Justia U.S. 6th Circuit Court of Appeals Opinion Summaries

Since enacting a program for black-lung benefits in 1969, known as the Black Lung Benefits Act,83 Stat. 742, Congress has repeatedly amended the claim-filing process, sometimes making it harder for miners and survivors to obtain benefits, sometimes making it easier. The most recent adjustment, part of the 2010 Patient Protection and Affordable Care Act, reinstated a presumption that deceased workers who had worked for at least 15 years in underground coal mines and had developed a totally disabling respiratory or pulmonary impairment were presumed to be totally disabled by pneumoconiosis and to have died from it. The presumption is rebuttable. The Act also reinstated automatic benefits to any survivor of a miner who had been awarded benefits on a claim filed during his lifetime, 124 Stat. at 260. Groves, a miner for 29 years, filed a claim for benefits in 2006 and died four months later. An ALJ denied his widow benefits. The law changed while her appeal was pending. The Benefits Review Board concluded that the new law covered this claim. The Sixth Circuit affirmed. View "Vision Processing, LLC v. Groves" on Justia Law

Sexton, a smoker, spent 25 years working in coal mines. He first applied for Black Lung Act (30 U.S.C. 901) benefits in 1973. The application was unsuccessful as were two other claims. In 2001, two years after the denial became final, Sexton filed a subsequent claim. The district director recommended an award of benefits. Buck Creek Coal requested a formal hearing. While his claim was pending Sexton died. His widow filed her own claim and the district director issued a proposed order awarding benefits in the survivor claim. Buck Creek requested a hearing. The administrative law judge considered four medical opinions, and based on that new evidence, determined that Sexton suffered a total disability from clinical and legal pneumoconiosis and that Sexton established a change in an applicable condition of entitlement pursuant to 20 C.F.R. 725.309 and awarded benefits. The Benefits Review Board affirmed with respect to Sexton’s claim and affirmed in part and vacated in part with respect to the survivor claim. The Sixth Circuit affirmed, holding that 20 C.F.R. 725.309 is valid and was correctly applied and that the Board’s decision did not violate principles of finality or res judicata. View "Buck Creek Coal Co. v. Sexton" on Justia Law

Keith has been deaf since his birth in 1980. Wearing a sound transmitter, he can detect noises. He is unable to speak and communicates using American Sign Language (ASL). In 2007, Keith successfully completed a lifeguard training program, with assistance from an ASL interpreter, and applied for a position at the county’s wave pool. Stavale, the county recreation specialist, explained to her supervisors that Keith had requested an ASL interpreter for meetings and classroom instruction. Having received no objection, Stavale extended an offer of employment, conditioned upon a pre-employment physical. During that physical, the doctor stated: “He’s deaf; he can’t be a lifeguard” and “I have to [fail him]. If something happens … they’re going to come after me.” Aquatic safety and risk management consultants expressed concern about whether a deaf individual could perform effectively as a lifeguard. Stavale identified accommodations that she believed could successfully integrate Keith. The employment offer was withdrawn. The district court granted the county summary judgment in his suit under the Americans with Disabilities Act, 42 U.S.C. 12101, and the Rehabilitation Act, 29 U.S.C. 794. The Sixth Circuit reversed, holding that issues of material fact exist regarding whether Keith is otherwise qualified to be a lifeguard, with or without reasonable accommodation. View "Keith v. Cnty. of Oakland" on Justia Law

Diaz, a Michigan Department of Corrections employee, he was diagnosed with heart and abdominal conditions that forced him to take intermittent leave. Diaz alleges he was fired for attendance violations after taking leaves and brought suit under 42 U.S.C. 1983, seeking damages and reinstatement, alleging: interference with Family Medical Leave Act, 29 U.S.C. 2612 (a)(1)(D) rights; retaliation for exercising FMLA rights; and deprivation of a protected federal right. Boden, an employee of the Michigan Department of Human Services, was placed on stress leave by her doctor; she claims that her supervisor dramatically increased her workload and disciplined her for petty infractions because of that leave. She brought suit with the same allegations. The district court dismissed. The Sixth Circuit remanded the claim for reinstatement, but affirmed with respect to claims for damages. The Supreme Court has held that a state employee may recover damages for a state’s failure to comply with family-care provision of the FMLA, but the Sixth Circuit has held that the rationale did not extend to FMLA self-care provision. Suits against the states for damages under 2612(a)(1)(D) are barred by the states’ sovereign immunity and public employers cannot be held individually liable under the FMLA.View "Boden v. MI Dep't of Human Servs." on Justia Law

Dorothy resided at the Landing assisted living facility from 2001 until 2007. She was 80 years old in 2007. She had Parkinson’s disease, dementia, and had suffered a stroke in 2001. She had no history of diabetes or hypoglycemia. She was able to groom herself, use the restroom, walk with a walker, and feed herself. An employee discovered Dorothy in an unresponsive state in her room. She spent 15 months in a semicomatose state before dying. Her son sued for negligence, violation of Ohio’s Patients’ Bill of Rights (OH Rev Code 3721.17), and wrongful death. He alleged that employees mistakenly gave Dorothy antidiabetic medication, which caused hypoglycemia and resulted in permanent brain dysfunction. Because he could not prove exactly how Dorothy received the medication, he requested a jury instruction on res ipsa loquitur, which the district court gave. The jury awarded $680,000 in compensatory damages and $1,250,000 in punitive damages, plus attorney fees. The Sixth Circuit affirmed with respect to jury instructions on res ipsa and punitive damages and rejected a claim of judicial bias, but remanded with instructions to reduce the punitive damages award to $800,000. View "Freudeman v. Landing of Canton" on Justia Law

