Justia Legal Ethics Opinion Summaries

James-Cornelius sought compensation under the National Vaccine Injury Compensation Program, alleging that her 17-year-old son, E.J., had suffered dysautonomia, postural orthostatic tachycardia syndrome (POTS), and other symptoms as a result of receiving three shots of the HPV vaccine, Gardasil®. While there are no records of medical visits between his first and second vaccinations, the records document his medical visits, symptoms, and diagnoses after his third vaccination. The petition identified medical articles hypothesizing that HPV vaccines can cause dysautonomia and POTS and alleged that the increasing severity of his symptoms is “evidence of re-challenge” and that the pattern of worsening reactions is “strongly probative of a causal relationship” between the vaccine and E.J.’s symptoms, some of which were listed as potential Gardasil® side effects.James-Cornelius unsuccessfully attempted to obtain medical records relating to urgent care visits that she believed occurred before E.J.’s second vaccination. She eventually dismissed her petition, explaining that “she [would] likely be unable to prove" entitlement to compensation. James-Cornelius sought $17,111.12 in attorneys’ fees and costs under 42 U.S.C. 300aa-15(e)(1), asserting that she had filed her petition in good faith and with a reasonable basis. . The Federal Circuit vacated the denial of the petition. The Special Master failed to consider relevant objective evidence. E.J.’s medical records support for James-Cornelius’s reasonable basis claim even without an express medical opinion on causation. The Special Master erroneously concluded that petitioners’ affidavits are categorically “not ‘objective" for evaluating reasonable basis. View "James-Cornelius v. Secretary of Health and Human Services" on Justia Law

O’Donnell, represented by attorney Horn, challenged the Social Security Administration’s (SSA) denial of her application for disability insurance benefits. A magistrate remanded the case, awarding O’Donnell $7,493.06 in Equal Access to Justice Act (EAJA), 28 U.S.C. 2412(b), fees, paid to Horn. On remand, an ALJ found that O’Donnell was disabled. SSA determined that she was eligible for benefits dating back several months and withheld 25% of O’Donnell’s past-due benefits, $14,515.37, for possible future payment of fees under 42 U.S.C. 406(a), which authorizes SSA to award a “reasonable fee” to persons who successfully represent claimants in administrative proceedings.Horn filed an unopposed motion for authorization to collect $14,515.37 in section 406(b) fees; having already received the $7,493.06 EAJA award, Horn proposed to keep the EAJA fee, with SSA to pay the balance ($7,022.31), leaving $7,493.06 with SSA for future payment of section 406(a) fees. The magistrate’s order stated that Horn was awarded $14,515.37 under section 406(b), payable by the SSA from the past-due benefits and that “Horn will refund" to O'Donnell $7,493.06, equal to the EAJA award, so that Horn would have to look to O’Donnell, not SSA, to satisfy any future section 406(a) fees. An ALJ subsequently awarded Horn $4,925.21 under section 406(a); he had to seek that amount from O’Donnell. The Seventh Circuit affirmed. No statute requires that the court order netting; the Savings Provision contemplates a refund by the attorney. View "O'Donnell v. Saul" on Justia Law

Graham served in the Marine Corps from 1967-1970 and has been receiving disability compensation benefits since 2001. The VA regional office (RO) informed Graham in 2009 that authorities had identified him as a fugitive felon and the subject of an outstanding warrant issued in 1992. That warrant was withdrawn in February 2009. In May 2009, the RO issued a rating decision that retroactively discontinued Graham’s compensation from December 2001 through February 2009, due to his then-fugitive felon status, and informed Graham that he had been improperly paid $199,158.70 and that his monthly compensation would be partially withheld to pay back the debt.Graham appointed Gumpenberger as his representative on appeal and signed a direct-pay agreement stating that Gumpenberger’s fee would be “20 percent of all past-due benefits awarded … as a result of winning … as provided in 38 C.F.R. 14.636.” In 2013, the Board reversed the RO’s debt ruling, finding that Graham was not a fugitive felon for VA purposes because he had never been aware of the outstanding warrant. The VA had recouped $65,464 from Graham’s monthly benefits. The Veterans Court and Federal Circuit affirmed the RO’s determination that Gumpenberger was entitled to a fee of $13,092.80. Although the total debt invalidated was $199,158.70, the past-due benefit, per 38 U.S.C. 5904(d)(1), being awarded was $65,464. View "Gumpenberger v. Wilkie" on Justia Law

