Mealey's Disability Insurance : Mealey's : Legal News & Analysis

Mealey's Disability Insurance

July 29, 2024
Ex-NFL Player Seeks High Court Review, Says Wrong Standard Of Review Applied

WASHINGTON, D.C. — A former National Football League player filed a petition for writ of certiorari in the U.S. Supreme Court, contending that the high court should review the Fifth Circuit U.S. Court of Appeals’ ruling that he failed to prove that he is entitled to additional disability benefits under the NFL’s benefits plan because a de novo standard of review should have been applied based on the plan’s procedural violations.
July 29, 2024
NFL Disability Plan Says Former Player’s Appeal Should Not Be Reinstated

ATLANTA — The 11th Circuit U.S. Court of Appeals should summarily deny a former National Football League player’s motion to reinstate his appeal in a dispute over additional disability benefits owed under the NFL’s disability plan because the motion is untimely and because the former player failed to show any good cause to excuse the untimeliness of the appeal, the NFL plan maintains in response to the former player’s motion.
July 26, 2024
Parties Stipulate To Dismissal Of Long COVID Disability Benefits Suit After Settlement

MIAMI — Following a second order issued by a Florida federal judge, the parties in a long-term disability (LTD) benefits suit stemming from a claimant’s diagnosis with long COVID filed a joint stipulation of dismissal on July 25 after settling the LTD claim.
July 24, 2024
Disability Insurer Permitted To File Entire Administrative Record Under Seal

CINCINNATI — A disability insurer is permitted to file the entire administrative record in a disability benefits suit under seal because redaction of the sensitive and confidential information from the record would be time consuming and burdensome and filing the administrative record under seal would ensure that the claimant’s personal and confidential information remains protected, an Ohio federal judge said in granting the parties’ joint motion to file the administrative record under seal.
July 23, 2024
Disability Claimant Deprived Of Full, Fair Review, Florida Federal Judge Says

MIAMI — A Florida federal judge on July 22 remanded a long-term disability (LTD) claim to the plan administrator after determining that the claimant was deprived of a full and fair review because the disability insurer issued a decision on appeal without affording the claimant the opportunity to respond to two reports upon which it relied when terminating the claimant’s benefits.
July 17, 2024
California Judge Dismisses LTD Plan From Suit, Leaving Insurer As Sole Defendant

OAKLAND, Calif. — A California federal judge dismissed a long-term disability (LTD) plan from a disability claimant’s suit, leaving the disability insurer as the sole defendant after the parties jointly agreed to dismiss the plan as a defendant.
July 17, 2024
Panel Affirms Ruling In Favor Of Disability Claimant, Says Denial Was De Novo Wrong

ATLANTA — A disability insurer’s denial of a medical doctor’s long-term disability (LTD) benefits claim was de novo wrong because the insurer construed the policy language referring to compensation from a medical partnership without considering the context of the policy language as a whole, the 11th Circuit U.S. Court of Appeals said in affirming a district court’s summary judgment ruling entered in favor of a disability claimant.
July 08, 2024
LTD Claim Remanded To Allow Claimant To Respond To Independent Peer Reviews

MINNEAPOLIS — A Minnesota federal judge remanded a long-term disability (LTD) claim to allow a disability claimant to respond to independent peer reviews conducted by the disability insurer and to submit additional evidence in response to the peer reviews.
July 05, 2024
Pro Se Litigant’s Disability Suit Was Properly Dismissed, 6th Circuit Affirms

CINCINNATI — The Sixth Circuit U.S. Court of Appeals on July 3 affirmed a district court’s dismissal of a pro se disability claimant’s suit after determining that the claimant was afforded the opportunity to allege claims under the Employee Retirement Income Security Act but failed to do so in accordance with the district court’s directives.
July 05, 2024
Failure To Consider Cognitive Issues Was Abuse Of Discretion, Federal Judge Says

BALTIMORE — A Maryland federal judge determined that a disability insurer abused its discretion in terminating a disability claimant’s long-term disability (LTD) benefits because the insurer failed to consider how the claimant’s cognitive issues affect her ability to work in her regular occupation.
July 03, 2024
Termination Of LTD Benefits Not Arbitrary, Capricious, Ohio Federal Judge Says

COLUMBUS, Ohio — A disability insurer’s termination of long-term disability (LTD) benefits after paying benefits for 19 years was not arbitrary and capricious because substantial evidence supports the finding that the claimant was no longer disabled from performing the duties of any occupation and the claimant failed to identify any evidence showing that the termination was arbitrary and capricious, an Ohio federal judge said in granting the disability insurer’s motion for judgment on the administrative record.
July 03, 2024
After Evidence Of Insurability Probes, DOL Reports Settlements With Life Insurers

WASHINGTON, D.C. — Saying in a news release that “[i]nvestigations into other life insurance companies’ practices surrounding evidence of insurability [EOI] are ongoing,” the U.S. Department of Labor (DOL) announced two settlements in which its investigations were resolved by life insurers’ agreements to follow certain procedures.
June 25, 2024
Termination Of LTD Benefits Supported By Evidence In Administrative Record

