ATLANTA — A disability insurer acted arbitrarily and capriciously in determining the date of a claimant’s disability, the 10th Circuit U.S. Court of Appeals said Oct. 17 in reversing a district court’s judgment in favor of the insurer (Greggory B. Owings v. United Of Omaha Life Insurance Co., No. 16-3128, 10th Cir., 2017 U.S. App. LEXIS 20228).
WASHINGTON, D.C. — The U.S. Department of Labor’s Employee Benefits Security Administration on Oct. 12 published in the Federal Register a proposal to delay the applicability of a final rule amending the claims procedure requirements that are applicable to employee disability benefit plans governed by the Employee Retirement Income Security Act.
NEW YORK — A New York federal judge on Oct. 12 overruled a disability claimant’s objections to a magistrate judge’s order denying the claimant’s request for statistical information on claim acceptance rates by a disability insurer after determining that the requested statistics do not directly relate to the disability claim at issue (Cherylle McFarlane v. First Unum Life Insurance Co., No. 16-7806, S.D. N.Y., 2017 U.S. Dist. LEXIS 169052).
CINCINNATI — A disability plan administrator did not act arbitrarily or capriciously in denying a plan participant’s claims for short-term disability benefits because the participant failed to provide objective medical evidence supporting the disability, the Sixth Circuit U.S. Court of Appeals said Oct. 10 (Rebecca Filthaut v. AT&T Midwest Disability Benefit Plan et al., No. 16-2707, 6th Cir., 2017 U.S. App. LEXIS 19882).
COLUMBUS, Ohio — An Ohio federal judge on Oct. 10 dismissed a claim for breach of fiduciary duty alleged against a disability insurer because the same equitable relief sought by the disability claimant can be obtained if the claimant prevails on his claim seeking recovery of disability benefits (Edward Osborn Sr. v. Principal Life Insurance Co., No. 17-329, S.D. Ohio, 2017 U.S. Dist. LEXIS 166877).
PEORIA, Ill. — An Illinois federal judge on Oct. 10 denied a motion to dismiss a complaint alleging wrongful denial of disability benefits after determining that the claimant exhausted her administrative remedies by submitting additional medical evidence in response to the disability insurer’s denial of her claim (Sherry Meyer v. Group Long Term Disability Plan for Employees of Edward D. Jones & Co. L.P., et al., No. 16-1282, C.D. Ill., 2017 U.S. Dist. LEXIS 166947).
SAN FRANCISCO — A disability insurer’s termination of benefits based on the plan’s self-reported symptoms limitation was reasonable because the claimant did not provide any additional evidence supporting her disability, the Ninth Circuit U.S. Court of Appeals said Sept. 22 (Robin Curran v. United of Omaha Life Insurance Co., and United of Omaha Life Insurance Co. v. Robin Curran, Nos. 15-56599, 15-56668, 9th Cir., 2017 U.S. App. LEXIS 18443).
DENVER — A Colorado federal judge on Sept. 29 determined that a plan administrator’s denial of long-term disability (LTD) benefits based on the plan’s pre-existing condition limitation was not arbitrary and capricious because substantial evidence supports the plan administrator’s finding that the disability for which the claimant sought benefits was likely caused by a pre-existing condition (Michael Green v. Life Insurance Company of North America, No. 16-2366, D. Colo., 2017 U.S. Dist. LEXIS 160900).
WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 2 refused to review the Sixth Circuit U.S. Court of Appeals’ decision that a former marketing director’s claims for disability insurance coverage against a medical review company are completely preempted by the Employee Retirement Income Security Act (James Hackney v. Allmed Healthcare Management Inc., No. 17-102, U.S. Sup.).
WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 2 denied a disability claimant’s petition for writ of certiorari of the Sixth Circuit U.S. Court of Appeals’ decision that a negligence claim is completely preempted by the Employee Retirement Income Security Act (Samantha Milby v. MCMC LLC, No. 16-1409, U.S. Sup.).
