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

Decker employed Pehringer at its Montana open-pit surface mine, 1977-1999. There were periods when Pehringer did not work, including a roughly three-year-long strike. For most of his mining career, Pehringer was regularly exposed to coal dust while working primarily as a heavy equipment operator. After being laid off in 1999, Pehringer was awarded Social Security total disability benefits. He never worked again. In 2014 a month before his sixty-fifth birthday, Pehringer sought black lung benefits, citing his severe COPD, 30 U.S.C. 923(b). A physician determined that “Pehringer is 100% impaired from his COPD” and that coal “dust exposure and smoking are significant contributors to his COPD impairment.”The Benefits Review Board affirmed a Department of Labor (DOL) ALJ’s award of benefits. The Ninth Circuit affirmed, first rejecting a constitutional challenge to 5 U.S.C. 7521(a), which permits removal of an ALJ only for good cause determined by the Merits Systems Protection Board. DOL ALJ decisions are subject to vacatur by people without tenure protection; properly appointed, they can adjudicate cases without infringing the President’s executive power. The ALJ did not err in adjudicating Pehringer’s claim nor in rejecting untimely evidentiary submissions. Decker did not rebut the presumption of entitlement to benefits after a claimant established legal pneumoconiosis and causation, having worked for at least 15 years in substantially similar conditions to underground coal mines. View "Decker Coal Co. v. Pehringer" on Justia Law

The Ninth Circuit reversed the district court's grant of summary judgment in favor of Agendia in an action alleging that the HHS wrongfully denied its claims for reimbursement for diagnostic tests under the Medicare health insurance program. Agendia contends that the denial was improper because the local coverage determination was issued without notice and opportunity for comment in violation of a provision of the Medicare Act—specifically, 42 U.S.C. 1395hh.The panel held that section 1395hh's notice-and-comment requirement does not apply to local coverage determinations, and that the district court erred in interpreting the statute otherwise. The panel rejected Agendia's alternative argument that the Medicare Act and its implementing regulations have unconstitutionally delegated regulatory authority to Medicare contractors by permitting them to issue local coverage determinations. The panel held that, because those contractors act subordinately to the HHS officials implementing Medicare, there is no unconstitutional delegation. View "Agendia, Inc. v. Becerra" on Justia Law

The Ninth Circuit affirmed the district court's preliminary injunction ordering E.E.'s current educational placement as his "stay put" placement during the pendency of judicial proceedings in a suit brought under the Individuals with Disabilities Education Act (IDEA).The panel concluded that the ALJ acted without legal authority in determining that E.E.'s potential future placement in the 2020 individualized education plan (IEP) constituted his current placement for purposes of E.E.'s stay put placement. Therefore, because the ALJ acted ultra vires, her stay put determination was void. Consequently, the parents' stay put motion did not seek to modify an existing stay put order, so the district court correctly entered an automatic preliminary injunction pursuant to Joshua A. v. Rocklin Unified Sch. Dist., 559 F.3d 1036, 1037 (9th Cir. 2009). Furthermore, the school district's proposed exception to the stay put provision is not supported by either the text of the IDEA or any other legal authority, and the panel declined to adopt it. View "E.E. v. Norris School District" on Justia Law

The Ninth Circuit affirmed the denial of social security disability benefits to claimant. At issue is whether knowledge of the Social Security Administration's longstanding interpretation of the term "medium work" as requiring standing or walking for approximately six hours out of an eight-hour workday can be imputed to a qualified vocational expert.The panel held that an expert in this field is presumptively aware of the agency's well-established definition of this term of art. Therefore, when the ALJ asked the expert in this case whether jobs existed for a hypothetical individual who was limited to medium work, that question adequately communicated the term's attendant standing and walking limitations. In this case, it follows that the expert's resulting testimony that a significant number of jobs existed in the national economy for an individual with claimant's limitations constituted substantial evidence in support of the ALJ's determination that he was not disabled within the meaning of the Social Security Act. View "Terry v. Saul" on Justia Law

The Ninth Circuit affirmed the district court's judgment affirming the ALJ's denial of claimant's application for Supplemental Security Income (SSI) under the Social Security Act. The panel published this decision to draw attention to the government's incorrect description, in its briefs in this and in other recent SSI cases, of the standard of review.In an SSI case, the panel reviews the decision of the ALJ for substantial evidence. If substantial evidence in the record supports the ALJ's decision, the panel must defer to the ALJ. In the absence of substantial evidence, however, the panel must set aside the ALJ's decision. The panel is not restricted to setting aside the ALJ's decision only when the evidence in the record compels a contrary conclusion. The panel rejected the government's application of I.N.S. v. Elias-Zacarias, 502 U.S. 478 (1992), which is an immigration case, and clarified that Elias-Zacarias does not describe the standard of review in an SSI case. In this case, considering the record as a whole, the panel held that the ALJ's disability determination was supported by substantial evidence. View "Ahearn v. Saul" on Justia Law