Hensley worked in various capacities as a coal miner at various times between 1972 and 1988. He also smoked half a pack of cigarettes every day for at least 10 years. From 1990 to 2010, Hensley sought benefits under the Black Lung Benefits Act, 30 U.S.C. 901. In 2010, after two rejections, an ALJ concluded that Hensley suffered from a disabling form of pneumoconiosis caused by his jobs in the coal mines and awarded him benefits. The Benefits Review Board affirmed. The Sixth Circuit reversed and remanded, holding that the ALJ failed to account for relevant record material, relying solely on x-ray evidence, while other evidence cut the other way, permitting a finding that Hensley does not suffer from pneumoconiosis. The biopsy of Hensley’s lungs came back negative, CT scans may have been inconclusive, and several physicians testified against an award of benefits. View "Dixie Fuel Co., LLC v. Dir. Office of Workers' Comp. Programs" on Justia Law

A dialysis provider created a wholly-owned subsidiary, RCGSC, which supplied dialysis equipment for home use, to take advantage of the Medicare reimbursement scheme and increase profits. In 2005 former employees filed a qui tam action under the False Claims Act, 31 U.S.C. 3729-33, alleging that RCGSC was not a legitimate and independent durable medical equipment supply company, but a “billing conduit” used to unlawfully inflate Medicare reimbursements. The United States intervened and the relators’ claim was voluntarily dismissed. The government alleged that defendants submitted claims, knowing that RCGSC was a sham corporation created solely for increasing Medicare reimbursements; knowing that RCGSC was not in compliance with Medicare rules and regulations; knowing that RCGSC was misleading patients over their right to choose between Method I and Method II reimbursements; and for facility support charges for services rendered to home dialysis patients who had selected Method II reimbursements. The government also brought common law theories of payment by mistake and unjust enrichment. The district court granted summary judgment in favor of the United States. The Sixth Circuit reversed on all counts and remanded some. Defendants did not act with reckless disregard of the alleged falsity of their submissions to Medicare.View "United States v. Renal Care Grp., Inc." on Justia Law

Tasis and his brother ran a sham medical clinic, recruited homeless Medicare recipients who had tested positive for HIV, hepatitis or asthma, paid the “patients” small sums in exchange for their insurance identification, then billed Medicare for infusion therapies that were never provided. During four months in 2006, the Center billed Medicare $2,855,785 and received $827,000 in return. The scheme lasted 15 months, during which Tasis and his collaborators submitted $9,122,159.35 in Medicare claims. An auditor notified the FBI. After an investigation, prosecutors indicted Tasis on fraud and conspiracy claims. Over Tasis’s objection, co-conspirator Martinez testified that she and Tasis had orchestrated a a similar scam in Florida. The court instructed the jury to consider Martinez’s testimony about the Florida conspiracy only as it related to Tasis’s “intent, plan and knowledge.” The jury found Tasis guilty, and the trial judge sentenced him to 78 months in prison and required him to pay $6,079,445.93 in restitution. The Sixth Circuit affirmed, rejecting various challenges to evidentiary rulings. View "United States v. Tasis" on Justia Law

In 2004, Ohio passed a law criminalizing the distribution of mifepristone, also known as RU-486, unless the distribution complied with protocols and gestational time limits identified by the FDA when mifepristone was first approved in 2000. Ohio Rev. Code 2919.123. Mifepristone, in combination with misoprostol, was the only form of medical abortion offered by Planned Parenthood in Ohio. Planned Parenthood’s Ohio regional clinics and two of its doctors challenged the Ohio Act. The district court entered a preliminary injunction to cover the Act’s failure to make an exception for circumstances involving the health and life of the mother, but the Act has otherwise been in force since February 2011. Following resolution of certified questions by the Ohio Supreme Court, the district court entered summary judgment that: the Act was no longer unconstitutionally vague; did not violate a woman’s right to bodily integrity under the Fourteenth Amendment; and did not impose an undue burden on a woman’s Fourteenth Amendment right to choose abortion. Whether the Act unduly burdens a woman’s right to health and life under the Fourteenth Amendment was held for trial. The Sixth Circuit affirmed summary judgment on the vagueness and bodily-integrity claims. View "Planned Parenthood SW OH Region v. DeWine" on Justia Law

In 2008, Michigan passed the MMMA, Comp. Laws 333.26421, to protect medical marijuana. Any “qualifying patient” who possesses a registry identification card is not “subject to arrest, prosecution, or penalty of any manner, or denied any right or privilege, including but not limited to civil penalty or disciplinary action by a business.” Plaintiff was employed by Wal-Mart for five years before he was terminated after testing positive for marijuana, in violation of the company’s drug use policy. The test was administered on the day after Plaintiff injured his knee at work. Plaintiff was diagnosed with sinus cancer and an inoperable brain tumor at age 17; he experiences constant pain and side effects of medications. In 2008, Plaintiff’s oncologist recommended marijuana; Plaintiff obtained a registry card and maintains that he followed state laws, never used marijuana at work, nor did he work under the influence. Plaintiff sued in state court for wrongful discharge and MMMA violation; defendants removed to federal court based on diversity. The district court denied remand and dismissed. The court held that the store manager, a Michigan resident, was fraudulently joined and that the MMMA does not regulate private employment. The Sixth Circuit affirmed, noting that the manager had no potential liability. View "Casias v. Wal-Mart Stores, Inc." on Justia Law