Justia U.S. 9th Circuit Court of Appeals Opinion Summaries

Plaintiff appealed the denial of social security benefits on the basis that she was not intellectually disabled. Plaintiff had received social security benefits because of her intellectual disability but the SSA concluded that she no longer qualified as disabled once she reached the age of 18. The court concluded that the ALJ had a duty to order further IQ testing and the ALJ's failure to do so was not harmless error. Accordingly, the court reversed and remanded for further proceedings.View "Garcia v. Comm's of Soc. Sec." on Justia Law

In these consolidated appeals, C.M's parents challenged the district court's decision affirming the OAH judge's conclusion that the District did not violate the Individuals with Disabilities Education Act (IDEA), 20 U.S.C. 1400-1487. The parents argued that the District violated the procedural requirements of the IDEA because it failed to properly incorporate C.M's Response-to-Intervention (RTI) data into C.M.'s initial evaluation and it failed to provide them with C.M.'s RTI data. The court concluded that the District did not fail to incorporate the RTI data into the evaluation, but that it violated the IDEA's procedural requirements by failing to provide the parents with the RTI data; the District's procedural violations prevented the parents from meaningfully participating in the individualized education program (IEP) process; and the court remanded for reconsideration of whether the parents were entitled to reimbursement for the cost of private instruction because C.M. was denied a free appropriate public education, and for attorneys' fees. The parents also contested three of the district court's rulings related to the first two OAH proceedings. The court concluded that the district court properly concluded that the parents' claim for reimbursement of the cost of Dr. Guterman's evaluation was moot; properly concluded that the parents' due process rights were not violated by a change in the wording of the issue presented; and correctly determined that two of the three claims raised in the second OAH proceeding were time-barred. Finally, the court remanded for consideration of the parents' reevaluation retaliation claim and affirmed as to the remaining claims.View "M.M. v. Lafayette Sch. Dist." on Justia Law

Plaintiff appealed the denial of his application for disability insurance benefits and supplemental security income. The court concluded that the ALJ improperly discounted the opinions of plaintiff's treating providers as to the severity of plaintiff's condition and his ability to work because the record revealed occasional indicia of improvement, a minimal capacity to perform basic chores, and some reliance by treating providers on plaintiff's self-reports. This was not an adequate evidentiary basis to reject the opinions of a treating physician or other treating providers. Even if plaintiff's expressed desire to receive disability benefits casts some doubt on the veracity of his testimony, standing alone, this scintilla of evidence cannot support an adverse credibility determination. Consequently, the ALJ's errors affected the ALJ's residual functional capacity assessment and his determination that plaintiff was unable to perform past relevant work as a kitchen helper and a commercial cleaner. Therefore, the court reversed the judgment of the district court and remanded for further proceedings.View "Ghanim v. Astrue" on Justia Law

E.M., who has an auditory processing disorder or a central auditory processing disorder, through his parents, filed suit against the district alleging that E.M. had been denied a free and appropriate public education (FAPE) pursuant to the Individuals with Disabilities Education Improvement Act of 2004 (IDEA), 20 U.S.C. 1400 et seq. The court concluded that plaintiffs failed to show that the district acted unreasonably in determining in 2005 that E.M. did not qualify for special education services under the "specific learning disability" category; the Department of Education's position that a central auditory processing disorder is eligible for consideration for benefits under the "other health impairment" category merits deference; but plaintiffs failed to show that the district acted unreasonably in not considering E.M. for benefits under the "other health impairment" category in 2005. Accordingly, the court affirmed the district court's denial of relief to plaintiffs. View "E.M. v. Pajaro Valley U.S.D." on Justia Law

Plaintiff appealed the denial of Social Security benefits. The court concluded that the ALJ erred in rejecting medical opinions, that she misunderstood a state examiner's opinion of plaintiff's impairments, and that she failed to meet the requirement of offering specific, clear, and convincing reasons for discrediting plaintiff's symptom testimony. The court reversed the district court's decision to remand the case to the ALJ for further proceedings and, instead, remanded to the district court with instructions to remand to the ALJ for a calculation and award of appropriate benefits. Plaintiff unquestionably satisfies all three conditions of the credit-as-true rule and a careful review of the record disclosed no reason to seriously doubt that she is, in fact, disabled. View "Garrison v. Colvin" on Justia Law

