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Mealey's Disability Insurance

  • June 22, 2017

    Disability Claimant’s Evidence Supports Finding That Benefits Are Owed

    NEW YORK — A New York federal magistrate judge on June 13 recommended that a disability claimant’s motion for summary judgment be granted because the medical opinions of the insurer’s reviewing physicians are not consistent with the medical evidence presented by the claimant (Philip Hafford v. Aetna Life Insurance Co., No. 16-4425, S.D. N.Y., 2017 U.S. Dist. LEXIS 91763).

  • June 22, 2017

    Florida Federal Magistrate Recommends Dismissal Of Claim For LTD Benefits

    WEST PALM BEACH, Fla. — A Florida federal magistrate judge on June 19 recommended that a claim seeking a declaration that long-term disability (LTD) benefits are owed be dismissed because the disability claimant did not file a claim for LTD benefits and did not exhaust all her administrative remedies related to the claim for such benefits (Jamie R. Nagy v. The Prudential Insurance Company of America, No. 17-80198, S.D. Fla., 2017 U.S. Dist. LEXIS 94819).

  • June 22, 2017

    Federal Judge Says Disability Claimant Is Entitled To Attorney Fees

    NEW HAVEN, Conn. — A Connecticut federal judge on June 20 awarded a disability claimant more than $38,000 in attorney fees after finding that the claimant is entitled to attorney fees for achieving some success on the merits of his claim (Jeff Schuman v. Aetna Life Insurance Co., et al., No. 15-1006, D. Conn., 2017 U.S. Dist. LEXIS 94557).

  • June 22, 2017

    Denial Of Disability Claim Was Reasonable Based On Evidence, Federal Judge Says

    DETROIT — A disability insurer did not act arbitrarily and capriciously in denying a claim for disability benefits because the medical evidence supports the denial of benefits and the claimant failed to provide any evidence to rebut the insurer’s evidence, a Michigan federal judge said June 20 (Philip J. Holmes v. Aetna Life Insurance Co., et al., No. 16-11538, E.D. Mich., 2017 U.S. Dist. LEXIS 94258).

  • June 21, 2017

    Pre-Existing Condition Provision Barred Claim For Long-Term Disability Benefits

    HARRISBURG, Pa. — A Pennsylvania federal judge on June 19 determined that a disability insurer’s denial of long-term disability (LTD) benefits was not arbitrary and capricious because the policy included a pre-existing condition exclusion that clearly precluded coverage to the claimant Yvonne Hilbert v. The Lincoln National Life Insurance Co., 15-471, M.D. Pa., 2017 U.S. Dist. LEXIS 93424).

  • June 19, 2017

    Substantial Evidence Supports Termination Of Disability Benefits, Appeals Panel Says

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on June 14 affirmed a district court’s ruling that a disability insurer did not abuse its discretion in terminating a claimant’s long-term disability benefits because there is substantial evidence supporting the insurer’s termination of benefits (Lashondra Davis v. Aetna Life Insurance Co., No. 16-10895, 5th Cir., 2017 U.S. App. LEXIS 10576).

  • June 19, 2017

    New York Federal Judge: Bipolar Disorder Subject To Disability Plan’s 24-Month Cap

    BROOKLYN, N.Y. — A New York federal judge on June 14 said a disability insurer did not act arbitrarily and capriciously in relying on the American Psychiatric Association’s definition of mental illness when determining that bipolar disorder is a mental illness and subject to the plan’s 24-month cap on disability benefits for a mental illness (Marry Kim v. The Hartford Life Insurance Co., No. 15-2474, E.D. N.Y., 2017 U.S. Dist. LEXIS 91660).

  • June 16, 2017

    Wisconsin Federal Judge Finds Termination Of Benefits Was Not Arbitrary

    MADISON, Wis. — A Wisconsin federal judge on June 14 granted summary judgment in favor of a disability plan after determining that the plan’s decision to terminate a claimant’s benefits after learning that the claimant worked as a dog trainer was not arbitrary and capricious (Sarah B. Kalnajs v. The Lilly Extended Disability Plan, No. 16-62, W.D. Wis., 2017 U.S. Dist. LEXIS 91276).

  • June 15, 2017

    Disability Plan Did Not Abuse Its Discretion By Denying Benefits Claim, Judge Says

    HOUSTON — A Texas federal judge on June 14 granted a disability plan’s motion for judgment on the administrative record after determining that the plan did not abuse its discretion when it denied a former National Football League player’s disability claim (Brian C. Jackson v. NFL Disability and Neurocognitive Benefit Plan, et al., No. 16-1278, S.D. Texas, 2017 U.S. Dist. LEXIS 91042).

  • June 15, 2017

    Termination Of Disability Benefits Was Reasonable, 9th Circuit Panel Affirms

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on June 12 affirmed a district court’s ruling that the termination of a disability claim was reasonable based on the plan’s mental health coverage limitation and the medical evidence considered by the disability insurer (Kathee A. Colman v. American International Group Inc. Group Benefit Plan, et al., No. 15-15903, 9th Cir., 2017 U.S. App. LEXIS 10394).

