Mealey's Disability Insurance

  • April 26, 2017

    Magistrate Judge Agrees With Disability Claimant, Says Rebuttal Was Not Timely

    LOUISVILLE, Ky. — A Kentucky federal judge on April 25 granted a disability claimant’s motion to exclude an expert witness rebuttal report filed by a disability insurer after determining that the report was not filed by the deadline established by the court (James H. Pogue v. The Northwestern Mutual Life Insurance Co., No. 14-598, W.D. Ky., 2017 U.S. Dist. LEXIS 62227).

  • April 26, 2017

    Plan Administrators Seek High Court’s Review Of Disability Benefits Decision

    WASHINGTON, D.C. — Because a district court and the Second Circuit U.S. Court of Appeals failed to follow prior decisions issued by the U.S. Supreme Court in disability insurance cases, the high court should grant the plan administrators’ petition for writ of certiorari, the plan administrators argue in an April 12 petition (Sun Life and Health Insurance Co., et al. v. Janet Solnin, No. 16-1238, U.S. Sup., 2017 U.S. S. Ct. Briefs LEXIS 1371).

  • April 25, 2017

    High Court Refuses To Review Ruling On Remand Of Disability Benefits Claim

    WASHINGTON, D.C. — The U.S. Supreme Court on April 24 denied a disability claimant’s petition for writ of certiorari, refusing to review the Sixth Circuit U.S. Court of Appeals’ decision that that the remand of a disability retirement claim was not an abuse of discretion or a violation of a previous court mandate (Kyle D. Kennard v. Means Industries Inc., No. 16-1117, U.S. Sup.).

  • April 20, 2017

    Disability Claimant Failed To Exhaust Administrative Remedies, Judge Says

    COVINGTON, Ky. — A Kentucky federal judge on April 17 granted a disability insurer’s motion to dismiss the claims alleged against it by a disability claimant after determining that the claimant did not exhaust her administrative remedies because she did not file an administrative appeal within the prescribed 180-day time period (Cheryl Stacy v. Appalachian Regional Healthcare Inc., et al., No. 16-186, E.D. Ky., 2017 U.S. Dist. LEXIS 57953).

  • April 19, 2017

    7th Circuit Panel Affirms Disability Plan Benefit Was Not Available To Claimant

    CHICAGO — The Seventh Circuit U.S. Court of Appeals on April 18 affirmed a district court’s ruling that a disability insurer did not act arbitrarily or capriciously in denying a claim for disability life insurance benefits because the disability life insurance benefit was not in the disability plan that was effective when the claimant became disabled (James B. Sumpter v. Metropolitan Life Insurance Co., No. 16-2012, 7th Cir., 2017 U.S. App. LEXIS 6552).

  • April 18, 2017

    Connecticut Federal Judge Says Disability Claimant Is Entitled To Attorney Fees

    NEW HAVEN, Conn. — A disability claimant is entitled to more than $40,000 in attorney fees because the claimant achieved some success on the merits as her claim for benefits was remanded to the plan administrator, a Connecticut federal judge said April 14 (Jennifer Dwinnell v. Federal Express Long Term Disability Plan, et al., No. 14-1439, D. Conn., 2017 U.S. Dist. LEXIS 57828).

  • April 18, 2017

    Disability Claimant Failed To Request Copy Of Plan Description, Judge Says

    MILWAUKEE — Because a disability claimant did not specifically request a copy of a disability plan’s summary plan description (SPD) when inquiring about the availability of disability benefits, the plan administrator did not violate the requirements of Employee Retirement Income Security Act, a Wisconsin federal judge said April 14 (Susan Limbach v. Weil Pump Co. Inc., No. 15-1531, E.D. Wis., 2017 U.S. Dist. LEXIS 57526).

  • April 17, 2017

    Panel Affirms Dismissal Of Disability Claimant’s Claim For Deprivation Of Rights

    CHICAGO — The Seventh Circuit U.S. Court of Appeals on April 14 affirmed a district court’s dismissal of a disability claimant’s allegation of deprivation of rights after determining that the pension plan that administered the disability plan at issue did not act in the interests of the “state” as required by the federal statute governing the claim for deprivation of rights (Joseph Reinwand v. National Electrical Benefit Fund, et al., No. 16-3381, 7th Cir., 2017 U.S. App. LEXIS 6472).

  • April 17, 2017

    Federal Judge Allows Disability Claimant To Amend Complaint Against Insurer

    SEATTLE — A Washington federal judge on April 13 granted a disability claimant’s motion to amend a complaint to add a claim against a disability insurer after determining that the insurer will not be prejudiced by the amendment (Abraham Ghorbanian DDS v. Guardian Life Insurance Company of America, et al., No. 14-1396, W.D. Wash., 2017 U.S. Dist. LEXIS 57015).

  • April 14, 2017

    Federal Judge Remands Claim To Consider If Claimant Was Disabled From Any Occupation

    LOS ANGELES — A California federal judge on April 12 remanded a disability claim to the plan administrator to determine whether the disability claimant was disabled under the plan’s “any occupation” standard (Bertha Campos v. Reliance Standard Life Insurance Co., No. 15-8304, C.D. Calif., 2017 U.S. Dist. LEXIS 56185).

