[Unpublished]
Bruce Bokony and his incapacitated adult son, Brandon, appeal after the district court dismissed the action they brought against certain Department of Defense (DoD) defendants for injunctive and declaratory relief, and reinstatement of Brandons TRICARE health insurance coverage. Having jurisdiction under 28 U.S.C. § 1291, this court affirms the judgment of the district court to the extent the court concluded that it lacked jurisdiction, and otherwise reverses and remands with instructions to dismiss the action in its entirety for lack of subject-matter jurisdiction.
In 2001, when Brandon was 18 years old, the Social Security Administration determined that he was disabled. In 2012, at the age of 60, Bruce became eligible as a Navy retiree to receive various military benefits, including TRICARE health insurance coverage for his dependents. Brandon enrolled in the coverage in 2012 and continued to receive coverage until 2017. At that time, Bruce received notification that he was required to recertify that, among other things, he provided over fifty percent of Brandons financial support in order for Brandon to continue to receive benefits. Bruce completed the application for recertification, but Brandons healthcare coverage was terminated after the Navy Personnel Command concluded that Bruce did not provide over fifty percent of Brandons financial support. After additional communications did not resolve the issue to their satisfaction, the Bokonys sought recourse in the district court, alleging that the termination of Brandons healthcare benefits was the result of a violation of the governing statutes and regulations, ran afoul of estoppel principles, was arbitrary and capricious, and denied Brandon due process under the Fifth Amendment.
The district court concluded that it lacked subject matter jurisdiction to review the DoDs ultimate determination that Brandon did not qualify as Bruces dependent under 10 U.S.C. § 1072(2)(D)(iii), which defines a “dependent” as a child who is incapable of self-support and who depends on a former member of a uniformed service “for over one-half of the childs support.” The district court further concluded that the Bokonys’ constitutional and other challenges—including to the DoDs method of evaluating statutory dependency—failed on the merits.
Upon de novo review, this court concludes that the statutory bar on review precludes jurisdiction over the Bokonys’ complaint, which sought to challenge the DoDs conclusion that Brandon was not Bruces dependent, and establish Bruces entitlement to TRICARE healthcare coverage. See 10 U.S.C. § 1084 (a determination of dependency is conclusive and may not be reviewed in any court absent fraud or gross negligence); Wheeler v. United States, 11 F.3d 156, 159 (Fed. Cir. 1993) (Secretarys determination of who is covered under definitions in § 1072 is an unreviewable part of the Secretarys determination of dependency; § 1084 does not distinguish between factual questions, such as finding of dependency, and legal questions, such as interpretation of a statutory term defining who is covered by health plan); see also Key Med. Supply, Inc. v. Burwell, 764 F.3d 955, 962, 965 (8th Cir. 2014) (standard of review; where broad statutory bar shields administrative action from judicial review, this court may not inquire into whether agency decision is arbitrary, capricious, or procedurally defective; statutory bar applies absent viable ultra vires argument or substantial constitutional question); McNary v. Haitian Refugee Ctr., Inc., 498 U.S. 479, 494-95, 111 S.Ct. 888, 112 L.Ed.2d 1005 (1991) (distinguishing actions where essence of claim is entitlement to payment or substantive declaration that claimants are entitled to certain status under relevant administrative program—as success in procedural objections would have the practical effect of establishing entitlement to benefits—from actions challenging agencys procedures where success would entitle claimants to have administrative case reopened and applications reconsidered; action falling into latter category was unimpaired by statutory bar to judicial review).
The judgment is affirmed in part and reversed in part, and the case is remanded with instructions to dismiss the complaint for lack of subject matter jurisdiction.
PER CURIAM.