TACOMA, Wash. — A Washington federal judge on Sept. 27 granted judgment in favor of a disability claimant after determining that the insurer’s vocational assessment was flawed because the assessment relied on unsupported information taken from the claimant’s social media profiles to conclude that the claimant had enough experience to secure a job in the media industry (Anthony Flaaen v. Principal Life Insurance Co. Inc., No. 15-5899, W.D. Wash., 2017 U.S. Dist. LEXIS 159142).
NEW YORK — An arbitrary and capricious standard of review will be applied in a disability benefits dispute because the plan at issue clearly granted discretionary authority to the insurer and the claimant failed to carry the burden of proving that a de novo standard of review should be applied, a New York federal judge said Sept. 26 (Laurie Tietjen v. Unum Life Insurance Company of America, No. 16-7021, S.D. N.Y., 2017 U.S. Dist. LEXIS 157721).
WASHINGTON, D.C. — The Second Circuit U.S. Court of Appeals erred in finding that New York law bars the offset of disability benefits when a claim for personal injuries is settled because the decision conflicts with rulings in other circuits and because the New York law is preempted by the Employee Retirement Income Security Act, a disability insurer argues in a Sept. 19 petition for writ of certiorari filed in the U.S. Supreme Court (Aetna Life Insurance Co. v. Salvatore Arnone, No. 17-416, U.S. Sup., 2017 U.S. S. Ct. Briefs LEXIS 3637).
YOUNGSTOWN, Ohio — An Ohio federal judge on Sept. 25 determined that a disability insurer’s denial of long-term disability (LTD) benefits based on the plan’s any-occupation standard was not arbitrary and capricious and found merit in the insurer’s argument that the claimant’s history of drug abuse would preclude him from benefits under the plan’s two-year limitation provision for drug and alcohol abuse (Robert M. Hoperich v. Aetna Life Insurance Co., No. 16-2590, N.D. Ohio, 2017 U.S. Dist. LEXIS 156490).
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Sept. 18 affirmed a district court’s finding that a disability insurer’s denial of benefits was reasonable, noting that the medical evidence supports the insurer’s determination (Nannette Fawn Anderson v. Life Insurance Company of North America, No. 16-15522, 9th Cir., 2017 U.S. App. LEXIS 18055).
BILLINGS, Mont. — A Montana federal judge on Sept. 20 granted a disability claimant’s motion for summary judgment after determining that Montana’s mental health parity law requires the plan to provide the claimant with the same benefits for her mental illness as it would if her disability were physical (Theresa Sand-Smith v. Liberty Life Assurance Company of Boston, No. 17-0004, D. Mont., 2017 U.S. Dist. LEXIS 153217).
SACRAMENTO, Calif. — A California federal judge on Sept. 12 granted a disability claimant’s motion for leave to proceed anonymously after determining that the private facts at issue and the absence of a compelling interest in exposing the claimant’s identity warrant anonymity (Jane Doe v. Hartford Fire Insurance Company Employee Income Protection Plan, No. 17-1714, E.D. Calif., 2017 U.S. Dist. LEXIS 147786).
SAN FRANCISCO — A California federal judge on Sept. 14 awarded a disability claimant more than $100,000 in attorney fees after determining that the award was warranted because the claimant achieved “some degree” of success on the merits (Robert Bosley v. Metropolitan Life Insurance Co., No. 16-00139, N.D. Calif., 2017 U.S. Dist. LEXIS 149453).
CHICAGO — A disability insurer did not breach its contract or act unreasonably by terminating a claimant’s total disability benefits because the evidence shows that the claimant was able to undertake a number of mentally and physically demanding activities, an Illinois federal judge said Sept. 14 (Henry G. Fiorentini v. Paul Revere Life Insurance Co., No. 15-3292, N.D. Ill., 2017 U.S. Dist. LEXIS 149392).
SAN JOSE, Calif. — A California federal judge on Sept. 7 granted a disability insurer’s motion for summary judgment after determining that the insurer thoroughly considered all of the medical records before finding that the claimant was not entitled to long-term disability benefits (Robert Gordon v. Metropolitan Insurance Co., No. 10-5399, N.D. Calif., 2017 U.S. Dist. LEXIS 145200).