Mealey's Disability Insurance
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January 12, 2022
Judgment Entered In Favor Of Disability Claimant; Attorney Fees, Costs Awarded
SANTA ANA, Calif. — In a Jan. 3 amended judgment, a California federal judge entered judgment in favor of a disability claimant and awarded the claimant approximately $226,097 in attorney fees and $4,489 in costs after he prevailed on a claim for long-term disability benefits.
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January 12, 2022
Disability Policy’s 3-Year Limitations Provision Is Enforceable, Judge Says
BALTIMORE — A three-year limitations provision in a disability policy is enforceable and bars a disability claimant’s lawsuit seeking a declaration that he is entitled to additional long-term disability benefits, a Maryland federal judge said Jan. 4.
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January 12, 2022
Termination Of Disability Benefits Was Not Arbitrary, Capricious, Judge Says
DETROIT — A disability insurer’s decision to terminate a claimant’s benefits was not arbitrary and capricious because the insurer properly found that the claimant was able to perform the duties of a sedentary occupation, a Michigan federal judge said Dec. 28 in granting the insurer’s motion to affirm its decision.
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January 12, 2022
Disability Claim Remanded To Determine If Pre-Existing Condition Exclusion Applied
NEW ORLEANS — A Louisiana federal judge on Dec. 29 upheld a disability insurer’s determination that a disability claimant is not entitled to long-term disability benefits for migraine headaches but remanded the disability insurer’s determination that the plan’s pre-existing condition exclusion barred benefits for other medical ailments because there is a discrepancy as to when the claimant was hired and whether the pre-existing condition exclusion applied.
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January 12, 2022
Disability Plan Is Not Church Plan; Claimant’s Suit To Remain In Federal Court
COVINGTON, Ky. — A Kentucky federal judge on Jan. 11 denied a disability claimant’s motion to remand after determining that federal jurisdiction exists because the plan at issue is governed by the Employee Retirement Income Security Act and does not qualify as an exempted church plan under ERISA.
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January 11, 2022
District Court Properly Found Claimant Not Disabled From Any Occupation
CINCINNATI — The Sixth Circuit U.S. Court of Appeals on Dec. 13 affirmed a district court’s ruling in favor of a disability insurer after determining that the lower court correctly found that the disability claimant failed to prove by a preponderance of the evidence that he is disabled from performing the duties of any occupation.
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January 10, 2022
District Court Erred In Entering Judgment For Disability Insurer, Panel Says
ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on Dec. 27 reversed a district court’s judgment entered in favor of a disability insurer after determining that the insurer failed to show that there was any new information or evidence to support its decision to terminate benefits after almost 10 years.
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January 07, 2022
Panel Says Any-Occupation Ruling Not Supported; Remand Necessary
PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeal on Dec. 27 affirmed a district court’s finding that a disability claimant is entitled to own-occupation benefits but reversed and remanded the lower court’s ruling that the claimant is entitled to any-occupation benefits because the evidence in the administrative record did not conclusively show that the claimant was disabled from performing the duties of any occupation.
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January 06, 2022
Insurer Waives Right To Respond To Petition Seeking Review Of Disability Ruling
WASHINGTON, D.C. — A disability insurer on Jan. 5 waived its right to respond to a disability claimant’s petition for writ of certiorari filed in the U.S. Supreme Court seeking a “uniform rule enforcing an ERISA plan’s choice of law and applying the chosen law to all plan participants” and a ruling that the Employee Retirement Income Security Act does not preempt state law prescribing de novo judicial review for challenged benefit determinations.
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January 04, 2022
Federal Judge Finds Attorney Fees Reasonable In Physician’s ERISA Disability Suit
WILMINGTON, Del. — A Delaware federal judge on Dec. 17 granted a disability claimant’s request for attorney fees, finding that the claimant met the burden of showing that the fees were not excessive.
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December 22, 2021
High Court Review Sought In Disability Benefits Case Over Discretionary Authority
WASHINGTON, D.C. — In a Dec. 9 petition to the U.S. Supreme Court for a writ of certiorari regarding judgment in favor of a disability insurer, a beneficiary seeks a “uniform rule enforcing an ERISA plan’s choice of law and applying the chosen law to all plan participants” and a ruling that the Employee Retirement Income Security Act does not preempt state law prescribing de novo judicial review for challenged benefit determinations.
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December 10, 2021
Connecticut Panel Affirms Decision In Favor Of Insurance Guaranty Association
HARTFORD, Conn. — A Connecticut appeals panel on Dec. 7 held that the Compensation Review Board did not err in affirming the workers' compensation commissioner for the Fourth District’s decision that the Connecticut Insurance Guaranty Association fulfilled its statutory duty regarding a claimant’s retroactive lump-sum cost of living adjustment (COLA) payment arising from a disability claim.
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December 09, 2021
Disability Claimant Permitted To Supplement Record With Therapist’s Letter
CENTRAL ISLIP, N.Y. — A New York federal magistrate judge on Nov. 29 partially granted a disability claimant’s request to supplement the administrative record with a letter from her physical therapist because the letter shows that there may have been some form of bad faith conduct committed by the disability insurer.