BOSTON — A disability insurer’s termination of a claimant’s long-term disability (LTD) benefits was not arbitrary and capricious, a Massachusetts federal judge concluded June 24 after determining that the evidence in the administrative record clearly supports the insurer’s finding that the claimant was no longer disabled from performing the duties of any occupation.
June 21, 2024
Claimant Failed To Meet Burden Of Showing He Is Disabled From Own Occupation

CONCORD, N.H. — A disability claimant is not entitled to long-term disability (LTD) benefits because he failed to meet his burden of proving by a preponderance of the evidence that he is disabled as a result of narcolepsy from performing the duties of his own occupation, a New Hampshire federal judge said in denying the claimant’s motion for judgment on the administrative record and in granting the disability insurer’s motion for judgment on the administrative record.
June 21, 2024
Disability Suit Dismissed For Failure To Timely File Suit, Exhaust All Benefits

NASHVILLE, Tenn. — A disability claimant’s suit against a disability insurer and employer must be dismissed because the claim based on a denial of short-term disability (STD) benefits is barred by the disability plan’s one-year limitations period for filing suit and the claim based on a denial of long-term disability (LTD) benefits cannot proceed based on the claimant’s failure to exhaust all available STD benefits under the plan, a Tennessee federal judge said.
June 21, 2024
Termination Of Benefits Under Any-Occupation Standard Was Reasonable, Judge Says

COLUMBIA, Tenn. — A Tennessee federal judge adopted a magistrate judge’s report and recommendation to grant a disability insurer’s motion for judgment on the administrative record, agreeing with the magistrate judge’s finding that the disability insurer’s decision to terminate the claimant’s benefits was reasonable and not arbitrary and capricious.
June 20, 2024
Termination Of LTD Benefits Was Not Abuse Of Discretion, Arizona Federal Judge Says

PRESCOTT, Ariz. — A disability insurer did not abuse its discretion in terminating a long-term disability (LTD) benefits claim because the termination was reasonable based on a lack of medical evidence in support of the claim, an Arizona federal judge said in entering judgment for the insurer.
June 19, 2024
Former NFL Player’s Appeal Dismissed By 11th Circuit For Want Of Prosecution

ATLANTA — The 11th Circuit U.S. Court of Appeals on June 18 dismissed a former National Football League player’s appeal in a dispute over additional disability benefits for want of prosecution because the former NFL player failed to file required disclosures and forms as required by the court.
June 19, 2024
Kentucky Panel Affirms Trial Court’s Offset Ruling In Disability Suit

FRANKFORT, Ky. — A disability insurer incorrectly offset a claim for long-term disability (LTD) benefits by the amount of a claimant’s first round of retirement benefits because the policy is ambiguous as to how multiple sets of retirement benefits should be offset against an LTD claim, the Kentucky Court of Appeals panel said in affirming a trial court’s ruling.
June 19, 2024
Oklahoma Federal Judge Says Disability Claimant’s Suit Fails To State A Claim

OKLAHOMA CITY — An Oklahoma federal judge granted a disability insurer’s motion to dismiss a disability claimant’s suit after determining that the claimant failed to plausibly plead claims for a denial of benefits or a breach of fiduciary duty.
June 07, 2024
LTD Benefits Cannot Be Offset By Social Security Retirement Benefits, Judge Says

ALEXANDRIA, Va. — A disability insurer abused its discretion for a third time by ignoring the language of the disability policy and contending that a claimant’s monthly long-term disability (LTD) benefits amount should be offset by the amount of the claimant’s earned-income Social Security retirement benefits, a Virginia federal judge said after determining that the plan permits an offset only for Social Security benefits paid because of a claimant’s disability.
June 07, 2024
Disability Claimant Says Any-Occupation Benefits Are Owed By Disability Insurer

SAN DIEGO — A disability insurer abused its discretion in determining that a disability claimant is not disabled from performing the duties of any occupation based on symptoms related to the claimant’s diagnoses of fibromyalgia and ankylosing spondylosis because the medical evidence submitted by the claimant supports a finding that the claimant is disabled from performing the duties of any occupation, the claimant maintains in a June 6 complaint filed in California federal court.
June 07, 2024
Oral Arguments Scheduled In Dispute Over Proof Of Continued Disability

PHILADELPHIA — The Third Circuit U.S. Court of Appeals scheduled oral arguments for July 9 in a disability plan’s appeal of a district court’s ruling that the plan abused its discretion when it terminated a claimant’s long-term disability (LTD) benefits for failure to provide proof of a continued disability.
June 07, 2024
Former NFL Player Files Notice Of Appeal After Dismissal Of Suit

ATLANTA — A former National Football League player who claims that he is owed additional disability benefits filed a notice of appeal to the 11th Circuit U.S. Court of Appeals, seeking review of the lower court’s dismissal of his second amended complaint based on a finding that he failed to exhaust all administrative remedies and failed to show that exhaustion would be futile.
June 06, 2024
Mental Illness Limitation Does Not Apply, Disability Claimant Says In Complaint

PORTLAND, Maine — A disability plan participant filed suit in Maine federal court against a disability insurer, claiming that he is entitled to reinstatement of long-term disability (LTD) benefits because the insurer wrongfully applied the plan’s mental illness limitation when it terminated his LTD benefits.