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

Mealey's Disability Insurance

July 07, 2021
Reduction Of LTD Benefits Was Not Abuse Of Discretion, Federal Judge Says

BOSTON — A Massachusetts federal judge on June 28 granted a motion to dismiss after determining that a reduction of a claimant’s long-term disability (LTD) was not an abuse of discretion because the reduction was permitted by the terms of the disability plan at issue.
July 01, 2021
Claimant Is Entitled To Payment Of LTD Benefits, Judge Says In Issuing Judgment

SAN FRANCISCO — A California federal judge on June 28 entered judgment in favor of a disability claimant after determining that a prior order finding that the claimant is owed long-term disability was a final order, entitling the claimant to a payment of past due and current benefits.
July 01, 2021
Disability Insurer’s Policy Provided LTD Coverage After Policy Change

NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on June 29 reversed and remanded a district court’s ruling that a disability insurer owed no coverage to a claimant after determining that the claimant’s disability coverage shifted from one insurer to another insurer at the end of a calendar year.
June 22, 2021
Disability Claimant Not Permitted To Amend Complaint To Add Bad Faith Claim

MINNEAPOLIS — A Minnesota federal judge on June 14 adopted a magistrate judge’s May 25 recommendation that a disability claimant’s motion to amend a complaint to add a bad faith claim be denied because the Minnesota statute under which the claimant seeks to add the bad faith claim does not apply to disability policies.
June 07, 2021
Claimant Says LTD Benefits Owed For Inability To Wear Face Mask While Working

SAN ANTONIO — A disability insurer should be ordered to pay a claimant more than $70,000 in past long-term disability (LTD) benefits, in addition to future LTD benefits, because the claimant’s respiratory illness prevented him from wearing a face mask, required by his employer in response to the COVID-19 pandemic, the claimant says in a May 26 complaint filed in Texas federal court.
June 07, 2021
ERISA Claims Permitted; Invasion Of Privacy Claim Not Permitted, Judge Says

WASHINGTON, D.C. — A disability claimant is permitted to amend claims relating to the termination of disability benefits under the Employee Retirement Income Security Act; however, the claimant cannot assert a claim for invasion of privacy based on the disability insurer’s use of the claimant’s Facebook, YouTube and travel blog because the claimant made the information on the sites publicly available, a District of Columbia federal judge said June 1 in partially granting the claimant’s motion for leave to file a second amended complaint.
June 04, 2021
5th Circuit Reverses Ruling, Says Claimant Is Owed LTD Benefits Per Policy Provision

NEW ORLEANS — A disability claimant is owed long-term disability benefits because a preexisting condition provision did not apply as the claimant qualified for coverage pursuant to the policy’s transfer of insurance coverage provision, the Fifth Circuit U.S. Court of Appeals said June 2 in reversing a district court’s ruling in favor of the disability insurer.
June 01, 2021
Panel Says Evidence Supports Disability Insurer’s Termination Of LTD Benefits

NEW YORK — The Second Circuit U.S. Court of Appeals on May 27 affirmed a district court’s ruling in favor of a disability insurer, agreeing with the lower court’s finding that substantial evidence supported the insurer’s termination of long-term disability (LTD) benefits after paying the claimant benefits for six years.
May 27, 2021
Disability Claimant, Insurer Ordered To Meet In Attempt To Resolve Discovery Request

ST. LOUIS — A Missouri federal judge on May 14 ordered a disability claimant and a disability insurer to meet in an attempt to resolve a request for discovery sought by the claimant.
May 26, 2021
Termination Of Disability Benefits Was Not Arbitrary, Capricious, Panel Says

ATLANTA — A disability insurer’s termination of benefits was not arbitrary and capricious, the 11th Circuit U.S. Court of Appeals said May 25 in affirming a district court’s ruling that the insurer’s termination of benefits was reasonable based on the medical evidence and the claimant’s failure to prove that he was disabled under the terms of the plan.
May 25, 2021
Emotional Distress Claim Is Not Preempted By ERISA, Federal Judge Determines

SAN DIEGO — A disability claimant’s intentional infliction of emotional distress claim arising out of a third-party claims administrator’s treatment of the claimant is not preempted by the Employee Retirement Income Security Act because the claim does not relate to or depend on the claimant’s ERISA benefits plan, a California federal judge said May 24 in denying a disability insurer’s motion to dismiss.
May 13, 2021
Denial Of STD, LTD Benefits Was Reasonable, Federal Judge Determines

ST. LOUIS — A disability claims administrator did not abuse its discretion in denying claims for short-term disability (STD) and long-term disability (LTD) benefits because the claims administrator’s finding that the claimant was not disabled from performing the duties of her own occupation was reasonable and because the administrator correctly determined that the claimant did not satisfy the LTD plan’s elimination period by failing to exhaust all available STD benefits, a Missouri federal judge said May 10.
May 13, 2021
NFL Players Lack Standing To Assert Claims Related To Changes In Disability Plans

