Mealey's Disability Insurance
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October 11, 2024
Disability Insurer Says Claimant Not Entitled To More Than $445K In Attorney Fees
MINNEAPOLIS — A disability plan participant is not entitled to more than $445,000 in attorney fees because the participant’s submissions in support of the requested amount are based on unreasonable hourly rates and unsupported time entries, a disability insurer says in its response to the participant’s motion for attorney fees filed in Minnesota federal court.
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October 11, 2024
LTD Benefits Owed Based On Fibromyalgia Diagnosis, Disability Claimant Says
ATLANTA — In a complaint filed in Georgia federal court, a disability claimant alleges that her long-term disability (LTD) benefits were wrongfully denied and urges the court to find that she remains disabled under the disability plan as a result of a fibromyalgia diagnosis.
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October 11, 2024
Illinois Federal Judge Says Disability Claimant Failed To Show She Remains Disabled
CHICAGO — An Illinois federal judge denied a disability claimant’s motion for judgment on the administrative record after determining that the claimant failed to meet her burden of proving by a preponderance of the evidence that she remained disabled from working in a sedentary occupation as a result of symptoms related to fibromyalgia.
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October 11, 2024
Disability Claimant Not Entitled To Supplement Claim Record, Magistrate Judge Says
SPRINGFIELD, Mass. — A Massachusetts federal magistrate judge on Oct. 10 denied a disability claimant’s motion to clarify and complete a claim record after determining that the disability insurer sufficiently attested that the claim record is the complete record.
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October 10, 2024
Disability Claimant, Insurer Settle Dispute; Judge Enters Order Of Dismissal
BALTIMORE — A Maryland federal judge dismissed a long-term disability (LTD) benefits suit after the parties reached a settlement and filed a stipulation of dismissal.
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October 10, 2024
Disability Claimant Appeals Any Occupation Standard Ruling To 11th Circuit
ATLANTA — A disability claimant filed a notice of appeal to the 11th Circuit U.S. Court of Appeals following a Georgia federal judge’s finding that a disability insurer’s termination of long-term disability (LTD) benefits was not wrong because the claimant failed to meet her burden of proving that she is disabled under the plan’s any occupation standard.
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October 09, 2024
Termination Of LTD Benefits Was Not Arbitrary, Capricious, Federal Judge Says
BATON ROUGE, La. — A disability insurer did not act arbitrarily or capriciously in terminating a claimant’s long-term disability (LTD) benefits because the insurer’s decision is supported by substantial medical evidence showing that the claimant was not disabled from performing the duties of any occupation, a Louisiana federal judge said in denying the claimant’s motion for judgment on the administrative record.
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October 09, 2024
Disability Claimant Failed To Prove Back Pain, Issues Are Disabling, Judge Says
ALEXANDRIA, Va. — A disability claimant failed to present sufficient evidence to meet her burden of showing that she is disabled from performing the duties of her own occupation as a result of chronic back pain and disc degeneration, a Virginia federal judge said in granting a disability insurer’s motion for judgment on the administrative record.
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October 07, 2024
High Court Refuses To Review 5th Circuit’s Ruling In NFL Disability Benefits Suit
WASHINGTON, D.C. — The U.S. Supreme Court denied a former National Football League player’s petition for a writ of certiorari in its list of orders issued Oct. 7, refusing to review the Fifth Circuit U.S. Court of Appeals’ ruling that the former NFL player failed to prove that he is entitled to additional disability benefits under the NFL’s benefits plan.
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September 24, 2024
Panel Says Insured Failed To Show He Is Disabled From Both Occupations As Required
TRENTON, N.J. — The Third Circuit U.S. Court of Appeals affirmed a district court’s ruling in favor of a disability income insurer, agreeing with the lower court’s determination that the insured failed to show that he cannot perform the substantial and material duties of his occupations as an ophthalmic surgeon and ophthalmologist.
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September 18, 2024
Disability Claimant Must Return $322K Overpayment To Disability Plan, Judge Says
SPARTANBURG, S.C. — A disability plan’s determination that a claimant must return $322,000 in overpayments made by the plan to the claimant was not an abuse of discretion because the plan requires any overpayment of benefits to be returned to the plan, a South Carolina federal judge said in granting the plan’s motion for summary judgment.
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September 18, 2024
Disability Claimant Owed LTD Benefits, Virginia Federal Judge Says
ALEXANDRIA, Va. — A Virginia federal judge granted a disability claimant’s motion for judgment on the administrative record and ordered the disability insurer to pay the claimant past-due long-term disability (LTD) benefits after determining that the claimant met her burden of showing that she is disabled from working as an engineer as a result of symptoms caused by long COVID.
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September 06, 2024
Disability Claimant’s LTD Benefits Must Be Reinstated, Minnesota Federal Judge Says
MINNEAPOLIS — A Minnesota judge reinstated a disability claimant’s long-term disability (LTD) benefits after determining that the evidence shows that the claimant’s symptoms were disabling and that his condition did not improve to the point where he could work in his own occupation as a medical malpractice attorney.
