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

Raymond, a veteran of the U.S. Air Force, was born in 1947 and was a long-term resident of Middlesboro, Kentucky. He worked in the coal-mining industry for over 20 years and developed severe respiratory issues. Raymond, a non-smoker, sought benefits under the Black Lung Benefits Act, 30 U.S.C. 901, but died while his claim was pending. Raymond’s claim was consolidated with a claim for survivor’s benefits submitted by his widow, Joanna. The ALJ awarded benefits to Joanna, on both Raymond’s behalf, and as his surviving spouse. The Benefits Review Board affirmed. Zurich, the insurer of Straight Creek Coal, sought review. The Sixth Circuit denied Zurich’s petition, upholding the ALJ’s conclusions that Zurich failed to rebut the presumption of timeliness, that Raymond had worked for at least 15 years in qualifying employment, and that Raymond had a total respiratory disability. Raymond worked only in surface mines or coal-preparation plants during his career; the ALJ properly relied on 20 C.F.R. 718.305(b)(2) and determined whether Raymond’s mining employment was “substantially similar” to underground mining. View "Zurich American Insurance Group v. Duncan" on Justia Law

In 2010, Dr. Menendez treated 15-year-old Garber for a fever, constipation, and back pain. Garber became a paraplegic. The state court dismissed Garber’s initial lawsuit because he failed to file an affidavit from an expert witness in support of his claim. In his second lawsuit, Garber tried to serve Menendez at his Ohio office, but (unbeknownst to him) Menendez had retired to Florida. Garber voluntarily dismissed the lawsuit. Garber sued Menendez a third time in May 2017 and properly served him. Ohio provides a one-year statute of limitations for medical malpractice claims, Ohio Rev. Code 2305.113, which began running on August 5, 2013, when Garber turned 18. Garber argued that Ohio tolls the statute of limitations when the defendant “departs from the state.” The Sixth Circuit reversed the dismissal of the suit. The court rejected an argument that the statute’s differential treatment of residents and non-residents violates the dormant Commerce Clause by disincentivizing individuals from leaving Ohio and offering their services (or retirement spending) in other states. The Ohio tolling provision does not discriminate against out-of-state commerce any more than many other policy benefits reserved for residents of a given state, including the existence of an estate tax for Ohioans but not for Floridians. View "Garber v. Menendez" on Justia Law

Grimsby invited Nancy to take a boat trip on Lake Erie. The boat hit a wave, jarring the passengers and injuring Nancy. In her suit, invoking the court’s diversity and admiralty jurisdiction, Nancy pleaded that “this action is not to be deemed an ‘admiralty and maritime claim’ within the meaning of” Rule 9 of the Federal Rules of Civil Procedure. In 2015, the district court held that the incident fell within the court’s admiralty jurisdiction, meaning that federal maritime law controlled the duty of care. In 2016, the court held that a boat hitting a wave did not count as a “collision” under the Coast Guard Navigation Rules. A jury subsequently found that Grimsby was not negligent. The court granted Nancy’s motion for a new trial, finding that the evidence did not support the verdict. Grimsby filed an interlocutory appeal, and Nancy cross-appealed, citing the interlocutory exception to the final judgment rule that applies to admiralty cases. The Sixth Circuit dismissed. The exception does not apply because Nancy chose to pursue claims under ordinary civil procedures. View "Buccina v. Grimsby" on Justia Law