  • April 14, 2017

    Disability Claimant Owed Benefits Under Own-Occupation Standard, Federal Judge Says

    SAN FRANCISCO — Because a disability claimant submitted substantial evidence proving that she was disabled  from her own occupation, the claimant is owed retroactive disability benefits for the 24-month period of disability under the own-occupation standard, a California federal judge said April 11 (Cathleen Murphy v. California Physicians Service, et al., No. 14-2581, N.D. Calif., 2017 U.S. Dist. LEXIS 55431).

  • April 12, 2017

    Disability Claimant Permitted To Depose Independent Medical Consultant, Federal Judge Says

    CHICAGO — A disability claimant is permitted to depose an independent medical consultant because a physician’s potential biases could affect a decision regarding whether the claimant was actually disabled, an Illinois federal judge said April 10 (Becky Harding v. Hartford Life and Accident Insurance Co., No. 16-6700, N.D. Ill., 2017 U.S. Dist. LEXIS 54241).

  • April 10, 2017

    Procedural Violation Does Not Justify Award Of Disability Benefits, 9th Circuit Says

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on April 4 vacated and remanded a district court’s ruling in a disability benefits suit after determining that the disability insurer’s failure to comply with procedural requirements does not, on its own, justify an award of benefits in favor of the claimant (Gregory Smith v. Reliance Standard Life Insurance Co., Nos. 16-15319, No. 16-15413, 9th Cir., 2017 U.S. App. LEXIS 5835).

  • April 6, 2017

    Federal Judge Affirms Disability Insurer’s Decision To Terminate LTD Benefits

    DENVER — A disability insurer’s decision to terminate a claimant’s long-term disability benefits after determining that the claimant was not disabled from performing “any occupation” was not arbitrary and capricious, a Colorado federal judge said March 28 in affirming the denial of benefits (Julie Johnson v. Life Insurance Company of North America, No. 15-699, D. Colo., 2017 U.S. Dist. LEXIS 45643).

  • April 6, 2017

    Disability Insurer’s Reliance On Mental Health Limitation Was In Error, Judge Says

    LOS ANGELES — Because a disability claimant established that his disability was caused by brain damage and not depression and anxiety, a disability insurer’s reliance on the plan’s mental illness limitation to terminate his benefits was in error, a California federal judge said March 27 (John Doe v. Prudential Insurance Company of America, et al., 15-04089, C.D. Calif.. 2017 U.S. Dist. LEXIS 45774).

  • April 6, 2017

    Federal Judge Dismisses Third-Party Administrator From Disability Benefits Suit

    PHILADELPHIA — A Pennsylvania federal judge on April 4 dismissed a third-party administrator from a disability claimant’s suit seeking benefits because the third-party administrator did not exercise final authority over disputed claims (Kimberly Lash v. Reliance Standard Life Insurance Co., et al., No. 16-235, E.D. Pa., 2017 U.S. Dist. LEXIS 51029).

  • April 5, 2017

    Disability Claimant’s Suit Dismissed For Failure To Timely File Appeal

    LOUISVILLE, Ky. — A disability claimant’s suit alleging wrongful denial of disability benefits must be dismissed because the claimant failed to exhaust all administrative remedies before filing suit, a Kentucky federal judge said March 27 (Bonnie E. Decola v. Prudential Insurance Company of America, No. 16-185, W.D. Ky., 2017 U.S. Dist. LEXIS 43960).

  • April 5, 2017

    Federal Judge Says Remand Of Disability Claim Needed On Reasonable Occupation Issue

    NEW HAVEN, Conn. — Because it is not clear from the administrative record whether a disability insurer correctly applied a plan’s “reasonable occupation” standard, a Connecticut federal judge on March 20 remanded the claim for further consideration of the reasonable occupation  issue (Jeff Schuman v. Aetna Life Insurance Co., et al., No. 15-1006, D. Conn., 2017 U.S. Dist. LEXIS 39388).

  • April 4, 2017

    Disability Claimant Failed To Timely Submit Claim, Federal Magistrate Judge Says

    WINSTON-SALEM, N.C. — A North Carolina federal magistrate judge on March 30 granted a disability plan’s motion for summary judgment after determining that the disability claimant failed to comply with the plan’s proof-of-loss requirement (Scott L. Hartquist v. Emerson Electric Co., et al., No. 11-1067, M.D. N.C., 2017 U.S. Dist. LEXIS 47611).

  • March 31, 2017

    Disability Plan’s Provision Is Not Barred By Calif. Statute, Federal Judge Says

    RIVERSIDE, Calif. — Because a short-term disability plan is a self-funded plan, the Employee Retirement Income Security Act preempts a California statute that bars the plan’s discretionary authority provision, a California federal judge said March 28 in determining that the plan’s denial of benefits was supported by substantial evidence (Daniel Johnson v. Aetna Life Insurance Co., et al., No. 15-1940, C.D. Calif., 2017 U.S. Dist. LEXIS 45858).