American Manufacturers Mutual Insurance Co. et al. v. Sullivan et al., 119 S.Ct. 977 (1999).
This case, brought by employees and employee representatives against state officials, a self-insured public school district, and private workers' compensation insurers, raised claims that defendants' withholding of payment for medical treatment without a pre-deprivation notice and opportunity to be heard violates due process. Under the state workers' compensation system, when an employer is liable for an employee's expenses arising from a work-related injury, an insurer may withhold benefits while a utilization review organization determines whether the expenses are reasonable and necessary. In a opinion by Chief Justice Rehnquist the Supreme Court has reversed a Third Circuit decision for the plaintiffs and has held 1) that there is no state action for Sec. 1983 purposes involved in a private insurer's decision to withhold payment for medical expenses pending utilization review of whether the expenses are reasonable and necessary; and 2) that employees do not have a protected property interest for due process purposes in payments before a determination that they are reasonable and necessary. As to the state action claim, the Court concluded that while the action was pursuant to state law, the private insurers did not satisfy the second part of the state action requirement, namely that the challenged conduct is fairly attributable to the state. It rejected arguments that the action could be attributable to the state because it had authorized or encouraged it; that the private insurers were exercising powers traditionally reserved for the states; or that there is "joint participation" of the private insurers with the state sufficient to constitute state action. As to a protected property interest, the Court rejected arguments that once employer liability is established, the employee has a protected property interest in workers' compensation medical benefits. Instead, the Court said that since state law does not entitle an employee to payment for all medical treatment, an employee's entitlement arises only after resolution of disputes over reasonableness and necessity. The Court said the property interest in this case is "fundamentally different" from that in Goldberg v. Kelly and Mathews v. Eldridge where the individual's entitlement to benefits had been established. Thus, while respondents "...have established their initial eligibility for medical treatment, they have yet to make good on their claim that the particular medical treatment they received was reasonable and necessary. Consequently, they do not have a property interest...in having their providers pay for treatment that has yet to be found reasonable and necessary." Justices O'Connor, Scalia, Kennedy, Souter, Thomas, and Breyer joined in Part I and Part II of the Opinion (Part II dealt with the state action issues); O'Connor, Kennedy, Thomas, and Ginsburg joined in Part III (involving the property interest issue). Justice Ginsburg filed an opinion concurring in part and concurring in the judgment. Justice Breyer filed an opinion concurring in part and concurring in the judgment, in which Justice Souter joined. Justice Stevens filed an opinion concurring in part and dissenting in part.
Gates v. McIntire, Civil Action No. _____ (Mass. Superior Ct., Suffolk) (complaint and preliminary injunction motion).
This case, filed as a class action, challenges the state's family cap provision under which a Transitional AFDC increment is denied to children born more than 10 months after their family begins receiving TAFDC. Plaintiffs claim that the family cap unfairly penalizes children for the reproductive conduct of their parents in violation of federal and state due process guarantees; that it encourages abortion and tries to influence reproductive conduct and family relationships in violation of federal and state due process guarantees; that it penalizes those with religious objections to abortion in violation of religious freedom rights guaranteed by the state and federal constitutions; that the welfare commissioner exercises her authority to grant exemptions for extraordinary circumstances without written or discernible standards and without providing a reason for the denial in violation of the state statute requiring "fair, just, and equitable" procedures and federal and state due process; and that it discriminates on the basis of sex in violation of the state Equal Rights Amendment. Plaintiffs have moved for preliminary relief on their first three claims. Plaintiffs' attorneys: Deborah Harris, Ruth Bourquin, Alan Rodgers, Massachusetts Law Reform Institute, 99 Chauncy Street, Suite 500, Boston, MA; tel. 617-357-0700; fax 617-357-0777; email dharris@gbls.org and rbourquin @gbls.org. NY
Wrobel v. Johannes, 99 Civ. ___ (N.D.N.Y.) (Complaint).