Arc challenged state officials' implementation of three new policies relating to state funding of home- and community-based services to developmentally disabled persons. California has reduced its funding for this program, as it has for other Medicaid-funded programs, 42 U.S.C. 1396-1396w-5, at various times. The court held that the district court abused its discretion in denying Arc's motion for a preliminary injunction because it misconstrued the Medicaid Act and applied deference to a federal agency decision where none was due; the court asserted pendant appellate jurisdiction over the dismissal of Arc's Medicaid Act claims, which relied on exactly the same reasoning, and reversed; the court could not go beyond correcting the district court's statutory interpretation to determining the propriety of preliminary injunctive relief; the primary state statute Arc challenges expired while the case was on appeal and, therefore, that challenge is moot; while the two other challenged statutes - the uniform holiday schedule and half-day billing rule - remain in effect, their impact was not the focus of the preliminary injunction proceeding and, therefore, the court remanded to allow augmentation of the record and reconsideration of the propriety of injunctive relief in the changed circumstances, applying the correct irreparable harm analysis. View "The Arc of California v. Douglas" on Justia Law

Plaintiff appealed the district court's order denying his motion for attorney's fees under the Equal Access to Justice Act (EAJA), 28 U.S.C. 2412. The court concluded that the underlying agency action lacked a reasonable basis in law because the Social Security ALJ disregarded competent lay witness evidence on plaintiff's symptoms without comment. The court concluded that, because the ALJ disregarded competent lay witness evidence without comment, the position of the United States in the underlying action was not substantially justified. Because the government's underlying position was not substantially justified, the court awarded fees, even if the government's litigation position may have been justified. Therefore, plaintiff was entitled to an award of attorney's fees. Accordingly, the court reversed and remanded. View "Tobeler v. Colvin" on Justia Law

PAMC appealed the district court's affirmance of the Secretary's decision denying PAMC its full Medicare Annual Payment Updated for the fiscal year 2009. PAMC claimed that the Department acted arbitrarily and capriciously when it refused to excuse PAMC's late filing of the required Reporting Hospital Quality Data for Annual Payment Updated (RHQDAPU) program data by the admittedly applicable deadline. The court concluded that PAMC neither pointed to any contrary or antithetical decisions by the Department under similar circumstances, nor otherwise demonstrated that the Board acted arbitrary or capriciously when it denied equitable relief. The court rejected PAMC's argument that the Board should have used the contract doctrine of substantial performance to excuse PAMC's failure to submit data at the proper time. The court did not view the Board's adherence to the policy of strict compliance with a deadline as arbitrary and capricious. Accordingly, the court affirmed the judgment of the district court. View "PAMC, LTD. v. Sebelius" on Justia Law

Plaintiff, a minor, challenged the district court's orders upholding the OAH's partial denial of reimbursement for educational costs under the Individuals with Disabilities Education Act (IDEA) in No. 12-55715 and granting in part and denying in part a related motion for attorney's fees in No. 12-56796. The district court affirmed the OAH's finding that the school districts denied the student a free appropriate public education for the 2007/2008 school year when they failed to comply with a previous settlement agreement's assessment requirements. The court concluded that the private placement was appropriate. As such, the child should be reimbursed for the cost of tuition. Because the court found that the private placement was an appropriate placement, the child was also entitled to transportation reimbursement; and the district court did not err in partially rejecting reimbursement for the cost of the private aides. Accordingly, the court affirmed in part and reversed in part No. 12-55715. The court dismissed No. 12-56796 for lack of jurisdiction to hear the untimely appeal of the district court's order on fees. View "S. L. v. Upland Unified Sch. Dist., et al." on Justia Law

In enacting comprehensive welfare reform in 1996, Congress rendered various groups of aliens ineligible for federal benefits and also restricted states' ability to use their own funds to provide benefits to certain aliens. As a condition of receiving federal funds, Congress required states to limit eligibility for federal benefits, such as Medicaid, to citizens and certain aliens. Plaintiffs filed suit claiming that Basic Health Hawai'i violated the Equal Protection Clause of the Fourteenth Amendment because it provided less health coverage to nonimmigrant aliens residing in Hawai'i (COFA Residents) than the health coverage that Hawai'i provided to citizens and qualified aliens who are eligible for federal reimbursements through Medicaid. The court concluded that Congress has plenary power to regulate immigration and the conditions on which aliens remain in the United States, and Congress has authorized states to do exactly what Hawai'i had done here - determine the eligibility for, and terms of, state benefits for aliens in a narrow third category, with regard to whom Congress expressly gave states limited discretion. Hawai'i has no constitutional obligation to fill the gap left by Congress's withdrawal of federal funding for COFA Residents. Accordingly, the court vacated the district court's grant of a preliminary injunction preventing Hawai'i from reducing state-paid health benefits for COFA Residents because Hawai'i is not obligated to backfill the loss of federal funds with state funds and its decision not to do so was subject to rational-basis review. View "Korab v. Fink" on Justia Law