disability benefits

Arellano v. McDonough

Issues

Does the rebuttable presumption of equitable tolling, which would allow a veteran to apply for disability benefits past the normal deadline, apply to 38 U.S.C. § 5110(b)(1), and if so, has the Government rebutted that presumption?

38 U.S.C. § 5110(b)(1) allows veterans who apply for disability compensation benefits within one year of discharge from the military to have retroactive disability compensation benefits counted from the date of discharge instead of the date of application for benefits. In this case, the Supreme Court will determine whether equitable tolling, an exemption to statutes of limitations under which plaintiffs who could not discover the basis to bring their lawsuits until after the expiration of the limitations period may bring a claim, applies to this one-year deadline. Although 38 U.S.C. § 5110(b)(1) does not have an explicit statute of limitation, Arellano argues that the statute functionally serves as a statute of limitations and that the Court has held that equitable tolling applies by default to functional statutes of limitations, including those applicable to suits against the government. McDonough counters that § 5110(b)(1) is not a statute of limitations, and that if Congress intended to allow equitable tolling to apply to the statute, it would have explicitly stated so in the law. The Court’s decision in this case will impact veterans’ welfare and the speed and procedure of disability claims administration.

Questions as Framed for the Court by the Parties

(1) Whether the rebuttable presumption of equitable tolling from Irwin v. Department of Veterans Affairs applies to the one-year statutory deadline in 38 U.S.C. § 5110(b)(1) for seeking retroactive disability benefits, and, if so, whether the government has rebutted that presumption; and (2) whether, if 38 U.S.C. § 5110(b)(1) is amenable to equitable tolling, this case should be remanded so the agency can consider the particular facts and circumstances in the first instance.

Congress has authorized disability benefits under 38 U.S.C. § 1110 for veterans who suffered disabilities during their service. Arellano v. McDonough at 1061. The size of the benefits is partly determined by the effective date of the award.

Acknowledgments

The authors would like to thank Professor Kevin M. Clermont for his guidance and insights into this case.

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Biestek v. Berryhill

Issues

Can a vocational expert’s testimony in a Social Security disability benefits hearing constitute substantial evidence of job availability if the vocational expert does not provide the data underlying their conclusions upon the applicant’s request?

This case asks the Supreme Court to decide whether a vocational expert’s testimony can constitute substantial evidence of job availability when a Social Security disability claimant requests but is not suppled with the data underlying that expert’s testimony. Petitioner Michael J. Biestek contends that the substantial evidence standard requires vocational experts to produce the underlying data upon an applicant’s request; otherwise, the expert’s testimony is unverifiable and allows the expert’s word to be unlawfully substituted for actual substantial evidence. Respondent Nancy A. Berryhill, the acting Commissioner of Social Security, counters that the substantial evidence standard focuses on the contents of the hearing record, not the procedure used to make that record. Additionally, Berryhill responds that plaintiffs already effectively undercut a vocational expert’s testimony on cross-examination and thus do not need to review the expert’s data. The outcome of this case will have large implications on litigation strategy in Social Security disability claims, for both claimants and the government.

Questions as Framed for the Court by the Parties

Whether a vocational expert’s testimony can constitute substantial evidence of “other work,” 20 C.F.R. § 404.1520(a)(4)(v), available to an applicant for social security benefits on the basis of a disability, when the expert fails upon the applicant’s request to provide the underlying data on which that testimony is premised

In March 2010, Biestek applied to the Social Security Administration (“SSA”) for Supplemental Social Security Income and benefits under 40 C.F.R. § 404, alleging that he had been disabled and unable to work since October 2009. Biestek v. Comm’r of Soc. Sec. at 2.

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disability law

Disability law refers to laws related to individuals with disabilities; specifically, these laws protect disabled individuals from certain kinds of discrimination. Disability laws are particularly concerned with employment, housing, education, and access to public services.

George v. McDonough

Issues

Did the Department of Veterans’ Affairs commit a clear and unmistakable error when it denied veteran disability benefits based on the agency’s interpretation of the law at the time, which was found to be erroneous by the agency’s later interpretation?

