Articles Posted in Public Benefits

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Jozefyk applied for Disability Insurance Benefits and Supplemental Security Income, claiming disability based on several conditions, including degenerative changes in his cervical spine, lumbar strain, obesity, affective disorder, and anxiety disorder. An ALJ denied benefits. The district court and Seventh Circuit affirmed, rejecting Jozefyk’s arguments that the ALJ did not establish a valid waiver of attorney representation before allowing Jozefyk to proceed pro se and that the residual functional capacity finding did not account for Jozefyk’s moderate limitations in concentration, persistence, or pace. Jozefyk was sent several Social Security Administration communications, including a publication entitled “Your Right to Representation,” explaining his right to an attorney, organizations that could help him find an attorney, the fee structure, and the benefits of representation. In his request for a hearing, Jozefyk certified: “I do not have a representative. I understand that I have a right to be represented and that if I need representation, the Social Security office or hearing office can give me a list of legal referral and service organizations to assist me in locating a representative.” The ALJ offered to continue the hearing to give Jozefyk more time to find an attorney, but Jozefyk again stated that he wanted to proceed. Jozefyk cited self-reported symptoms that doctors, including his own treating physician, could not confirm. View "Jozefyk v. Berryhill" on Justia Law

Posted in: Public Benefits

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Since his March 2008, birth, L.D.R. has consistently received medical care in the fields of pediatrics, otolaryngology, pulmonology, psychology, and speech pathology. His mother first sought social security benefits on his behalf when he was one year old. L.D.R.’s health, development, and behavioral issues deteriorated and improved at various times. A child is disabled under social security income rules if the child has a “medically determinable physical or mental impairment, which results in marked and severe functional limitations” that “has lasted or can be expected to last for a continuous period of not less than 12 months,” 42 U.S.C. 1382c(a)(3)(C)(i). The Social Security Administration determined that L.D.R. was disabled as of August 2015, just before he enrolled in second grade. The Seventh Circuit rejected a request for retroactive payments and a challenge to the constitutionality of the law prohibiting an award of benefits for a period before the application for benefits. The AuSgust 2015 disability date was well supported in the ALJ’s decision, which considered in particular detail L.D.R.’s various conditions, their history, the treatments he received, and L.D.R.’s reactions to these treatments. The prohibition on pre-application benefits satisfies rational basis scrutiny. View "L.D.R. v. Berryhill" on Justia Law

Posted in: Public Benefits

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In 2010, Burmester applied for disability benefits alleging a 2008 onset of her disability. She described degenerative disc disease, pseudo-gout in her left knee, osteoarthritis in both knees and left thumb, a heart condition, and depression. Burmester’s education included one year of technical college; she worked as a hand-packager for many years. The application was denied. At a hearing, Burmester testified that her husband helped her out of bed, did the cooking, cleaning, and went grocery shopping and a friend helped with cleaning. Burmester was able to go to church; out to dinner once a month; use the computer to check her email and social media; and let her dog out. Following a remand, the ALJ again found that Burmester had the residual function capacity to perform light work, and was mentally limited to simple, routine, repetitive tasks requiring only simple work-related decisions and no more than occasional interaction with supervisors, coworkers, and the general public. Based on the testimony of a vocational expert, the ALJ found that Burmester could not continue her past relevant work but that a significant number of jobs existed in the national economy that Burmester could perform—such as router, price marker, or routing clerk. The district court and Seventh Circuit upheld the ALJ’s decision. The ALJ did not improperly evaluate Burmester’s credibility, nor erroneously reject the opinions of medical experts. The ALJ’s opinion that Burmester was not disabled was supported by substantial evidence. View "Burmester v. Berryhill" on Justia Law

Posted in: Public Benefits

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Hernandez filed a voluntary Chapter 7 bankruptcy petition in December 2016, reporting one sizable asset: a pending workers’ compensation claim valued at $31,000. To place that claim beyond the reach of creditors, she listed it as exempt under section 21 of the Illinois Workers’ Compensation Act, 820 ILCS 305/21, applicable via 11 U.S.C. 522(b). Two days after filing for bankruptcy, Hernandez settled the claim. Hernandez owed significant sums to three healthcare providers who treated her work-related injuries. The providers objected to her claimed exemption, arguing that 2005 amendments to the Illinois Act enable unpaid healthcare providers to reach workers’ compensation awards and settlements. The bankruptcy court denied the exemption and the district judge affirmed. The Seventh Circuit certified to the Illinois Supreme Court the question: Whether the Illinois Workers’ Compensation Act, as amended, allows care-provider creditors to reach the proceeds of workers’ compensation claims. The court noted that Section 21 has been interpreted by bankruptcy courts to create an exemption for these assets; 2005 amendments imposed a new fee schedule and billing procedure for care providers seeking remuneration. The Illinois Supreme Court has not addressed the interplay between these competing components of state workers’ compensation law. View "Hernandez v. Marque Medicos Fullerton, LLC" on Justia Law