Attorney Ravin represented veteran Cook on a claim for past-due disability benefits. Their agreement provided for a contingent fee and contemplated that VA would withhold the fee from any past-due benefits awarded and pay that amount directly to Ravin under 38 U.S.C. 5904(d)(3). Within days of executing that agreement, Ravin sent a copy to the Board of Veterans’ Appeals, where it was date-stamped on December 11, 2009. No copy of the agreement was submitted to the Regional Office (RO) “within 30 days of the date of execution,” as required by 38 C.F.R. 14.636(h)(4). The RO awarded Cook past-due benefits in April 2010. On April 13, 2010, the RO’s Attorney Fee Coordinator searched for any attorney fee agreement and determined that “no attorney fee decision is required” and “[a]ll retroactive benefits may be paid directly to the veteran.” The RO paid the past-due benefits to Cook. On April 27, 2010, Ravin mailed a copy of Cook’s direct-pay fee agreement to the RO. The RO informed Ravin that it had not withheld his attorney’s fees because the agreement was “not timely filed.”The Veterans Court and Federal Circuit affirmed the Board’s denial of Ravin’s claim. Section 5904(d)(3) does not mandate withholding and direct payment; 38 C.F.R. 14.636(h)(4)'s submission requirement is valid. Ravin’s fees have not been forfeited; he may use all available remedies to obtain them from Cook, per their agreement. View "Ravin v. Wilkie" on Justia Law

After appellant successfully litigated her claim to supplemental social security income, she challenged the district court's denial of her application for attorney's fees under 42 U.S.C. 406(b).The Second Circuit affirmed the denial of appellant's attorney's fee application as untimely, because she filed well beyond the 14 days prescribed by Federal Rule of Civil Procedure 54(d)(2)(B). Assuming the court would entertain appellant's argument, it failed on the merits because she provided no factual basis to support a claim that it was reasonable to delay the filing of her section 406(b) application for more than six months after she received notice of the benefits calculation on remand. View "Sinkler v. Berryhill" on Justia Law

For representation in administrative proceedings, the Social Security Act provides that if a fee agreement exists, fees are capped at the lesser of 25% of past-due benefits or a set dollar amount—currently $6,000, 42 U.S.C. 406(a)(2)(A); absent an agreement, the agency may set any “reasonable” fee, section 406(a)(1). In either case, the agency is required to withhold up to 25% of past-due benefits for direct payment of fees. For representation in court proceedings, section 406(b) caps fees at 25% of past-due benefits; the agency may withhold benefits to pay these fees. Culbertson represented Wood in Social Security disability benefit proceedings before the agency and in court. The agency ultimately awarded Wood past-due benefits, withheld 25%, and awarded Culbertson fees under section 406(a) for representation before the agency. Culbertson sought a separate award under 406(b) for the court proceedings, requesting 25% of past-due benefits. The Eleventh Circuit held that 406(b)’s 25% limit applies to the total fees awarded under both sections.The Supreme Court reversed. Section 406(b)(1)(A)’s 25% cap applies only to fees for court representation, not to the aggregate fees awarded under 406(a) and (b). The subsections address different stages of the representation and use different methods for calculating fees. Applying 406(b)’s 25% cap on court-stage fees to 406(a) agency-stage fees, or the aggregate fees, would make little sense and would subject 406(a)(1)’s reasonableness limitation to 406(b)’s 25% cap—a limitation not included in the statute. The fact that the agency presently withholds a single pool of past-due benefits for payment of fees does not support an aggregate reading. The amount of past-due benefits that the agency can withhold for payment does not delimit the amount of fees that can be approved for representation before the agency or the court. View "Culbertson v. Berryhill" on Justia Law