This case asks the Supreme Court to decide whether an agency commits “clear and unmistakable error” when it denies benefits to a veteran by relying on a binding regulation that is later invalidated. Petitioner Kevin George enlisted in the military when he was seventeen years old and was later medically discharged when he was diagnosed with schizophrenia. George sought benefits for the aggravation of his symptoms but was denied because the Board of Veterans’ Appeals relied on a later-invalidated regulation that incorrectly interpreted the statutory requirements for proving aggravation. After the regulation was invalidated in the early 2000s, George brought a claim for revision of the Board’s decision. The Federal Circuit Court, however, denied George’s claim, concluding that the agency had correctly relied on the law as interpreted at the time of its decision. George claims that an agency commits clear and unmistakable error when relying on later invalidated regulations. Respondent Denis McDonough, the Secretary of Veterans Affairs, counters that agencies do not commit clear and unmistakable error when relying on binding regulations in existence at the time of decision making. This case has important implications for military veterans’ benefits claims and the efficiency of Veterans’ courts.

Questions as Framed for the Court by the Parties

Whether, when the Department of Veterans’ Affairs denies a veteran’s claim for benefits in reliance on an agency interpretation that is later deemed invalid under the plain text of the statutory provisions in effect at the time of the denial, that is the kind of “clear and unmistakable error” that the veteran may invoke to challenge VA’s decision.

The Department of Veterans’ Affairs (“VA”) administers a federal program that provides disability benefits to United States military veterans. See George v. McDonough at 1229. The VA does not give benefits to veterans for disabilities which existed before the veteran’s time in the military except for those noted at the time of the veteran’s examination.

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Hardt v. Reliance Standard Life Insurance

Issues

Whether ERISA § 502(g)(1) requires a party to be a prevailing party before a court can award attorney fees, and if so, whether Hardt satisfies that standard.

 

Petitioner, Bridget Hardt (“Hardt”), a former employee of Dan River Inc., brought suit against Respondent, Reliance Insurance Co. (“Reliance”), the insurance provider for Dan River Inc., in an attempt to recover attorney’s fees for a previous suit Hardt had brought in the Eastern District of Virginia to recover benefits pursuant to Dan River Inc.’s Group Long-Term Disability Insurance Program Plan (“the Plan”). The Eastern District remanded the case to Reliance, which, under ERISA, not only administers the Plan, but also decides whether an applicant is entitled to benefits. On remand, Reliance provided Hardt with the requested benefits. Hardt now sues seeking attorney’s fees under ERISA § 502(g)(1). Reliance counters that Hardt did succeed on the merits in the lower court and, therefore, cannot satisfy ERISA’s definition of “prevailing party.” Hardt, on the other hand, argues that the text of the statute does not include a prevailing party standard as a prerequisite to recovering attorney fees. In this case, the Supreme Court will decide whether ERISA § 502(g)(1) requires a party to succeed on the merits before attorney’s fees may be awarded and, if so, whether Hardt satisfies that requirement.

Questions as Framed for the Court by the Parties

1. Whether the Fourth Circuit erred in holding that ERISA § 502(g)(1) provides a district court discretion to award reasonable attorney's fees only to a prevailing party? 

2. Whether a party is entitled to attorney's fees pursuant to § 502(g)(1) when she persuades a district court that a violation of ERISA has occurred, successfully secures a judicially-ordered remand requiring a redetermination of entitlement to benefits and subsequently receives the benefits sought on remand?

Bridget Hardt, worked as an executive assistant to the president of a textile manufacturer, Dan River Inc.; in 2000, she was diagnosed with carpal tunnel syndrome (“CTS”) and had surgery on both wrists to relieve the pain. See Hardt v. Reliance Standard Life Ins. Co., 336 Fed. Appx.

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·      Wex: Law about ERISA

·      Department of Labor: Health Plans & ERISA

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Henderson v. Shinseki

Issues

Does equitable tolling apply to Section 7266(a) of the Veterans Judicial Review Act, which sets a 120-day time limit for veterans to file a notice of appeal with the Court of Appeals for Veterans Claims?

 

David Henderson, a veteran of the Korean War, was discharged after being diagnosed with paranoid schizophrenia. After receiving a final decision from the Department of Veterans Affairs denying his request for home care, Henderson had 120 days to file notice of his intent to appeal. Henderson failed to file until 15 days after the deadline had passed and claimed that his illness prevented him from filing on time. Appearing pro se, Henderson requested the Veterans Court apply equitable tolling to permit his appeal. The court denied Henderson’s request but then requested pro bono counsel to assist Henderson in filing for rehearing. While the request for rehearing was in process, the Supreme Court of the United States decided Bowles v. Russell. The lower courts interpreted Bowles to mean that all statutory deadlines for filing appeals are jurisdictional, and therefore Henderson’s request for equitable tolling was rejected because the court could not hear the case. The Supreme Court’s decision will clarify how lower courts should evaluate statutory time limits and will help determine which procedural limits are jurisdictional and thus not subject to equitable tolling.