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December 09, 2021
Disability Insurer Is Not Entitled To Attorney Fee Award, Judge Says
TACOMA, Wash. — Despite the fact that a disability insurer prevailed on the merits of a long-term disability (LTD) claim, a Washington federal judge on Dec. 3 denied the insurer’s motion for attorney fees after determining that the insurer failed to prove that the disability claimant acted in bad faith in filing suit and failed to prove that the disability claimant has the ability to pay an award for attorney fees.
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December 09, 2021
Disability Insurer Abused Discretion In Denying Benefits, Oregon Federal Judge Says
PORTLAND, Ore. — After applying a “higher degree of skepticism” as instructed by the Ninth Circuit U.S. Court of Appeals, an Oregon federal judge on Nov. 29 determined that a disability insurer abused its discretion in denying a claim for long-term disability (LTD) benefits because the insurer ignored evidence showing that the claimant remain disabled.
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December 08, 2021
Disability Claimant Was Incapable Of Working Full Time, 4th Circuit Panel Says
RICHMOND, Va. — A disability claimant is entitled to a reinstatement of disability benefits because the medical evidence shows that the claimant was incapable of working in a sedentary full-time employment position when his benefits were terminated, the Fourth District U.S. Court of Appeals said Dec. 7 in reversing a district court’s judgment in favor of the disability insurer.
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December 08, 2021
Disability Insurer’s Denial Of Benefits Was Not Arbitrary, Capricious, Judge Says
CHICAGO — A disability insurer’s denial of disability benefits was not arbitrary and capricious because the insurer reasonably construed the disability plan to require proof of ongoing radiculopathy, an Illinois federal judge said Dec. 6 in granting the insurer’s motion for summary judgment.
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December 08, 2021
Doctor Is Disabled From Performing Duties Of Own Occupation, Judge Determines
SEATTLE — A Washington federal judge on Dec. 6 granted judgment in favor of a disability claimant after determining that the medical evidence supports a finding that the claimant is disabled from her own occupation as a medical doctor based on her stage IV breast cancer diagnosis.
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December 06, 2021
Breach Of Contract Claim Preempted By ERISA, Kentucky Federal Judge Says
LEXINGTON, Ky. — A breach of contract claim alleged against a disability insurer cannot proceed because the claim is based on a plan governed by the Employee Retirement Income Security Act and, therefore, is preempted by ERISA, a Kentucky federal judge said Dec. 3 in dismissing the breach of contract claim.
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December 06, 2021
Disability Claimant Denied Full, Fair Review Under ERISA, 1st Circuit Panel Says
BOSTON — The First Circuit U.S. Court of Appeals on Nov. 10 vacated a district court’s ruling in favor of a disability insurer after finding that a disability plan participant’s claim must be remanded to the plan administrator for a full and fair review because the insurer did not allow the claimant the opportunity to respond to the findings of an independent medical exam.
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December 03, 2021
District Court Did Not Err In Finding Claimant Is Disabled From Any Occupation
CHICAGO — While a district court erred in resolving factual disputes on motions for summary judgment, the district court did not err in finding that a disability claimant is unable to perform the duties of any occupation, the Eighth Circuit U.S. Court of Appeals said Nov. 30.
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November 30, 2021
Termination Of Benefits Was Arbitrary, Capricious, 3rd Circuit Panel Says
PHILADELPHIA — A disability insurer’s termination of benefits was arbitrary and capricious because the insurer “deviated significantly from its normal eligibility-review processes” by requesting an outside evaluation of the claimant, the Third Circuit U.S. Court of Appeals said Nov. 26 in affirming a district court’s decision to reinstate a disability claimant’s benefits.
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November 10, 2021
Judgment Entered For Disability Insurer; Claimant Failed To Exhaust All Remedies
SAN DIEGO — A California federal judge on Nov. 5 entered judgment in favor of a disability insurer after determining that the disability claimant is not entitled to long-term disability benefits because the claimant failed to exhaust her administrative remedies and the medical evidence does not support a finding that the claimant is disabled from performing the duties of her own occupation.
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November 10, 2021
Disability Claimant Cannot Perform Sedentary Work, Ohio Federal Judge Says
CINCINNATI — A disability claimant is entitled to long-term disability (LTD) benefits because the medical evidence supports a finding that the claimant is unable to perform any occupation, including sedentary work, an Ohio federal judge said Nov. 5 in granting judgment in favor of the claimant.
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November 05, 2021
ERISA Claim Seeking Disability Benefits Can Proceed, Judge Says
MINNEAPOLIS — A Minnesota federal judge on Nov. 3 denied a disability insurer’s motion to dismiss a claim seeking disability benefits under the Employee Retirement Income Security Act because the claimant asserted a plausible claim for benefits; however, the judge granted the disability’s insurer’s motion to dismiss the claimant’s breach of fiduciary claim after finding no support for the claim.