Mealey's Disability Insurance
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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.
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November 05, 2021
Benefits Wrongfully Terminated Based On Request To Reschedule Exam, Claimant Says
FORT MYERS, Fla. — A disability claimant alleges in an Oct. 27 complaint filed in Florida federal court that a disability insurer wrongfully and unreasonably terminated his disability benefits based on his request to reschedule a medical evaluation until after he could receive the COVID-19 vaccine.
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November 04, 2021
Termination Of LTD Benefits Was Reasonable Based On Medical Evidence, Panel Says
CHICAGO — A district court properly found that a disability insurer’s termination of long-term disability benefits was reasonable based on the medical evidence, the Seventh Circuit U.S. Court of Appeals said Nov. 3 in rejecting the claimant’s argument that the insurer failed to properly credit the opinion of his treating physician.
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November 04, 2021
Termination Of LTD Benefits Supported By Medical Evidence, Texas Federal Judge Says
HOUSTON — The termination of a claimant’s long-term disability (LTD) benefits was not arbitrary or capricious, a Texas federal judge said Nov. 1 in granting the disability plan’s motion for summary judgment, because the medical records support the plan administrator’s finding that the claimant was not disabled from performing any work for compensation or profit.
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November 03, 2021
District Court Retained Jurisdiction In Disability Benefits Suit, Panel Says
CINCINNATI — A district court erred in determining that it did not have jurisdiction to hear a disability claimant’s motion for attorney fees and motion to reopen her case because the court retained jurisdiction over the suit even though the Sixth Circuit U.S. Court of Appeals previously remanded the claims to the plan administrator, the Sixth Circuit said Nov. 2 in vacating the lower court’s ruling.
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November 03, 2021
Denial Of Disability Benefits Was Not An Abuse Of Discretion, Judge Says
CHARLOTTE, N.C. — A disability plan did not abuse its discretion in denying claims for short-term disability (STD) and long-term disability (LTD) benefits because the plan’s denial was not unreasonable or unsupported by substantial evidence, a North Carolina federal judge said Oct. 27.
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November 02, 2021
Offset Of Disability Benefits Permitted Under Disability Plan, Judge Says
OWENSBORO, Ky. — A disability insurer’s decision to offset a claimant’s benefits was not arbitrary and capricious because the claimant’s benefits from the Veterans Administration qualify as other income benefits under the disability plan at issue, a Kentucky federal judge said Oct. 29 in granting the insurer’s motion for judgment.
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November 02, 2021
Judge: Disability Insurer’s Decision To Deny LTD Benefits Was Arbitrary, Capricious
BOSTON — A Massachusetts federal judge on Oct. 28 granted a disability claimant’s motion for summary judgment after determining that the disability insurer’s decision to deny long-term disability (LTD) benefits was arbitrary and capricious because the insurer did not rely on any substantial evidence in denying the claim.
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November 01, 2021
Disability Claimant Permitted To Conduct Limited Discovery, Federal Judge Says
CAPE GIRARDEAU, Mo. — A Missouri federal judge on Oct. 21 granted a disability claimant’s motion to conduct limited discovery because limited discovery will help to determine whether the plan committed any procedural irregularities in handling the plan participant’s long-term disability (LTD) claim.
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November 01, 2021
Disability Claimant Failed To Prove He Was Covered Employee, Judge Says
PORTLAND, Ore. — A disability insurer is entitled to judgment on the administrative record because the disability claimant failed to meet his burden of proving that he was a covered employee under a long-term disability plan, an Oregon federal magistrate judge said Oct. 25.
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October 28, 2021
Judge Awards $259,276 In Fees For Remand Of 1 Issue In Long-Term Disability Case
PHOENIX — An Arizona federal judge on Oct. 8 granted in part and denied in part a claimant’s motion for attorney fees in a suit seeking long-term disability benefits, finding that the award should be reduced because the lower hourly rate agreed to in the fee agreement should apply, that the fees requested are “excessive in light of the maximum benefits due in the case” and that some of the billing was related to clerical tasks.
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October 21, 2021
Federal Judge Finds Employee’s Disability Continuous, Awards More Than $180,000
SAN DIEGO — A federal judge in California on Oct. 5 ruled that an insurer erred in determining that an employee’s disability due to depression and anxiety stopped for a span of approximately 10 months before starting again and, on Oct. 20, after requesting supplemental briefing, awarded the man past-due benefits of more than $180,000 plus pre- and post-judgment interest.