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

Mealey's Disability Insurance

September 08, 2023
LTD Insurer’s Denial Of Claim Was Correct, Magistrate Judge Says

GALVESTON, Texas — A Texas federal magistrate judge recommended granting a disability insurer’s motion for judgment on the administrative record after determining that the insurer’s denial of a long-term disability (LTD) claim was correct and supported by the medical evidence.
September 08, 2023
Disability Benefits Claim Denial Was Not Arbitrary, Capricious, Judge Says

PORTLAND, Maine — The denial of a long-term disability (LTD) claim was not arbitrary and capricious because the denial of benefits was reasonable and supported by substantial evidence, a Maine federal judge said in denying the claimant’s motion for judgment on the administrative record and in granting the disability plan’s motion for judgment.
September 08, 2023
Claims Against Disability Plan Fail, Kentucky Federal Judge Determines

PADUCAH, Ky. — A Kentucky federal judge dismissed a disability plan participant’s claims against a disability plan after determining that the disability claimant failed to show that the plan misstated the amount of long-term disability (LTD) benefits available to the claimant.
September 08, 2023
Disability Insurer’s Motion To Dismiss Complaint Denied As Premature

DAYTON, Ohio — An Ohio federal judge denied a disability insurer’s motion to dismiss a claimant’s suit alleging wrongful denial of disability benefits after determining that the motion is premature and that the parties must participate in discovery before the insurer’s arguments can be considered.
September 07, 2023
Disability Insurer Seeks 8th Circuit’s Review Of Any-Occupation Ruling

MINNEAPOLIS — A disability insurer filed a notice of appeal in the Eighth Circuit U.S. Court of Appeals, seeking review of a judge’s finding that a disability claimant met her burden of showing that she is disabled from performing the duties of any occupation.
September 06, 2023
Disability Claimant Files Appeal After Denial Of Motion For Attorney Fees

LANSING, Mich. — A disability claimant filed a notice of appeal to the Sixth Circuit U.S. Court of Appeals, seeking review of a district court’s denial of the claimant’s motion for attorney fees based on a finding that the claimant failed to show that the insurer acted in bad faith or that the insurer’s position in the suit was without merit.
September 06, 2023
Termination Of LTD Benefits Was Not Arbitrary, Capricious, Federal Judge Says

NEW YORK — A disability insurer’s termination of a claimant’s long-term disability (LTD) benefits was not arbitrary and capricious because the termination was based on substantial evidence, a New York federal judge said in granting the insurer’s motion for summary judgment and in denying the claimant’s motion for summary judgment.
September 06, 2023
7th Circuit: Failure To Consider Disability Claimant’s Inability To Sit Was Error

CHICAGO — A district court committed clear error by failing to consider that a disability claimant was unable to sit at a desk for eight hours a day because the ability to sit at a desk for eight hours a day is required to perform the duties of his own occupation, the Seventh Circuit U.S. Court of Appeals said in vacating and remanding the district court’s ruling in favor of a disability insurer.
August 11, 2023
Claimant Says Disability Benefits Are Still Owed Under Company’s LTD Plan

BOSTON — A disability plan violated the Employee Retirement Income Security Act when he wrongfully terminated a claim for long-term disability (LTD) benefits because the claimant remains disabled as a result of a chronic facial pain disorder, the claimant says in a complaint filed in Massachusetts federal court.
August 11, 2023
Disability Claimant’s Suit Reopened To Determine If Plan Rider Bars Benefits

BALTIMORE — A Maryland federal judge granted a disability claimant’s motion to reopen a suit seeking any-occupation disability benefits to review whether a disability plan’s special conditions limitation rider applies as a bar to the claimant’s benefits.
August 11, 2023
Fiduciary Exception Applies In Disability Discovery Dispute, Magistrate Judge Says

MINNEAPOLIS — A Minnesota federal magistrate judge determined that a disability claimant is entitled to communications between a disability insurer and its attorney because the communications are exempted from protection under the fiduciary exception in the Employee Retirement Income Security Act as the communications occurred before the development of an adversarial relationship between the clamant and the disability insurer.
August 10, 2023
Disability Plan’s Termination Of Benefits Was Arbitrary, Capricious, Claimant Says

PORTLAND, Ore. — A disability plan’s termination of long-term disability (LTD) benefits was arbitrary and capricious because the plan’s termination was not based on substantial evidence showing that the claimant was no longer disabled from performing the duties of his own occupation as a software development engineer, the claimant says in a complaint filed in Oregon federal court.
August 10, 2023
LTD Benefits Owed Under Disability Plan, Claimant Says In Complaint

BOSTON — A disability insurer wrongfully terminated a claim for long-term disability (LTD) benefits because the claimant remains disabled from performing the duties of any occupation as required by the disability plan, the claimant contends in a complaint filed in Massachusetts federal court.
August 09, 2023
Disability Claimant Permitted To File Appeal In Forma Pauperis, Circuit Judge Says