WASHINGTON, D.C. — Two former National Football League players failed to show that they will suffer an injury in fact by the implementation of two new provisions that change how eligibility for disability benefits are determined under the NFL’s disability plans, a District of Columbia federal judge said May 7 in granting the NFL defendants’ motion to dismiss.
May 12, 2021
11th Circuit Dismisses NFL Disability Plan’s Appeals For Lack Of Final Orders

TAMPA, Fla. — The 11th Circuit U.S. Court of Appeals on May 11 dismissed two appeals filed by the Bert Bell/Pete Rozelle NFL Player Retirement Plan and the NFL Player Disability and Neurocognitive Benefit Plan after determining that district court’s orders remanding a former National Football League player’s disability claim and awarding the player attorney fees are not final and appealable orders.
May 12, 2021
Disability Claimant Denied Discovery In ERISA Long-Term Benefits Row

ST. LOUIS — A man who sued his long-term disability (LTD) provider for retroactive benefits under the Employee Retirement Income Security Act (ERISA), saw his quest to take discovery beyond the administrative record denied May 10, with a Missouri federal magistrate judge finding the requested discovery unnecessary to consider a purported conflict of interest between two physicians’ medical opinions.
May 12, 2021
Denial Of LTD Benefits Supported By Medical Evidence, Federal Judge Determines

POCATELLO, Idaho — A disability insurer did not abuse its discretion in denying a claim for long-term disability (LTD) benefits because the insurer’s conclusion that the claimant is capable of performing sedentary work is supported by the medical evidence, a U.S. Court of International Trade judge, sitting by designation in Idaho federal court, said May 7 in granting the insurer’s motion for summary judgment.
May 12, 2021
Disability Insurer’s Denial Of Benefits Was Reasonable, Supported By Evidence

LONDON, Ky. — A disability insurer’s decision to deny a claim for long-term disability (LTD) benefits was reasonable and supported by substantial evidence, a Kentucky federal judge said May 10 in denying the claimant’s motion for judgment on the administrative record and in granting the insurer’s motion for judgment on the administrative record.
May 11, 2021
Prior Plan Exclusion Correctly Applied By Disability Insurer; No Benefits Owed

BIRMINGHAM, Ala. — A disability insurer’s decision to deny a long-term disability benefits claim based on the plan’s prior plan exclusion was not wrong because the exclusion clearly applies as a bar to the benefits sought by the claimant, an Alabama federal judge said May 6.
May 11, 2021
Denial Of Disability Benefits Was Arbitrary, Capricious, Federal Judge Says

MILWAUKEE — A Wisconsin federal judge on May 7 denied a disability insurer’s motion for summary judgment after determining that the insurer’s denial of benefits was arbitrary and capricious because the claimant could not perform all of the required duties of her own occupation.
May 06, 2021
Disability Claimant Permitted To File Amended Complaint Against Insurer’s Subsidiary

NEW ORLEANS — A Louisiana federal judge on May 4 denied a motion to dismiss filed by a subsidiary of a disability insurer and determined that the disability claimant should be granted leave to file an amended complaint against the subsidiary to plead additional facts in support of her claims.
April 30, 2021
Disability Claimant Failed To Prove He Was Disabled From Own Occupation

HOUSTON — A disability claimant failed to prove by a preponderance of the evidence that he was disabled from performing the duties of his own occupation as a result of shoulder, elbow, knee and back problems, a Texas federal judge said April 29 in denying the claimant’s motion for summary judgment and granting the disability insurer’s motion for judgment on the administrative record.
April 30, 2021
Disability Claimant Failed To Show She Was Disabled From Working In Own Occupation

SANTA ANA, Calif. — A disability insurer properly denied a claim for long-term disability (LTD) benefits because the claimant failed to show that she was disabled under the terms of the plan and unable to perform the duties of her own occupation, a federal judge said April 16 in granting judgment in favor of the insurer.
April 28, 2021
Panel Affirms Finding That Disability Claimant Failed To Prove Disability

SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on April 27 affirmed a district court’s finding that a disability claimant failed to prove that he was disabled from his own occupation as a result of sickness or injury according to the plan’s terms and pursuant to a de novo standard of review.
April 26, 2021
High Court Refuses To Review Choice-Of-Law Ruling In Disability Suit

WASHINGTON, D.C. — The U.S. Supreme Court on April 26 denied a disability claimant’s petition for a writ of certiorari, refusing to review the 10th Circuit U.S. Court of Appeals’ ruling on a disability plan’s choice-of-law provision.
April 23, 2021
Insured’s Contract Claim In Bad Faith Suit Dismissed As Vague, Conclusory

HOUSTON — A federal judge in Texas on April 8 dismissed an insured’s claims against his long-term disability insurer stemming from the insurer’s denial of benefits, ruling that the insured failed to sufficiently plead the necessary elements of his breach of contract claim.