Tuesday, June 30, 2009

federal courts - private right of action - Nursing Home Reform Amendments - 42 USC 1396r et seq.

Grammer v. John J. Kane Regional Centers - 3d Cir. - June 30, 2009


We are asked in this appeal to determine whether an action will lie under 42 U.S.C. § 1983 to challenge the treatment Appellant’s decedent received (or did not receive) at the Appellee nursing home – treatment Appellant argues violated the Federal Nursing Home Reform Amendments (FNRA), 42 U.S.C. § 1396r et seq. We answer that question in the affirmative and will reverse and remand the cause to the District Court.

In so holding, we conclude that the language of the FNHRA is sufficiently rights-creating and that the rights conferred by its various provisions are neither “vague and amorphous” nor impose upon states a mere precatory obligation. See Gonzaga Univ. v. Doe, 536 U.S. 273, 287 (2002) (citing Alexander v. Sandoval, 532 U.S. 275-288-89 (2001)). Further, we conclude that § 1983 provides the proper avenue for relief because the Appellee has failed to demonstrate that Congress foreclosed that option by adopting another, more comprehensive enforcement scheme. See Gonzaga Univ., 536 U.S. at 284.

UC- able and available - health issues

Poolpak Technologies v. UCBR - Cmwlth Court - June 30, 2009 - unreported decision


The court affimed the UCBR decision that the claimant was able to work and available for work, despite his prior health leave of absence from the employer, which was caused by work-related stress caused by his relationship with his supervisor.

The Board made findings that, after Claimant’s FMLA leave expired, Employer replaced Claimant because Employer was not willing to accommodate Claimant’s need for a different work situation. Claimant was able to work and was available for work, except work with his previous supervisor.

Section 401(d) of the UC Law states that unemployment benefits are payable to any employee who is unemployed and who is able to work and is available for suitable work. It is presumed that an employee who registers for unemployment benefits is able to work and is available for suitable work. Penn Hills School District v. UCBR, 496 Pa. 620, 437 A.2d 1213 (1981). However, an employer may rebut this presumption by presenting countervailing evidence. Id.
If the UCBR’s finding of availability is supported by substantial evidence, it is binding on an appellate court. Penn Hills. To see if substantial evidence exists in the record to support a finding of availability, an appellate court must examine the evidence in the light most favorable to the party in whose favor the fact-finder has ruled, giving that party the benefit of all logical and reasonable inferences. Id.

Here, Claimant applied for unemployment benefits, thereby creating the presumption that he was able to work and was available for suitable work. Employer rebutted the presumption with a psychologist’s report stating that Claimant was being seen by a psychologist and by a psychiatrist for major depression and was considered unable to work at that time.

Claimant, however, presented the decision of Employer’s own short-term disability insurer, which had rejected Claimant’s appeal from the insurer’s denial of benefits. Claimant testified that he submitted the psychologist’s report to Employer’s insurer in support of his appeal, but the insurer still denied Claimant benefits because, although Claimant was not able to work with a particular supervisor, Claimant was able to work for a different employer or in a different work situation. Such testimony constitutes substantial evidence to support the UCBR’s finding that Claimant was able to work and was available for suitable work.