The Fifth Circuit affirmed the district court's denial of attorneys' fees for plaintiff under the Individuals with Disabilities Education Act (IDEA). The court held that the hearing officer's decision did not make plaintiff a prevailing party under the IDEA and thus she was not entitled to attorneys' fees. In this case, the officer's decision effected no change to plaintiff's educational plan, which the officer agreed was entirely appropriate despite lacking a prior autism diagnosis. Furthermore, the IDEA focuses, not on a student's diagnostic label, but on whether the student received appropriate education services, which the officer found plaintiff had received from the school district. View "Lauren C. v. Lewisville Independent School District" on Justia Law

In November 2010, Hayes engaged Cybriwsky to represent him related to the denial of Hayes’s application for Social Security disability benefits. In February 2011, the case was remanded for further administrative hearings (42 U.S.C. 405(g)) because faulty recordings of the hearings rendered the record inaudible. On remand, the Administrative Law Judge entered a fully favorable decision for Hayes in August 2011. The district court affirmed in April 2012. The next month Cybriwsky sought attorney’s fees under the Equal Access to Justice Act, 28 U.S.C. 2414. The court granted attorney’s fees of $2,225 in August 2012. In April 2017, Cybriwsky moved, under 42 U.S.C. 406(b), seeking more than $11,000. in fees. He subsequently provided documentation of the fee arrangement, benefits paid to Hayes, and an itemized description of the work performed. By the time Cybriwsky filed his 2017 motion, the SSA had released the 25% of past-due benefits normally reserved to pay attorney’s fees; $5,300 was awarded to Hayes’s attorney at the administrative level and the remainder was released to Hayes. Any fees awarded to Cybriwsky would have to be recovered from Hayes, either directly or by having fees taken from Hayes’s monthly disability payments. The Sixth Circuit affirmed denial of the motion as untimely and determined that the circumstances did not merit the exercise of equitable tolling. View "Hayes v. Commissioner of Social Security" on Justia Law

Robinson, a Marine Corps veteran, served in Vietnam from 1966-1969 and later had coronary problems. He sought treatment at a VA medical facility. In 2006, a VA cardiologist recommended that he undergo certain medical testing. The tests, performed 14 months later, revealed that Robinson suffered from left ventricular diastolic dysfunction. The VA granted Robinson a 60% disability rating effective April 2, 2007, the date he underwent cardiac testing. The Board denied Robinson entitlement to a higher rating. In the Veterans Court, Robinson argued for the first time—through the same counsel that represented him before the Board—that his rating should have been assigned an effective date in February 2006, when his doctor ordered tests. The court did not identify any error by the Board but “set aside” its decision and remanded for it to address Robinson’s argument in the first instance. Robinson sought attorney fees, arguing that, because he secured remand, he was a prevailing party under the Equal Access to Justice Act. The Federal Circuit affirmed denial of Robinson’s application. This particular remand did not confer prevailing party status on Robinson because it “was not predicated on administrative error by the Board,” did not materially alter the legal relationship of the parties, and was solely to allow the Board to consider an issue first raised on appeal. View "Robinson v. O'Rourke" on Justia Law

Simmons contacted counsel in 2011, claiming that he developed Guillain-Barre Syndrome as a result of his 2010 flu vaccination. He provided his vaccination record. Counsel agreed to represent him. Counsel was subsequently unable to contact Simmons and sent a letter in 2013, stating that their attorney-client relationship had terminated. That letter was returned as undeliverable. Nearly two years later, shortly before the limitations period on his Vaccine Act claim would expire, Simmons contacted counsel’ and expressed that he would like to proceed. Counsel spoke with Simmons one additional time. The next day, on October 22, 2013, counsel filed Simmons’s petition, without any medical records or other supporting evidence. In January 2014, the special master ordered counsel to produce medical records. Counsel stated that counsel had again lost contact with Simmons and was unable to acquire those records. The master dismissed the case for failure to prosecute. Counsel then filed petitions seeking $8,267.89 in fees and costs. The master noted that because there was no direct evidence of bad faith and counsel had a vaccination receipt, counsel had satisfied the good faith and reasonable basis requirements and awarded fees. The Claims Court and Federal Circuit disagreed. The master erred in finding that counsel had a reasonable basis for Simmons’s claim. The fact that the statute of limitations was about to expire did not excuse counsel’s obligation to show some basis for the claim that Simmons suffered Guillain-Barre beyond their conversations. View "Simmons v. Secretary of Health and Human Services" on Justia Law