ALJ Appeals

News & Analysis as of

OCSLA Coverage for Land Injuries Has Limits

James Baker, Jr. v. Director, OWCP; Gulf Island Marine Fabricators, LLC, U.S. Fifth Circuit No. 15-60634 (August 19, 2016). In this case the Court of Appeals affirmed the Administrative Law Judge’s (ALJ) determination that...more

A Favorable, New Climate for Challenging Medicare Appeals

Over the past decade, health care providers seeking to challenge Medicare claim denials have faced increasing delays in reaching what many consider the most important step in the Medicare appeals process - a hearing before an...more

Financial Services Weekly News - August 2016 #2

Editor's Note - OATS Reporting Violations and FINRA Enforcement. FINRA’s Order Audit Trail System (OATS), is an integrated audit trail of order, quote and trade information for all NMS stocks and OTC equity securities,...more

D.C. Circuit Upholds Constitutionality of SEC Administrative Law Judges

The Securities and Exchange Commission (“SEC”) scored a significant victory yesterday in its quest to defend the increased use of its in-house judges when a three-judge panel of the D.C. Circuit ruled that the appointment of...more

D.C Circuit rejects constitutional challenge to SEC’s use of administrative law judges

A challenge to the constitutionality of the SEC’s use of administrative law judges (ALJ) was rejected by the U.S. Court of Appeals for the D.C. Circuit. In Raymond J. Lucia Companies, Inc. et al. v. Securities and Exchange...more

FTC Slaps Down ALJ’s Data Security Ruling in LabMD, Sets Broad Mandate for Protection of “Sensitive” Consumer Data

In a sweeping statement of its data security expectations for organizations that maintain consumer information, the Federal Trade Commission on Friday found that LabMD, the defunct medical testing lab, failed to employ...more

HHS Proposes Significant Changes to ALJ Hearing Procedures

HHS announced a Proposed Rule on July 5, 2016 aimed at reducing the backlog of appeals at the Office of Medicare Hearings and Appeals (OMHA) and Departmental Appeals Board (DAB) for Medicare payment and coverage...more

Hill v. SEC: Eleventh Circuit Buries District Court Challenges to the Constitutionality of SEC Enforcement Actions

Last week, the United States Court of Appeals for the Eleventh Circuit held that a district court cannot hear constitutional challenges to an ongoing administration enforcement action of the U.S. Securities and Exchange...more

FTC Delays Ruling in LabMD Appeal

The Federal Trade Commission has decided to put off until late July a decision about whether to overturn a ruling by the agency’s chief administrative law judge in the closely watched data security action against LabMD, the...more

Maine Workers’ Compensation Board Appellate Division Rules on Application of Rule 1.1

In Nickerson v. Paul’s Marina, App. Div. Dec. No. 16-17, the employee was struck in the head with a beam on May 4, 2010. He reported the injury to a representative of the employer on May 7, 2010. Paul’s Marina contacted its...more

Cutting Through the Constitutionality Haze in the Battle Between PHH Corporation and the Consumer Financial Protection Bureau

So much has been written in recent weeks about the battle between PHH Corporation and the Consumer Financial Protection Bureau in the U.S. Court of Appeals for the D.C. Circuit. The panel heard oral argument on April 12,...more

Maine WC Board Appellate Division Addresses Several Cases Dealing with the Application of the “Retirement Presumption”

Under the “retirement presumption” (Section 223 of the Act), an employee who terminates active employment and is receiving nondisability pension or retirement benefits is presumed not to have a loss of earnings as the result...more

D.C. Circuit Appears Poised to Overturn First CFPB Enforcement Action to Reach the Court: Five Key Takeaways From Yesterday’s Oral...

Major financial firms almost never litigate with their regulators. As a result, regulators often take aggressive enforcement positions with little fear of judicial scrutiny. That’s been especially true for the Consumer...more

D.C. Circuit Judge Expresses Concern That CFPB Concentrates “Huge Power” in Single Director

Yesterday’s oral argument in the CFPB v. PHH Corporation appeal included sharp questioning about the constitutionality of the Consumer Financial Protection Bureau’s (CFPB) single-director structure, which the parties agreed...more

Constitutionality of CFPB structure at issue in D.C. Circuit oral argument

The constitutionality of the CFPB’s structure was front and center at this past Tuesday’s oral argument in PHH Corporation et al. v. CFPB before the U.S. Court of Appeals for the D.C. Circuit. The case involves PHH’s appeal...more

OMHA Expands Settlement Conference Facilitation Program to Part A Appeals: 10 Things to Know

On Feb. 25, 2016, the Office of Medicare Hearings and Appeals (OMHA) conducted a teleconference to address Phase III of the Settlement Conference Facilitation (SCF) project, which also became effective on Feb. 25, 2016. SCF,...more

Fourth Circuit Affirms Hospital Did Not Have A Right to an ALJ Hearing Within 90 Days

On March 7, 2016, the United States Court of Appeals for the Fourth Circuit affirmed the district court’s dismissal of hospital system’s request for a mandamus order directing HHS to provide a hearing before an...more

NLRB Invalidates Another Employer Conduct Policy

On December 24, 2015, in Whole Foods Market, Inc., 363 NLRB No. 87 (2015) (Whole Foods), the National Labor Relations Board (Board) invalidated two Whole Foods Market policies that prohibited employees' use of recording...more

Court Finds School District May Have Violated Disabled Student’s Civil Rights

In T.B., et al. v. San Diego Unified School District (No. 12-56060, Amended 11/19/15), the United States Court of Appeals for the Ninth Circuit held that a reasonable jury could find the San Diego Unified School District...more

Maine Workers’ Compensation Board Appellate Division to Rule on Compensability of Medical Marijuana

In December 2015 the Workers’ Compensation Board Appellate Division will hear oral argument in Bourgoin v. Twin Rivers Paper Company, WCB No. 89-01-36-55 (March 16, 2015), a case in which the WCB found the cost of medical...more

D.C. Circuit Court of Appeals May Limit the Board’s Standard for Evaluating Employers’ Confidentiality Policies

In Hyundai Am. Shipping v NLRB, No. 11-1351 (Nov. 6, 2015), the D.C. Circuit Court of Appeals recently enforced a Board order with respect to a work rule that prohibited employees from discussing matters under investigation...more

Four Key Takeaways on the Expansion of the Medicare Appeals Settlement Conference Project

On October 15, 2015, the Office of Medicare Hearings and Appeals (“OMHA”) conducted a teleconference to address Phase II of the Settlement Conference Facilitation (“SCF”) Pilot, effective October 1, 2015. SCF, launched in...more

Second Circuit Holds Facebook “Likes” Protected by NLRA

Recently, the U.S. Court of Appeals for the Second Circuit (“Second Circuit”) released a summary order and held that an employee’s “like” on Facebook can be protected by the National Labor Relations Act (“NLRA”)....more

Full Eighth Circuit Rejects OSHA's Expansive Reading of Machine Guarding Standard

Earlier this month, in a rare en banc decision, the full Eighth Circuit Court of Appeals held eight to four that the federal Occupational Safety and Health Administration exceeded its authority by interpreting a safety...more

Eighth Circuit Rejects OSHA’s Attempt to Expand the Scope of its Machine Guarding Standard

In a review of an Occupational Safety & Health Review Commission (OSHRC) decision, the U.S. Court of Appeals for the Eighth Circuit ruled this week to vacate a $490,000 penalty for failure to employ machine guards to prevent...more

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