  • June 14, 2017

    Claimant Owed Disability Benefits Under Plan’s ‘Own Occupation’ Provision

    SAN FRANCISCO — Following a one-day bench trial, a California federal judge on June 13 determined that a disability claimant submitted sufficient evidence showing that he was disabled under a plan’s “own occupation” provision but failed to prove that he was disabled under the plan’s “any occupation” standard (Robert Bosley v. Metropolitan Life Insurance Co., No. 16-00139, N.D. Calif., 2017 U.S. Dist. LEXIS 90803).

  • June 12, 2017

    Disability Insurer’s Offset Of Benefits Was Reasonable, 3rd Circuit Panel Determines

    PHILADELPHIA — A disability insurer was entitled to offset a disability claimant’s long-term disability benefits against income the claimant earned by working part time for her medical practice because the claimant still received the benefit of her earnings even though the earnings were applied against debt she owed her medical practice, the Third Circuit U.S. Court of Appeals said June 7 (Amy Patrick, M.D. v. Reliance Standard Life Insurance Co., No. 16-3980, 3rd Cir., 2017 U.S. App. LEXIS 10105).

  • June 9, 2017

    Protective Order For Disability Insurer Granted By New York Federal Magistrate Judge

    NEW YORK — A New York federal magistrate judge on June 2 granted a disability insurer’s motion for a protective order after determining that the insurer demonstrated that the public disclosure of the information would be valuable to its competitors and place it at a competitive disadvantage (David Robert Aitken v. Aetna Life Insurance Co., No. 16-4606, S.D. N.Y., 2017 U.S. Dist. LEXIS 88181).

  • June 9, 2017

    Disability Claimant Provided Administrator With Objective Medical Findings, Panel Says

    CINCINNATI — A district court erred in determining that a disability plan administrator’s denial of disability benefits was not arbitrary and capricious, the Sixth Circuit U.S. Court of Appeals said June 8 after determining that the disability claimant provided the administrator with objective findings that support a disability (Bruce Corey v. Sedgwick Claims Management Services Inc., et al., No. 16-3817, 6th Cir., 2017 U.S. App. LEXIS 10179).

  • June 8, 2017

    California Federal Judge: Disability Insurer Failed To Properly Weigh All Evidence

    SAN JOSE, Calif. — A California federal judge on June 5 reversed a disability insurer’s termination of long-term disability (LTD) benefits after determining that the insurer failed to properly consider the reports of the claimant’s treating physicians when it found that the claimant was not disabled from the duties of her regular occupation (Lisa Gallegos v. The Prudential Insurance Company of America, No. 16-1268, N.D. Calif., 2017 U.S. Dist. LEXIS 86123).

  • June 8, 2017

    9th Circuit Panel Certifies Questions In Disability Suit To Oregon High Court

    SEATTLE — The Ninth Circuit U.S. Court of Appeals on June 6 certified two questions to the Oregon Supreme Court regarding the appropriate limitations period in a disability policy after determining that the claimant’s suit cannot be resolved until the certified questions are answered (Cynthia Raynor v. United of Omaha Life Insurance Co., No. 14-36090, 9th Cir., 2017 U.S. App. LEXIS 10015).

  • June 7, 2017

    Arkansas Federal Judge: Insurer Wrongfully Terminated Disability Claimant’s Benefits

    FAYETTEVILLE, Ark. — An Arkansas federal judge on June 5 reversed a disability insurer’s decision to terminate a claimant’s long-term disability benefits after determining that the insurer ignored relevant evidence from the claimant’s treating physicians (Damon Zaeske v. Liberty Life Assurance Company of Boston, No. 15-5305, W.D. Ark., 2017 U.S. Dist. LEXIS 85345).

  • June 6, 2017

    Disability Claimant’s Injury Was Related To Intoxication, 11th Circuit Panel Concludes

    ATLANTA — The 11th Circuit U.S. Court of Appeals on June 2 reversed a District Court’s ruling that a disability insurer’s denial of benefits based on the plan’s intoxication exclusion was de novo wrong after determining that that the evidence clearly shows that the claimant’s injury was related to intoxication (Steven D. Prelutsky v. Greater Georgia Life Insurance Co., No. 16-15900, 11th Cir., 2017 U.S. App. LEXIS 9759).

  • June 5, 2017

    Disability Claimant Says 6th Circuit’s Preemption Decision Must Be Reviewed

    WASHINGTON, D.C. — The Sixth Circuit U.S. Court of Appeals incorrectly determined that a negligence claim is completely preempted by the Employee Retirement Income Security Act because the Sixth Circuit’s reasoning conflicts with the U.S. Supreme Court’s analysis for complete preemption, a disability claimant says in a May 22 petition for writ of certiorari filed in the high court (Samantha Milby v. MCMC LLC, No. 16-1409, U.S. Sup., 2017 U.S. S. Ct. Briefs LEXIS 1860).

  • June 5, 2017

    Beneficiary’s Claim Is Barred By 6-Year Statute Of Limitations, Panel Affirms

    NEW YORK — The Second Circuit U.S. Court of Appeal on May 24 affirmed that a beneficiary’s claim for increased disability pension benefits is barred by New York’s six-year statute of limitations because the beneficiary knew in 2004 that she was not receiving the increased benefits (Julienne Moses, as beneficiary of Paul Moses [deceased] v. Revlon Inc. et al., No. 16-2960, 2nd Cir., 2017 U.S. App. LEXIS 9005).