CINCINNATI — A Sixth Circuit U.S. Court of Appeals judge granted a disability claimant’s motion to proceed in forma pauperis on appeal because it does not appear that the claimant’s appeal of a district court’s ruling in favor of a disability pension plan on the issue of the claimant’s disability onset date is frivolous.
August 09, 2023
Termination Of LTD Benefits Not Arbitrary, Capricious, 6th Circuit Panel Says

CINCINNATI — A third-party disability claims administrator’s termination of long-term disability (LTD) benefits was not arbitrary and capricious because the administrator engaged in a reasoned and principled process before terminating the benefits, the Sixth Circuit U.S. Court of Appeals said in affirming a district court’s decision.
August 09, 2023
Disability Claimant’s Suit Against Employer Is Barred By Doctrine Of Res Judicata

WASHINGTON, D.C. — The District of Columbia Circuit U.S. Court of Appeals affirmed a district court’s ruling that a disability claimant’s suit is barred by the doctrine of res judicata because the claimant’s suit is based on the same facts that were at issue in a previously dismissed lawsuit filed by the claimant.
July 24, 2023
Termination Of Disability Benefits Supported, Panel Majority Says In Reversing

ST. LOUIS — The majority of the Eighth Circuit U.S. Court of Appeals reversed a district court’s summary judgment ruling in favor of a disability claimant after determining that substantial evidence supports the disability insurer’s termination of benefits and that the disability insurer’s delay in deciding the claimant’s appeal was not an abuse of discretion.
July 20, 2023
Union Member Failed To Show Disability Was Caused By On-The-Job Injury, Panel Says

CHICAGO — A district court properly entered judgment in favor of a pension trust fund because the union member failed to offer evidence showing that his disability was caused by an injury sustained while working as required to qualify for disability benefits under the trust fund, the Seventh Circuit U.S. Court of Appeals said.
July 07, 2023
Breach Of Contract, Fraud Claims Preempted By ERISA, Federal Magistrate Judge Says

WEST PALM BEACH, Fla. — A Florida federal magistrate judge recommended dismissing a disability claimant’s breach of contract and fraud suit filed against three attorneys of her employer’s disability insurer after determining that the state law claims of breach of contract and fraud are preempted by the Employee Retirement Income Security Act because they relate to the denial of a short-term disability (STD) claim under a disability plan governed by ERISA.
July 07, 2023
Denial Of Benefits Was Arbitrary, Capricious, Judge Says In Remanding Claim

CAMDEN, N.J. — A disability insurer’s denial of benefits was arbitrary and capricious because it failed to conduct a substantive review of the claim for benefits, a New Jersey federal judge said in remanding the claim for further consideration.
July 07, 2023
Denial Of LTD Claim ‘Supported By Substantial Evidence,’ Panel Says

DENVER — A disability insurer’s denial of a long-term disability (LTD) benefits claim was not arbitrary and capricious because the insurer’s decision that the claimant was not disabled from performing the duties of her own occupation was “reasonable and supported by substantial evidence,” the 10th Circuit U.S. Court of Appeals said in affirming a district court’s ruling.
July 07, 2023
Bad Faith Claim In Disability Suit Proceeds; Emotional Distress Claim Dismissed

CAMDEN, N.J. — A New Jersey federal judge on July 6 determined that a disability claimant’s bad faith claim can proceed because the claimant sufficiently stated facts in support of the claim but a claim for intentional and negligent infliction of emotional distress cannot proceed because the claimant failed to show that the disability insurer’s conduct caused her to suffer emotional distress.
July 06, 2023
Termination Of LTD Benefits Was Result Of Deliberate Reasoning Process

CINCINNATI — The termination of a claimant’s long-term disability (LTD) benefits claim was not arbitrary and capricious under New York law because the record supported the denial of benefits and the third-party claims administrator’s decision was the result of a deliberate and principled reasoning process, the Sixth Circuit U.S. Court of Appeals said in affirming a district court’s judgment.
July 06, 2023
Evidence Supports Finding That Claimant Not Disabled From Working In Own Occupation

CHICAGO — A disability insurer’s denial of a long-term disability (LTD) benefits claim was not arbitrary and capricious because the evidence in the administrative record supports the insurer’s conclusion that the claimant was not disabled from performing the duties of her own occupation, an Illinois federal judge said in granted the insurer’s motion for summary judgment.
July 06, 2023
Question Of Fact Exists As To Whether Payments Were Disability Or Workers’ Comp

WASHINGTON, D.C. — A district court erred in granting summary judgment in favor of an employer in a dispute over whether an injured employee’s wages were properly reported as disability payments, which are taxable income, on W-2s filed with the Internal Revenue Service as opposed to workers’ compensation payments, which are nontaxable income, because a question of fact exists regarding what type of payments the employee received, the District of Columbia Circuit U.S. Court of Appeals said in reversing and remanding.