Heimer, one year over the legal drinking age, drank alcohol with friends and then rode motorbikes in a field. Heimer and his friend collided. Heimer suffered extensive injuries, incurring more than $197,333.50 in medical bills. Heimer’s blood alcohol level shortly after the crash was 0.152, nearly twice the limit to legally use an off-road vehicle in Michigan. Heimer was insured. As required by his plan, he submitted a medical claim form shortly after the accident. The plan administrator denied coverage based on an exclusion for “[s]ervices, supplies, care or treatment of any injury or [s]ickness which occurred as a result of a Covered Person’s illegal use of alcohol.” After exhausting administrative appeals, Heimer filed suit. The district court held that the plan exclusion did not encompass Heimer’s injuries, reasoning that there is a difference between the illegal use of alcohol—such as drinking while under 21 or drinking in defiance of a court order—and illegal post-consumption conduct, such as the illegal use of a motor vehicle. The Sixth Circuit affirmed. Reading “illegal use of alcohol” to disclaim coverage only for the illegal consumption of alcohol, and not for illegal post-consumption conduct is consistent with the ordinary meaning of “use” and best gives effect to the contract as a whole. View "Heimer v. Companion Life Insurance Co." on Justia Law

Doe and her daughter flew aboard Etihad Airways from Abu Dhabi to Chicago. During the journey, Doe’s tray table remained open because a knob had fallen off. Doe’s daughter found the knob on the floor; Doe placed it in a seatback pocket. When a flight attendant reminded Doe to place her tray in the locked position for landing, Doe attempted to explain by reaching into the seatback pocket to retrieve the knob. She was pricked by a hypodermic needle that lay hidden within, which drew blood. Doe sought damages from Etihad for her physical injury and her “mental distress, shock, mortification, sickness and illness, outrage and embarrassment from natural sequela of possible exposure to” various diseases. Her husband claimed loss of consortium. The court granted Etihad partial summary judgment, citing the Montreal Convention of 1999, an international treaty, which imposes capped strict liability “for damage sustained in case of death or bodily injury of a passenger upon condition only that the accident which caused the death or injury took place on board the aircraft.” The Sixth Circuit reversed. The district court erred in reading an additional “caused by” requirement into the treaty and concluding that Doe’s bodily injury did not cause her emotional and mental injuries. The Convention allows Doe to recover all her “damage sustained” from the incident. View "Doe v. Etihad Airways, P.J.S.C." on Justia Law

A tree fell on Kaitlyn and Joshua. Kaitlyn died. She was pregnant. Doctors delivered the baby, but he died an hour later. Joshua survived with serious injuries. A state jury found the Somerset Housing Authority liable and awarded $3,736,278. The Authority belonged to the Kentucky Housing Authorities Self-Insurance Fund, which provided a policy with Evanston. Evanston sought a declaratory judgment limiting its liability under the Fund’s policy to $1 million. Meanwhile, through mediation of the state court case, Evanston agreed to pay the “policy limits” in return for an agreement to dismiss the state court action and release the Authority from further liability. Evanston claimed that $1 million was the coverage cap; the defendants claimed it was $2 to $4 million. The district court determined that there was complete diversity and ruled for Evanston on the merits. The Sixth Circuit affirmed. The district court properly aligned the parties given their respective interests in the primary dispute at the time of filing, so that diversity jurisdiction was not destroyed. The policy obligates Evanston to provide a maximum of $1 million of coverage per “occurrence,” with an aggregate limit of $2 million for more than one occurrence. The contract defines “occurrence” as “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.” When one tree falls at one time, that is one occurrence and one accident. View "Evanston Insurance Co. v. Housing Authority of Somerset" on Justia Law

In 2009, Williamson, an Army veteran and U.S. postal worker, began experiencing pain in his right foot. He usually worked a walking route, walking up to eight miles per day on the job. He was also doing other physical activity, including running and CrossFit, which could have contributed to his injury. He eventually received benefits under the Federal Employees’ Compensation Act (FECA): $79,379.66 in temporary total disability net compensation from March 20, 2010 through October 25, 2012; $27,801.27 for medical expenses; and $19,974.19 as a lump-sum “schedule award.” Williamson then sought damages under the Federal Tort Claims Act (FTCA) for medical malpractice by the Department of Veterans Affairs in the treatment of his injuries, which included two unsuccessful surgeries. The district court denied the government’s motion for summary judgment. The Sixth Circuit reversed. Liability under FECA is “exclusive” of “all other liability of the United States” to the employee “under a Federal tort liability statute,” 5 U.S.C. 8116(c) (2012). Because this exclusion applies broadly even when a work-related injury has been negligently treated by an entirely non-work-related federal hospital, Williamson may not recover under the FTCA. View "Williamson v. United States" on Justia Law

