionals diagnosed: chronic back pain; cubital tunnel syndrome; a somatoform disorder; depression, anxiety, panic attacks, agoraphobia, low intelligence, dizziness, migraine headaches, and deficient short-term memory. The applicant and his father testified to sleeplessness, loss of balance, blurred vision, and abdominal pain. The ALJ concluded that he was capable of unskilled light work of a routine and repetitive character and was not disabled. The Seventh Circuit reversed the denial of benefits, finding the opinion “riddled with errors.” View "Adaire v. Colvin" on Justia Law

Defendant-appellant Dr. Kamal Patel was a physician who commonly prescribed home health care services for his patients. Federal investigators learned that defendant had been receiving undisclosed payments from Grand Home Health Care. Patel was charged with six counts of violating (and one count of conspiring to violate) the Anti-Kickback Statute. During his bench trial, at the close of the government’s evidence, defendant moved to acquit, arguing that he had not “referred” any patients to Grand because there was no evidence that he steered or directed his patients to Grand; rather, the patients independently chose Grand as their provider after defendant prescribed home health care. The district court rejected that argument, holding that, even if a patient had initially chosen Grand, defendant “referred” the patient to Grand when he certified or recertified that the patient needed care, that the care would be provided by Grand, and that Grand could be reimbursed by Medicare for services provided. On appeal, defendant argued that the district court erred by holding that the certification and recertification, via a standardized Medicare form (Form 485), of patients for treatment constituted a “referral” under the Anti-Kickback Statute. He also argued that even if those certifications were referrals, there was insufficient evidence to conclude that Patel was paid “in return for” certifications, as required by the statute. Finding no reversible error, the Seventh Circuit affirmed the district court's judgment. View "United States v. Patel" on Justia Law

The Association of Administrative Law Judges, a union, represents the Social Security Administration’s administrative law judges in collective bargaining pursuant to the Federal Labor-Management Relations Act, 5 U.S.C. 7101. The Association and ALJs employed by the SSA sued, claiming that, by setting a goal that its ALJs decide 500-700 social security disability cases a year, the Administration has interfered with their decisional independence, in violation of the Administrative Procedure Act, 5 U.S.C. 554(d)(2), 3105. The district court dismissed the complaint for want of subject-matter jurisdiction, holding that the Civil Service Reform Act of 1978 precluded resort to the APA by creating remedies for “prohibited personnel practices” taken against federal employees, including “significant change in duties, responsibilities, or working conditions,” 5 U.S.C. 2302(a)(1), (2)(A)(xii), (b). The Seventh Circuit affirmed, holding that the remedy under the Administrative Procedure Act for interference with decisional independence does not extend to the incidental consequences of a bona fide production quota. View "Ass'n of Admin. Law Judges v. Colvin" on Justia Law

Sierra Club challenged the Environmental Protection Agency’s decisions to redesignate three geographic areas—Milwaukee-Racine, Greater Chicago, and the Illinois portion of the St. Louis area—as having attained the 1997 National Ambient Air Quality Standards for ozone under the Clean Air Act, 42 U.S.C. 7401. The CAA mandates that before redesignating an area, EPA must confirm not just that ozone in an area dropped below a certain level, but also that the improvement in air quality resulted from “permanent and enforceable reductions in emissions.” EPA interprets that edict to require a finding that the requisite ozone drops are “reasonably attributable” to permanent and enforceable reductions. Sierra Club argued that the Agency acted arbitrarily and capriciously in making this causation finding in each of the redesignations. The Seventh Circuit denied a petition for review. EPA demonstrated that it “examined the relevant data and articulated a satisfactory explanation for its action including a rational connection between the facts found and the choice made, that the Agency’s decision was based on a consideration of the relevant factors, and that the Agency has made no clear error of judgment.” View "Sierra Club v. United States Envtl. Prot. Agency" on Justia Law

Whitaker, formerly employed by Milwaukee County, alleged that she was discriminated against in violation of the Americans with Disabilities Act, 42 U.S.C. 12101 when the county failed to accommodate her disability by refusing to extend her period of medical leave, refusing to transfer her to another position, and then terminating her for reasons related to her disability. The district court granted the County summary judgment. The Seventh Circuit affirmed, upholding the district court’s conclusion that the complaint impermissibly went beyond the scope of the EEOC charge and that the County was not her “employer” under the statute. Although Milwaukee County was Whitaker’s official employer and was responsible for her compensation, it had no involvement in the principal decisions that she claims violated the statute and no authority to override those decisions, made by the State Department of Health Services. With respect to whether the County is liable for any of its own actions,. Whitaker’s allegations on these matters were outside the scope of her EEOC charge, and, therefore, not subject to judicial consideration. View "Whitaker v. Milwaukee Cnty." on Justia Law