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DeCamp, age 55, has a history of depression, drug overdoses, and suicidal thoughts. She overdosed on medication three times in October 2007. She attempted suicide and was cutting her legs. She also has a history of alcohol abuse. In 2010 DeCamp complained of headaches, and an MRI revealed a tumor in her pineal gland, which secretes hormones that regulate sleep cycles. A neurosurgeon noted that the mass was benign. The district court affirmed the denial of her application for Disability Insurance Benefits and Supplemental Security Income. The ALJ had made an adverse credibility determination and found that DeCamp would be off-task up to 10 percent of the workday. The Seventh Circuit remanded, finding that the ALJ failed to properly evaluation DeCamp’s limits with concentration, persistence, or pace. The ALJ focused her analysis on the doctors’ bottom-line conclusion that DeCamp was not precluded from working without giving the vocational expert any basis to evaluate all DeCamp’s impairments, including those in concentration, persistence, and pace. View "DeCamp v. Berryhill" on Justia Law

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Ray lives with diabetes, hypertension, obesity, kidney disease, degenerative disc disease, anxiety, and depression. When his conditions worsened, he began working gradually easier jobs, from janitor to forklift operator to bus monitor for children with special needs, until eventually, he gave up his employment entirely. An ALJ denied Ray’s application for Supplemental Security Income and Disability Insurance Benefits, finding that Ray was severely impaired by most of his physical conditions, but that the ALJ erroneously evaluated Ray’s symptoms and daily activities, misinterpreted medical evidence, and failed to ask why he skipped some appointments. he could perform his past relevant work as a school bus monitor. The Seventh Circuit vacated. The ALJ erroneously evaluated Ray’s symptoms and daily activities, misinterpreted medical evidence, and failed to ask why he skipped some appointments. Substantial evidence does not support the ALJ’s conclusion that Ray’s previous job was not a composite job. On remand, the ALJ should revisit her assessment of Ray’s mental impairment View "Ray v. Berryhill" on Justia Law

Posted in: Public Benefits

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Winsted was 42 years old when he applied for disability benefits, asserting an onset date of October 2010. Although he initially alleged he became disabled in 2005, two prior applications alleging this onset date were denied and deemed administratively final. Winsted suffers from multiple physical impairments, including degenerative disc disease, osteoarthritis, and anxiety, mostly associated with his previous work in hard labor as an industrial truck driver, a highway maintenance worker, and an operating engineer. An ALJ denied benefits, finding that Winsted could work with certain limitations. The district court affirmed. The Seventh Circuit remanded. The ALJ did not adequately explain how the limitations he placed on Winsted’s residual functional capacity accounted for the claimant’s mental difficulties; the ALJ did not consider Winsted’s difficulties with concentration, persistence, and pace. View "Winsted v. Berryhill" on Justia Law

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McHenry, a 49-year-old former hair stylist who suffers from several physical and mental disabilities, challenged the denial of her application for Social Security disability benefits. The ALJ had concluded that, although McHenry suffers from degenerative disc disease and fibromyalgia, she lacked sufficient medical evidence that the conditions were disabling, and that she was not credible about her limitations. The district court affirmed. The Seventh Circuit vacated. The ALJ erred by failing to have a medical expert review a consequential MRI report. The court rejected arguments that the ALJ improperly determined McHenry’s residual functional capacity by not accounting for McHenry’s anxiety-related limits on social functioning and limits in her ability to sustain concentration because of her medications’ side effects and by discounting McHenry’s credibility. View "McHenry v. Berryhill" on Justia Law

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Ross worked as a coal miner for approximately 30 years. He smoked cigarettes for almost as long but was able to quit after his first heart attack. Ross continued to work as a coal miner even though he suffered another heart attack and had difficulty breathing at work. Approximately six years after Ross stopped working in the coal mines, his breathing problems became severe. In 2012, Ross sought benefits under the Black Lung Benefits Act, 30 U.S.C. 901. The Department of Labor’s Benefits Review Board vacated a denial. On remand, the ALJ granted Ross’s claim. The Board affirmed. The Seventh Circuit enforced the decision. Rejecting a due process argument, the court noted the employer had the opportunity to argue its case twice before the ALJ and twice before the Board, including the chance to submit supplemental medical opinion evidence. A theory that something must be amiss because the ALJ changed his mind on remand is particularly unpersuasive here because the parties submitted five additional medical opinions after the Board’s second decision. Ross proved by a preponderance of the evidence that he was totally disabled. View "Consolidation Coal Co. v. Director, Office of Workers’ Compensation Programs, United States Department of Labor" on Justia Law

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Neighbors is a skilled nursing facility participating in Medicare and Medicaid. The Centers for Medicare and Medicaid Services (CMS) determined that Neighbors inadequately addressed sexual interactions between three cognitively impaired residents and that Neighbors’ failure to act put the residents in “immediate jeopardy,” and issued Neighbors a citation and an $83,800 penalty under 42 U.S.C. 1395i‐3(h)(2)(B)(ii)(I). An ALJ and the Department of Health and Human Services Departmental Appeals Board upheld the decision. The Seventh Circuit affirmed, concluding that substantial evidence supports the Agency’s determinations and rejecting claims that the sexual interactions were consensual. The court noted findings that staff, aware of the sexual interactions, did not talk to the residents about their feelings about these “relationships”; did not document the residents’ capacity for consent (or lack thereof) or communicate with residents’ physicians for medical assessment of how their cognitive deficits impacted that capacity; did not discuss the developments with the residents’ responsible parties; and did not record any monitoring of the behaviors or make any care plans to account for them. Neighbors’ non‐intervention policy prevented any real inquiry into consent, except in the extreme situation where a resident was yelling or physically acting out. View "Neighbors Rehabilitation Center, LLC v. United States Department of Health and Human Services" on Justia Law