Articles Posted in Public Benefits

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The Supreme Court affirmed in part and reversed and remanded in part the decision of the Workers’ Compensation Court of Appeals (WCCA) upholding the decision of the compensation judge ordering that Atlas Staffing, Inc. and its insurer, Meadowbrook Claims Services, pay workers’ compensation benefits to Anthony Gist. The compensation judge found that Gist’s exposure to silica, a known cause of end stage renal disease (ESRD), during his employment with Atlas was a substantial contributing factor to his kidney disease. In the consolidated appeals brought by Appellants and Fresenius Medical Care, which treated Gist after Appellants denied coverage and accepted payments from Medicaid and Medicare for the costs of that treatment, the Supreme Court held (1) the compensation judge did not abuse her discretion by relying on a certain medical report to find that work-related silica exposure was a substantial contributing factor to Gist’s kidney failure; (2) under 42 C.F.R. 447.15, a provider cannot recover payment from third parties for any services billed to Medicaid after the provider has accepted payment from Medicaid for those services; and (3) the WCCA erred when it dismissed Fresenius’s cross-appeal as untimely. View "Gist v. Atlas Staffing, Inc." on Justia Law

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Respondent, the chief investigator for the Medicaid Fraud Control Unit (MFCU) of the Minnesota Attorney General’s Office, was investigating Affiliated Counseling Center, LLC (Affiliated) when she applied for and received a search warrant for Affiliated’s premises. The police executed the warrant and seized numerous documents from Affiliated’s office, including patient files. Thereafter, Appellant, the sole owner of Affiliated, sued Respondent, alleging that Respondent committed conversion and trespass to chattels by losing and/or destroying some of Affiliated’s patient files. Respondent moved to dismiss, asserting that she was entitled to prosecutorial immunity. The district court denied the motion. The court of appeals reversed, concluding that Respondent was entitled to prosecutorial immunity because her challenged conduct was taken pursuant to her statutory authority to investigate Medicaid fraud. The Supreme Court reversed, holding (1) prosecutorial immunity does not extend to an investigator when the investigator’s conduct is not intimately involved with the initiation and maintenance of criminal charges; and (2) therefore, the court of appeals erred when it concluded that Respondent was entitled to prosecutorial immunity. View "Stresemann v. Jesson" on Justia Law

Posted in: Public Benefits

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Relator was injured while working for Employer. Relator began receiving workers’ compensation benefits in 2010. In 2012, Relator began receiving a retirement annuity from the Public Employees Retirement Association (PERA). At some point, Relator began receiving federal social security retirement benefits. While Employer was entitled under Minn. Stat. 176.101(4) to offset Relator’s permanent total disability benefits by the amount of her social security retirement benefits, the parties disagreed as to whether Employer was entitled to apply the offset to Relator’s PERA retirement benefits. A compensation judge granted Employer the offset. The Workers’ Compensation Court of Appeals (WCCA) affirmed, concluding that Relator’s PERA retirement annuity was an “old age and survivor insurance benefit.” The Supreme Court reversed, holding that, under the reasoning in Ekdahl v. Independent School District #213, also decided today, section 176.101(4) does not permit permanent total disability benefits to be offset by public employee pension benefits. Remanded. View "Hartwig v. Traverse Care Ctr." on Justia Law

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Relator was injured while working for a School District. Relator eventually sought and was awarded permanent total disability (PTD) benefits. Relying on Minn. Stat. 176.101(4) and claiming that the statute authorizes an offset for “any old age and survivor insurance benefits,” the School District sought to offset its PTD benefit payment by the amount of government-service pension benefits Relator was receiving. A compensation judge concluded that the School District was not entitled to the offset. The Workers’ Compensation Court of Appeals (WCCA) reversed, concluding that government-service pension benefits are included in the phrase “old age and survivor insurance benefits” and therefore can be offset from the School District’s disability-benefit payment. The Supreme Court reversed the WCCA and reinstated the decision of the compensation judge, holding that the phrase “old age and survivor benefits” refers only to federal social security benefits, and therefore, the WCCA erred when it applied section 176.101(4) to Relator’s retirement annuity. View "Ekdahl v. Indep. Sch. Dist. #213" on Justia Law