Articles Posted in Public Benefits

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Appellant Jeffrey Allen, on behalf of his daughter, appealed the Administrative Law Court's (ALC) order affirming the Appeals Committee of the South Carolina Budget and Control Board Employee Insurance Program's (EIP Appeals Committee) decision to deny Appellant's insurance claim for his daughter's diabetes educational training session. Blue Cross's Appeals Review Committee upheld the denial of benefits on the basis that diabetes educational training was excluded under the State Health Plan, and that section 38-71-46 of the South Carolina Code, did not apply to the State Health Plan. Upon review, the Supreme Court reversed the ALC's decision that section 38-71­46 of the South Carolina Code did not apply to this matter. The EIP was mandated to promptly determine and pay the benefits that were due for Appellant's daughter under the State Health Plan. View "Allen v. SC Public Employee Benefit Authority" on Justia Law

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Respondent Kimberly Legette was employed by Appellant Nucor Corporation from 1998, through 2010. Nucor terminated Legette's employment after she failed a random on-site drug test in violation of Nucor's drug policy. Although Legette obtained an independent drug test, which tested negative for drugs, she was fired from her job at Nucor based on the two positive drug test results. Legette subsequently applied for unemployment benefits. Nucor requested that Legette be denied unemployment benefits, contending she was statutorily ineligible to receive them because she was fired for violating Nucor's drug policy by testing positive for drugs. This direct appeal from the Administrative Law Court (ALC) presented for the Supreme Court's review a threshold procedural challenge to appealability, and substantively, to the awarding of unemployment benefits to an employee terminated for failing a drug test administered by a laboratory that was not properly certified. Because this appeal arose from a final resolution of all issues, the Court found the matter is appealable. The Court affirmed the ALC. View "Nucor v. SCDEW" on Justia Law

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Appellants Phillip Grimsley and Roger Mowers were retired and later rehired employees of the South Carolina Law Enforcement Division (SLED). As employees, they were members of the Police Officers Retirement System. As part of the rehire process, SLED required Appellants to sign a form which provided that they would take a pay cut in the amount it would cost SLED to pay "the employer portion" of retirement. According to their suit, Appellants claimed that provision was contrary to state law, which assigned the responsibility for the employer portion of the retirement to the employer. On behalf of themselves and others similarly situated, Appellants brought suit against SLED and the State, seeking a declaratory judgment and asserting causes of action for a violation of S.C. Code Ann. section 9-11-90 and for unlawful takings. The trial court dismissed the complaint for failure to exhaust administrative remedies under the South Carolina Retirement Contribution Procedures Act (Retirement Act), which Appellants challenged on appeal to the Supreme Court. Appellants additionally appealed the trial court's alternative ruling dismissing their unlawful takings claim. Upon review, the Supreme Court agreed with Appellants and found the trial court erred in dismissing their complaint: "Appellants have asserted a cognizable property interest rooted in state law sufficient to survive the motion to dismiss. In so finding, [the Court] also [held] the trial court erred in dismissing Appellants' unlawful takings claim." View "Grimsley v. So. Carolina Law Enforcement Div." on Justia Law

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The issue on appeal before the Supreme Court was whether Respondent South Carolina Department of Health and Human Services and its agent, the South Carolina Department of Disabilities and Special Needs (DDSN), "properly ceased Mental Retardation/Related Disability services to" Appellant Jane Doe, a twenty-eight-year-old woman with undeniable cognitive and adaptive deficits. Based on a legal standard that the "onset of Mental Retardation must be before the age of eighteen (18) years according to accepted psychological doctrine[,]" the Hearing Officer concluded Doe was not mentally retarded. The Administrative Law Court (ALC) affirmed this legal determination, as well as the Hearing Officer's factual findings. Because the decision of the Hearing Officer and ALC was controlled by an error of law, the Supreme Court reversed and remanded the case: "DDSN could have promulgated regulations incorporating […] additional criteria as part of the definition of mental retardation. But no such steps were taken. Rather, South Carolina adopted a broad definition of mental retardation […] using language that parallels the SSI definition, and in Regulation 88-210, DDSN interpreted that definition in a manner consistent with the SSA. DDSN's interpretation of section 44-20-30 in its policy guidelines directly conflicts with Regulation 88-210 and should be disregarded." View "Doe v. South Carolina Dept. Health Human Svcs." on Justia Law

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This case was a direct appeal in a workers' compensation matter from a master's order reversing the Full Commission and finding respondent's decedent was totally disabled as the result of an occupational disease. On appeal, Appellant W. L. Gore & Associates contended this matter should have been dismissed because Respondent's admittedly untimely appeal to the Commission deprived the Commission of jurisdiction. Upon review of the Commission's record, the Supreme Court agreed that the untimely appeal to the Commission required it to vacate both the master's order and the decision of the Full Commission. View "Allison v. W. L. Gore" on Justia Law

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Employee-Petitioner Melenia Trotter was awarded workers' compensation benefits for a back injury by the South Carolina Workers' Compensation Commission ("Commission").  Petitioner worked at "the turb and trim station," which consisted of using an "air driver" (a screwdriver with a blade) to trim down tubes to the same length, and then "turbulating" the tubes by putting a spring into each tube. According to Petitioner, she began having spasms and some lower back pain that extended down her legs in December 2004, which she mentioned to her Team Leader and Trane's Safety Coordinator.  Petitioner continued to work with increasing discomfort in December 2004 and January 2005. An MRI revealed Petitioner had a herniated disc at L5-S1 with marked compression of the right S1 nerve root.  Following a doctor's recommendation, Petitioner underwent surgery in early 2005. In May 2005, Petitioner filed a claim alleging a job-related injury to her back. Trane denied the claim, maintaining it did not receive notice of the injury until after her surgery and that there was insufficient proof of a work-related injury. An Appellate Panel of the Commission unanimously upheld the commissioner's order finding Petitioner's injury was work related and granted her benefits.  The circuit court affirmed.  Trane appealed, and the appellate court reversed. Upon review, the Supreme Court concluded the Court of Appeals erred in finding the Commission abused its discretion in denying Trane's motions for a continuance or to keep the record open for depositions to be taken.  Consequently, the Court reversed the opinion of the Court of Appeals and reinstated the order of the Commission.  View "Trotter v. Trane Coil Facility" on Justia Law

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Appellant Essie Simmons and Respondent Rubin Simmons divorced in 1990. The parties entered into a settlement agreement that was approved by the family court. Central to the agreement was the requirement that Mr. Simmons give Ms. Simmons a half or third of his Social Security benefits, depending on his age when he retired. When he retired, Mr. Simmons did not pay his ex-wife. She sued, but the family court declined to hear the complaint, finding that it could not hear a case that primarily dealt with Social Security benefits. Mr. Simmons appealed the dismissal, and the appellate court reversed. The court voided the division of Mr. Simmons' benefits, holding that the Social Security Act specifically precluded parties from dividing benefits under the settlement agreement. Because the agreement was partly voided by the court, Ms. Simmons sought to reopen the matter entirely. The family court dismissed again, holding that it lacked jurisdiction to revisit the agreement. On appeal, the Supreme Court was presented with the question of whether the family court could revisit the now partially voided agreement. Upon careful review of the arguments and applicable legal authority, the Court held that "basic principles of equity suggest[ed] that all issues should be revisited by the family court." The Court recognized the practical difficulties confronting the family court, but the Court noted, "that challenge pales in comparison to [Mr. Simmons'] suggestion that we simply end this matter with the remnant of the agreement remaining valid." The Court reversed the decision of the lower court and remanded the case to the family court for further proceedings. View "Simmons v. Simmons" on Justia Law