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September 06, 2024
Amici File Briefs Urging High Court To Review NFL Disability Benefits Suit
WASHINGTON, D.C. — Three amicus curiae briefs, filed in the U.S. Supreme Court in support of a former National Football League player’s petition for a writ of certiorari, urge the high court to review the Fifth Circuit U.S. Court of Appeals’ ruling that the former NFL player failed to prove he is entitled to additional disability benefits under the NFL’s benefits plan, arguing that a de novo standard of review applies based on the plan’s procedural violations.
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September 06, 2024
Utah Federal Judge Denies Disability Claimant’s Motion To Reopen Disability Suit
SALT LAKE CITY — A Utah federal judge denied a disability claimant’s motion to reopen a disability suit after determining that the claimant is required to file a civil enforcement action under the Employee Retirement Income Security Act because the dispute is centered on the disability insurer’s calculation of benefits.
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September 06, 2024
Disability Plan’s Special Conditions Limitation Rider Bars LTD Benefits Claim
BALTIMORE — A Maryland federal judge on Sept. 5 granted a disability insurer’s motion for summary judgment after determining that the disability plan’s special conditions limitation rider applies as a bar to the disability claimant’s long-term disability (LTD) benefits.
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September 06, 2024
Disability Claimant Failed To Show Termination Of Benefits Was Arbitrary, Capricious
NEW YORK — A disability insurer’s termination of a long-term disability (LTD) benefits claim was not arbitrary and capricious because nothing in the medical record reviewed by the insurer and its reviewing physicians supported a finding that the claimant was disabled from working on a full-time basis, a New York federal magistrate judge said in recommending that the insurer’s motion for summary judgment be granted and that the disability claimant’s motion for summary judgment be denied.
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September 06, 2024
Default Judgment Entered Against Disability Claimant For Failure To Repay Plan
CINCINNATI — A plan administrator is entitled to default judgment on a breach of fiduciary duty claim alleged against a disability claimant who failed to reimburse the long-term disability (LTD) plan for the overpayment of benefits following the claimant’s award of Social Security disability benefits because the claimant failed to respond to the plan administrator’s suit and breached his fiduciary duty by not repaying the plan as required by the plan’s terms, an Ohio federal judge said.
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September 05, 2024
Denial Of Attorney Fee Award To Disability Claimant Was Proper, Panel Says
CINCINNATI — A district court did not abuse its discretion in denying a disability claimant’s motion for attorney fees because the claimant failed to carry his burden of showing that the attorney fees he sought to recover were reasonable, the Sixth Circuit U.S. Court of Appeals said in affirming the lower court’s ruling.
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September 05, 2024
Breach Of Contract, Bad Faith Suit Against Disability Insurer Remanded
MILWAUKEE — A Wisconsin federal magistrate judge remanded an insured’s breach of contract and bad faith suit against a disability insurer and an independent insurance agent after determining that the agent was not fraudulently joined as a defendant to defeat the diversity of citizenship requirement because the insured’s negligent misrepresentation claim against the agent alleges sufficient facts in support of the claim.
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September 04, 2024
Attorney Fees, Costs Not Warranted, Minnesota Federal Judge Says
MINNEAPOLIS — A Minnesota federal judge denied a disability claimant’s motion for attorney fees and costs after determining that an award of fees and costs is not warranted because no other plan participant will benefit from the claimant’s suit and the suit did not resolve an important legal question.
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August 30, 2024
Disability Insurer’s Alleged Conduct Does Not Support Request For Punitive Damages
RIVERSIDE, Calif. — An insured’s request for punitive damages against a disability insurer must be dismissed because the insured’s complaint does not allege conduct that supports punitive damages, a California federal judge said in granting the insurer’s motion to dismiss the request without prejudice.
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August 21, 2024
High Risk Of Developing Complications From COVID-19 Rendered Doctor Disabled
SAN FRANCISCO — A disability insurer’s denial of a pediatrician’s long-term disability (LTD) benefits claim was de novo wrong because the pediatrician’s high risk of exposure to COVID-19 and high risk of developing complications from the virus based on her underlying medical issues rendered her disabled from performing the duties of her own occupation, a California federal judge said in granting the pediatrician’s motion for judgment on the administrative record.
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August 15, 2024
Fact Issue Exists On Cause Of Disability Claimant’s Symptoms, Judge Says
FORT MYERS, Fla. — A Florida federal judge partially denied a disability insurer’s motion for summary judgment after determining that a question of fact exists as to whether the insured received regular medical care from the appropriate medical professional for symptoms of shakiness and motor tics.
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August 09, 2024
LTD Insurer Must Pay Retroactive, Future Benefits, Minnesota Federal Judge Says
MINNEAPOLIS — A disability plan participant is entitled to retroactive long-term disability (LTD) benefits and future LTD benefits because the plan participant met her burden of proving by a preponderance of the evidence that cognitive difficulties rendered her disabled from performing the duties of her own occupation as an attorney, a Minneapolis federal judge said in granting the plan participant’s motion for judgment on the administrative record.