Questions as Framed for the Court by the Parties

Section 7266(a) of Title 38, U.S.C., establishes a 120-day time limit for a veteran to seek judicial review of a final agency decision denying the veteran's claim for disability benefits. Before the decision below, the Federal Circuit in two en banc decisions held that Section 7266(a) constitutes a statute of limitations subject to the doctrine of equitable tolling under this Court's decision in Irwin v. Department of Veterans Affairs, 498 U.S. 89 (1990). In the divided en banc decision below, however, the Federal Circuit held that this Court's decision in Bowles v. Russell, 551 U.S. 205 (2007), superseded Irwin and rendered Section 7266(a) jurisdictional and not subject to equitable tolling.

The question presented is whether the time limit in Section 7266(a) constitutes a statute of limitations subject to the doctrine of equitable tolling, or whether the time limit is jurisdictional and therefore bars application of that doctrine. 

Petitioner David Henderson is a Korean War veteran who was discharged from active duty in 1952 due to paranoid schizophrenia. See Henderson v. Shinseki, 589 F.3d 1201, 1203 (Fed. Cir.

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MetLife v. Glenn

Issues

Given that an administrator of an ERISA plan has a conflict of interest because it both pays claims and determines whether claims are eligible for payment, how much weight should a court give that conflict of interest in deciding whether the administrator abused its discretion regarding a claim?

 

The Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001 et seq., provides a private cause of action for employees challenging wrongful denials of benefits under an employee benefits plan. Under ERISA, Wanda Glenn challenged MetLife's discontinuation of her disability benefits on the ground that the company faced a conflict of interest by both determining eligibilities for benefits payments and making these same payments. The U.S. District Court for the Southern District of Ohio affirmed MetLife's discontinuation of benefits. The U.S. Court of Appeals for the Sixth Circuit, siding with five other Circuits, ruled that a court reviewing a claims-denial must consider whether and to what extent a plan administrator's conflict of interest may have affected its determination of benefits. In this case, the U.S. Supreme Court will determine whether and to what extent a plan administrator that both authorizes the payment of benefits and is responsible for the payment of those benefits has a conflict of interest that must be considered on judicial review.

Questions as Framed for the Court by the Parties

If an administrator that both determines and pays claims under an ERISA plan is deemed to be operating under a conflict of interest, how should that conflict be taken into account on judicial review of a discretionary benefit determination?

In 1989, Wanda Glenn's heart suddenly stopped. Glenn v. MetLife, 461 F.3d 660, 663 (6th Cir.

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Soto v. United States

Issues

Does 10 U.S.C. § 1413a, a statute that authorizes combat-related special compensation for veterans, provide a settlement mechanism to be used instead of the default mechanism in the Barring Act?

This case asks the Supreme Court to clarify the procedures used when granting combat-related special compensation (“CRSC”)—specifically, whether the statute enacting CRSC also provides a settlement mechanism. Generally, military-related claims are governed by the Barring Act, which has a six-year statute of limitations. Soto argues that the Barring Act does not apply here because the CRSC-enacting statute provides its own mechanism for settling claims, thereby displacing the Barring Act. The United States instead asserts that the Barring Act is only displaced when a statute explicitly grants settlement authority, which is not granted in the CRSC statute, and that applying a different rule would be contrary to prior decisions. This case raises important questions regarding combat-wounded veterans’ access to compensation and the administrative and legal burden on the government. 

Questions as Framed for the Court by the Parties

Given the U.S. Court of Appeals for the Federal Circuit’s holding that a claim for compensation under 10 U.S.C. § 1413a is a claim “involving … retired pay” under 31 U.S.C. § 3702(a)(1)(A), does 10 U.S.C. § 1413a provide a settlement mechanism that displaces the default procedures and limitations set forth in the Barring Act? 

Typically, retired veterans must waive a portion of their retirement pay in order to receive disability pay. Soto v. United States at 2. However, under 10 U.S.C.

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