Plaintiff in this action received Safety Net Assistance (SNA) for a period in 1998 during which she worked for the defendant Fulton County Department of Social Services as a Work Experience Program participant in fulfillment of the requirement to work in exchange for benefits. The plaintiff also applied and was found eligible for SSI and was awarded retroactive SSI. The retroactive benefits were sent directly to the defendant which reimbursed itself for SNA benefits provided to the plaintiff. The defendant's action to retain the retroactive SSI benefits meant that plaintiff had worked for the defendant without payment. The plaintiff seeks back pay and liquidated damages for violations of the Fair Labor Standards Act, 29 U.S.C. . 201 et seq., resulting from its failure to compensate plaintiff at the minimum wage rate for the work she performed. Plaintiff's attorneys: Susan Antos, Greater Upstate Law Project, 119 Washington Avenue, Albany, NY 12210-2273, tel. 518-462-6831, fax 518-462-6687, email santos@wnylc.com; Catherine Ruckelshaus, National Employment Law Project, 55 John Street, 7th Floor, New York, NY 10038-3712, tel. 212-285-3025, fax 212-285-3044, email cruckelshaus @nelp.org.
Sanders v. City of New York, Index No. ____ (N.Y. Sup. Ct., N.Y. County, Feb. 3, 1999).
Officials of District Council 37, American Federation of State, County, and Municipal Employees, AFL-CIO, the union representing New York City park workers, have filed a lawsuit claiming that the city is violating the state Social Services Law which prohibits the use of workfare participants to displace regular city employees. The lawsuit claims that the number of individual workers in City Park Worker and Park Service Worker positions has declined since 1993, that the city is reducing this workforce and using increasing numbers of workfare participants to perform the work of these park workers. The complaint also alleges that some workfare participants are performing heavy duty crew work and depriving City Park Workers the opportunity to join these crews and receive higher compensation. The plaintiffs seek injunctive relief and monetary damages. Plaintiffs' attorney: Mary J. O'Connell, Assistant General Counsel, District Council 37 AFSCME, AFL-CIO, 125 Barclay St., New York, NY 10007; tel. 212 815-1450.
Mankins v. Paxton, Case No. 99CVH01-202 (Franklin Cty. Court of Common Pleas, General Div., Ohio, Jan. 11, 1999)(Complaint).
Plaintiff's action grows out of a sanction imposed by the county welfare department for her failure to comply with workfare requirements imposed after a sham assessment. Following a work-related injury which prevented her continued employment, plaintiff applied for public assistance for herself and her daughter. She alleges that the welfare worker failed to conduct a proper assessment and develop a self-sufficiency plan that took account of her injury and that she was required to sign a boiler-plate facially-inadequate self-sufficiency contract. Despite her disability, the agency representative assigned plaintiff to a manual labor workfare position. About the same time, her physician approved her limited return to her job, but the plaintiff re-injured herself, and the doctor significantly limited her activities. While the plaintiff was in the doctor's office, he telephoned the agency to report the disability and activity restrictions. The plaintiff, believing she had verified her inability to work, did not complete her workfare hours and thereafter received a sanction notice. The agency claimed she had not established good cause because she had not provided written medical verification. A state fair hearing upheld the sanction based on the county's interpretation of its good cause standards and this was affirmed by the state Administrative Hearing Examiner. Plaintiff alleges violation of federal due process, equal process and federal statutory rights, the Americans With Disabilities Act and . 504 of the Rehabilitation Act of 1973. She also raises various state claims, including a claim that the administrative actions were arbitrary and against the weight of evidence, a claim that the delegation of legislative authority to the county violated various state constitutional provisions, and breach of contract claims. She seeks declaratory and injunctive relief and compensatory damages against the county. Plaintiff's attorney: Gary M. Smith, Equal Justice Foundation, 2010 North Walnut Street, Dover, OH 44622, tel./fax 330 364-4113.