BOSTON — A Massachusetts federal judge on Oct. 16 granted a disability insurer’s motion for judgment on the pleadings in a U.S. Army veteran’s class action alleging that the insurer wrongfully offset disability benefits payable under its policy by disability benefits received from the U.S. Department of Veterans Affairs after determining that the remaining claims cannot stand based on the court’s prior ruling that the offset was permitted under the plan (Marco Martinez v. Sun Life Assurance Company of Canada, No. 16-12154, D. Mass., 2018 U.S. Dist. LEXIS 178188).
SIOUX CITY, Iowa — An Iowa federal judge on Oct. 16 granted a disability insurer’s motion to dismiss a claim alleging wrongful denial of long-term disability (LTD) benefits because the claimant failed to exhaust all administrative remedies under the LTD policy and failed to prove that exhaustion would be futile (Brandy J. Sievers v. United of Omaha Life Insurance Co., No. 18-3048, N.D. Iowa, 2018 U.S. Dist. LEXIS 177259).
SALT LAKE CITY —A Utah federal magistrate judge on Oct. 9 denied a disability claimant’s motion for summary judgment after determining that the disability insurer’s termination of long-term disability (LTD) benefits was reasonable and is supported by substantial evidence (Jon E. Sadler v. United of Omaha Life Insurance Co., No. 17-979, D. Utah, 2018 U.S. Dist. LEXIS 174428).
MINNEAPOLIS — A claimant’s long-term disability (LTD) benefits were not wrongfully terminated because the record shows that the evidence supports the plan’s determination that the claimant was not disabled from working in any occupation, a Minnesota federal judge said Oct. 9 (Doris Rogers v. Eaton Corp., et al., No. 17-4391, D. Minn., 2018 U.S. Dist. LEXIS 173580).
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Oct. 4 awarded a disability claimant $20,000 in attorney fees incurred in his appeal over a dispute regarding the claimant’s entitlement to own-occupation long-term disability (LTD) benefits (Dave Nagy v. Group Long Term Disability Plan for Employees of Oracle America Inc., et al., Nos. 16-16160, 9th Cir., 2018 U.S. App. LEXIS 28166).
CENTRAL ISLIP, N.Y. — A New York federal judge on Sept. 28 rejected a disability plaintiff’s challenge to the hourly rate used by a magistrate judge to calculate attorney fees and adjusted an overall reduction in the amount of billed hours, resulting in an award of more than $222,000 in attorney fees in favor of the claimant (Janet Solnin v. Sun Life and Health Insurance Co., et. al., No. 08-2759, E.D. N.Y., 2018 U.S. Dist. LEXIS 168047).
DENVER — A disability insurer properly denied long-term disability (LTD) benefits based on the plan’s pre-existing condition provision because the claimant was diagnosed with a condition that caused his loss of sight three months before filing a claim for disability benefits, the 10th Circuit U.S. Court of Appeals said Sept. 26 (Michael Green v. Life Insurance Company of North America, No. 17-1383, 10th Cir., 2018 U.S. App. LEXIS 27439).
ATLANTA — A disability insurer’s termination of long-term disability (LTD) benefits was not arbitrary and capricious because the insurer’s termination was reasonable based on surveillance video of the claimant and based on independent physician reviews it obtained, the 11th Circuit U.S. Court of Appeals said Oct. 1 (Timothy P. O’Leary v. Aetna Life Insurance Co., No. 17-15162, 11th Cir., 2018 U.S. App. LEXIS 27771).
NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on Oct. 1 reversed and remanded a district court’s dismissal of a disability plan participant’s claims for breach of fiduciary duty and for failure to provide plan documents against the disability plan after determining that the district court failed to consider the plan participant’s argument that the plan documents provided by the employer are somewhat different from the copies, provided by the plan insurer, in the administrative record (Michael N. Manuel v. Turner Industries Group LLC et al., No. 17-30835, 5th Cir., 2018 U.S. App. LEXIS 27810).
PHILADELPHIA — After finding support for a disability claimant’s argument that the Employee Retirement Income Security does not apply to foreign nationals working outside of the United States, a Pennsylvania federal judge on Sept. 27 rejected the insurer’s argument that the claims are preempted under ERISA and remanded the disability claimant’s suit to state court (Salih Bajrami v. Reliance Standard Life Insurance Co., No. 18-162, E.D. Pa., 2018 U.S. Dist. LEXIS 166098).
WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 1 denied a petition for writ of certiorari seeking review of the Colorado Supreme Court’s dismissal of two long-term disability insurance lawsuits based on its finding that the benefit plan governed by the Employee Retirement Income Security Act is not a proper defendant (Brenda Olivar v. Public Service Employee Credit Union Long Term Disability Plan, and Caroline Burton, et al. v. Colorado Access, et al., No. 17-1543, U.S. Sup.).
WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 1 denied a disability claimant’s petition for writ of certiorari in a dispute regarding the offsetting of the claimant’s long-term disability (LTD) benefits to account for Social Security disability income (SSDI) benefits received on behalf of the claimant’s dependents (Susan Rene Jones v. Merck Sharpe & Dohme Corp., et al., No. 17-1478, U.S. Sup.).
SAN FRANCISCO — A California federal judge on Sept. 24 denied a disability plan’s motion to transfer a disability claimant’s suit to Georgia, where the claimant lived and was treated for his disability, after determining that the claimant’s choice of forum is entitled to some deference and that none of the convenience factors weighs strongly in favor of transferring the suit (Mark Ennis v. Aetna Life Insurance Co. et al., No. 18-1617, N.D. Calif., 2018 U.S. Dist. LEXIS 163442).
OAKLAND, Calif. — A disability insurer wrongfully denied long-term disability (LTD) benefits to a plan participant suffering from liver cancer because the insurer failed to consider whether the participant could continue to perform the duties of his job with “reasonable continuity,” a California federal judge said Sept. 19 (Shelley Lyttle v. United of Omaha Life Insurance Co., No. 17-1361, N.D. Calif., 2018 U.S. Dist. LEXIS 160300).
CHATTANOOGA, Tenn. — A Tennessee federal judge on Sept. 25 granted a disability insurer’s motion for summary judgment and denied a disability claimant’s motion for summary judgment because the claimant failed to exhaust all administrative remedies before filing suit and failed to prove that exhausting all administrative remedies would have been futile (Lisa House v. Unum Life Insurance Company of America et al., No. 17-220, E.D. Tenn., 2018 U.S. Dist. LEXIS 164124).
CAMDEN, N.J. — A disability insurer did not abuse its discretion in terminating a claimant’s long-term disability benefits because the insurer consulted with numerous medical experts and conducted a thorough investigation before terminating benefits, a New Jersey federal judge said Sept. 21 (Daniel Naphys v. Prudential Insurance Company of America, No. 16-1450, D. N.J., 2018 U.S. Dist. LEXIS 162302).
BOSTON — A disability claimant is entitled to the reinstatement of long-term disability (LTD) benefits and past due benefits because the claimant met her burden of proving that she is disabled as a result of fibromyalgia from working in her own occupation, a Massachusetts federal judge said Sept. 21 (Judith Kamerer v. Unum Life Insurance Company of America, No. 15-40146, D. Mass., 2018 U.S. Dist. LEXIS 161522).
PIKEVILLE, Ky. — An arbitrary and capricious standard of review applies in disability suit because the disability plan delegates discretionary authority to the insurer for the administration of claims made under the plan, a Kentucky federal judge said Sept. 18 (Regina Hurd v. Life Insurance Company of North America, No. 18-67, E.D. Ky., 2018 U.S. Dist. LEXIS 158595).
COLUMBUS, Ohio — An Ohio federal judge on Sept. 18 remanded a claim to a disability insurer for further fact finding on the issues of whether a disability claimant was made whole by a settlement she received following injuries sustained in a car accident and whether the disability claimant’s benefits can be offset based on the settlement (Sepanta Jalali v. Unum Life Insurance Company of America, No. 16-512, S.D. Ohio, 2018 U.S. Dist. LEXIS 159015).
CINCINNATI — The Sixth Circuit U.S. Court of Appeal on Sept. 11 affirmed a district court’s ruling in favor of a retirement benefits plan because the appellant, seeking retirement disability benefits, failed to challenge the district court’s finding that the retirement plan was properly amended to delete a provision stating that a claimant would be considered totally disabled if the Social Security Administration (SSA) declared the claimant disabled (Patsy Saylor v. Appalachian Regional Hospital, No. 17-6266, 6th Cir., 2018 U.S. App. LEXIS 25828).