In his 2010 Chapter 7 petition, the debtor listed a claim against Simms based on an injury while under Simms’ employ, but did not claim an exemption on Schedule C. In 2011, a complaint was filed against Simms; in 2012, a companion action was filed against BWC. The debtor filed amended schedules, valuing the Simms claim at $21,625, but claiming no exemption. The debtor never listed the BWC claim. In 2013, the certified that the estate had been fully administered except for the Simms claim, stating: The ... settlement shall remain property of the bankruptcy estate upon the entry of a final decree; if money becomes available ... the case will be re-opened. The bankruptcy court closed the case; the order contained no reservations regarding the claim. In 2015, the trustee was notified of a settlement offer and moved to reopen the case. The debtor argued that the trustee had abandoned any interest in the personal injury litigation and that the settlement encompassed the claim against BWC in which the trustee had no interest. The court approved a settlement of $180,000. At a hearing, without evidence or testimony, the bankruptcy court found that the claims were not abandoned. The Sixth Circuit Bankruptcy Appellate Panel reversed in part. The court made no findings to support approval of the settlement over the debtor’s objections. Because no court order preserved the personal injury claim as an asset, the bankruptcy court erred by holding that the trustee did not abandon that claim under 11 U.S.C. 554(c); the unscheduled BWC claim was not abandoned. View "In re: Wayne Wright" on Justia Law

Fleming had a sporadic work history in the coal industry. Between 1970 and 1991, Fleming worked for 25 different employers. In 2010, Fleming sought Black Lung Benefits Act payments. The DOL Office of Workers’ Compensation calculated that Fleming was employed as a miner for nine and one-quarter years and that he had contracted pneumoconiosis as a result of that employment. Aberry was designated as the employer responsible for payment of benefits. On appeal, an ALJ determined that Fleming could show he had worked 273.50 weeks in the industry (about 5.25 years), but that Fleming was credible and established that he had either been paid under the table or without proper records having been kept. Based on that determination, the ALJ found that Fleming engaged in coal-mine employment “for at least 15 years,” which entitled Fleming to the presumption of total disability under 30 U.S.C. 921(c)(4). The Benefits Review Board remanded, stating that the ALJ had neither explained how he resolved the conflict between Fleming’s “not [being] a good historian” and the ALJ’s crediting of Fleming’s testimony, nor resolved the conflicting evidence. The ALJ's second Decision again awarded benefits. finding that Fleming worked more than 15 years in coal-mine employment. The Sixth Circuit vacated. The evidence was insufficient to establish that Fleming had 15 years of employment. View "Aberry Coal, Inc. v. Fleming" on Justia Law

Jackson died in a car accident on U.S. Highway 70 after he lost control of his 2012 Ford Focus. Mrs. Jackson, who was a passenger in the car, was seriously injured. She sued, alleging that Ford was responsible for the accident because it equipped the car with a defective “Electronic Power Assisted Steering” (EPAS) system that caused the loss of control. The district court dismissed, finding that Jackson did not adequately plead proximate cause. The Seventh Circuit reversed, stating that “the district court demanded too much of Jackson under the familiar Iqbal and Twombly pleading requirements.” Jackson plausibly alleged that a defect in the 2012 Ford Focus’s EPAS system was a substantial factor in bringing about the accident, as is apparent from the litany of other accidents identified by Jackson where the EPAS system allegedly failed, causing the driver to lose control of the vehicle. Ford’s “hypertechnical arguments regarding the allegations” in Jackson’s complaint rest on an inaccurate understanding of notice pleading. View "Jackson v. Ford Motor Co." on Justia Law