As part of its response to the COVID-19 pandemic, Congress enacted the Families First Coronavirus Response Act (Families First Act), which provides for emergency assistance to households participating in the Supplemental Nutrition Assistance Program (SNAP).The Ninth Circuit affirmed the district court's order denying a motion for a preliminary injunction brought by a putative class of Californians, who normally receive the maximum monthly allotment of SNAP benefits, seeking to bar the USDA from denying California's request under section 2302(a)(1) of the Families First Act to issue emergency allotments to households already receiving maximum SNAP benefits. After determining that plaintiffs had Article III standing, the panel held that the USDA, which administers SNAP, correctly interpreted the statute by concluding that it allows households receiving less than the maximum monthly allotment of SNAP benefits to be brought up to the maximum but does not permit those already receiving the maximum to be given any additional benefits. When the panel examined the Families First Act as a whole, as well as other statutes addressing emergency SNAP benefits, three considerations lead it to conclude that the government's reading of section 2302(a)(1) is more consistent with the overall statutory scheme. Therefore, because plaintiffs were unlikely to succeed on the merits of their claims, the district court did not abuse its discretion in denying a preliminary injunction. View "Hall v. United States Department of Agriculture" on Justia Law

The Ninth Circuit vacated the district court's judgment dismissing as time-barred plaintiff's challenge to the Appeals Council's decision affirming the denial of social security disability benefits. The district court found that declarations from plaintiff and her attorney were insufficient to rebut the presumption that she received notice five days after the denial, triggering a 60-day deadline to file a challenge in federal court.The panel held that plaintiff has made a sufficient "reasonable showing" to rebut the presumption that notice was received within five days of its issuance. In this case, the combination of circumstances—including unrebutted declarations from both plaintiff and her attorney, an officer of the court, that neither received the notice, where the face of the notice indicates that both were supposed to have been mailed copies—is sufficient to rebut the presumption and shift the burden of proving actual receipt to the government. Because the district court did not perform this burden-shifting analysis, the panel remanded for further proceedings. View "Ashe v. Saul" on Justia Law

The Ninth Circuit vacated the district court's judgment affirming the denial of claimant's application for social security disability benefits. In Bellamy v. Secretary of Health and Human Services, 755 F.2d 1380 (9th Cir. 1985), the panel held that a claimant's prior disability determination entitled claimant to a presumption of continuing disability. The SSA interpreted then-recent amendments to the Social Security Act as foreclosing any presumption of continuing disability.Deferring to the SSA's intervening interpretation of the Social Security Act, which is a reasonable one, the panel held that there is no presumption of continuing disability under the Act. Consequently, the ALJ did not err in evaluating, without any such presumption, the SSA's determination that claimant is no longer disabled. However, the ALJ did err in failing to articulate sufficient reasons for refusing to credit plaintiff's testimony about the severity of her medical condition. The panel remanded for further proceedings. View "Lambert v. Saul" on Justia Law

The Ninth Circuit affirmed the denial of social security disability benefits to claimant under Title II of the Social Security Act. The panel held that the ALJ did not err in discounting claimant's testimony where substantial evidence supported the ALJ's finding that claimant had engaged in drug-seeking behavior; the ALJ did not err in weighing the medical-opinion evidence; and the ALJ did not err in excluding pain disorder as a severe impairment. View "Coleman v. Saul" on Justia Law

Plaintiff challenged the denial of her application for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. The ALJ found that plaintiff was not disabled because she could perform two occupations that existed in significant numbers in the economy.The Ninth Circuit held that the ALJ's identification of two occupations is insufficient to satisfy the "significant range of work" requirement of the Medical-Vocation Guidelines. The panel explained that, because plaintiff's skills were readily transferrable to only two occupations, the ALJ erred in concluding that she was not disabled. The panel reversed in part and remanded with instructions for calculation and payment of benefits for the period after plaintiff reached 55 years of age. Finally, the panel affirmed the district court's disability determination as to the time period before plaintiff reached the age of 55. View "Maxwell v. Saul" on Justia Law