Mealey's Disability Insurance

  • February 15, 2018

    Federal Judge Dismisses ERISA Claim For Failure To Provide Discovery

    CLARKSBURG, W.Va. — A West Virginia federal judge on Feb. 12 found that a benefits plan and insurer were not obligated to provide a plan participant with documents in relation to his discovery request because they are not the plan administrators, granting them summary judgment on his claim for violation of the Employee Retirement Income Security Act of 1974 (Figlioli v. Liberty Life Assurance Company of Boston, et al., No. 1:17CV171, N.D. W.Va., 2018 U.S. Dist. LEXIS 22155).

  • February 13, 2018

    Claimant Failed To Prove Back Pain Was Sole Cause Of Disability

    PHILADELPHIA — The Third Circuit U.S. Court of Appeals on Feb. 12 affirmed a district court’s ruling that a disability insurer’s termination of benefits was not arbitrary and capricious because the claimant failed to prove that she suffered solely from a physical disability that precluded her from performing the duties of any occupation (Serilyn Krash v. Reliance Standard Life Insurance Group, No. 17-1814, 3rd Cir., 2018 U.S. App. LEXIS 3240).

  • February 9, 2018

    Motion To Transfer Disability Suit Denied; Suit Remains In California

    LOS ANGELES — A California federal judge on Feb. 6 denied a motion to transfer a disability claimant’s suit to Pennsylvania federal court because the defendants failed to prove that transferring the suit would serve the convenience of the parties and would promote the interests of justice (Stephanie Stefan v. Life Insurance Company of North America, et al., No. 17-6165, C.D. Calif., 2018 U.S. Dist. LEXIS 20356).

  • February 8, 2018

    Statute Of Limitations Bars Disability Claimant’s Suit, Maryland Federal Judge Says

    BALTIMORE — A Maryland federal judge on Feb. 1 determined that a disability claimant’s breach of contract suit is barred by the applicable statute of limitations because the statute of limitations began to run when the insurer issued its denial letter and not when the insurer denied the claimant’s appeal (Nancy F. George v. Massachusetts Mutual Life Insurance Co., No. 17-1073, D. Md., 2018 U.S. Dist. LEXIS 16528).

  • February 8, 2018

    Disability Benefits Claim Was Properly Denied, California Federal Judge Determines

    SAN FRANCISCO — A claim for pension disability benefits was properly denied because the disability claimant failed to submit medical records detailing his disability as requested on multiple occasions by the plan at issue, a California federal judge said Feb. 6 (Vanmark Strickland v. AT&T Pension Benefit Plan, No. 17-01393, N.D. Calif., 2018 U.S. Dist. LEXIS 19566).

  • February 7, 2018

    Denial Of Disability Benefits Was Not Arbitrary, Capricious, Federal Judge Says

    LEXINGTON, Ky. — A Kentucky federal judge on Feb. 5 affirmed a disability plan’s denial of long-term disability benefits after determining that the evidence supports the denial of benefits for the claimant’s injury and that the plan provided a reasoned explanation for its denial of benefits (Tracy Kellar v. Aetna Life Insurance Co., et al., No. 17-81, E.D. Ky., 2018 U.S. Dist. LEXIS 18065).

  • February 7, 2018

    Magistrate Judge Says Discovery Not Warranted In Disability Dispute

    INDIANAPOLIS — An Indiana federal magistrate judge on Feb. 2 denied a disability claimant’s motion to compel discovery on the basis that the claimant failed to meet her burden of proving that the plan operated under a conflict of interest that would entitle her to conduct discovery (Angel Allen v. The Lilly Extended Disability Plan, et al., No. 16-2224, S.D. Ind., 2018 U.S. Dist. LEXIS 17290).

  • February 2, 2018

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

    TUCSON, Ariz. — An Arizona federal judge on Jan. 19 determined that a disability claimant is entitled to current and retroactive long-term disability (LTD) benefits because the evidence supports a finding that the claimant is clearly disabled from performing the duties of any occupation (Rebecca Brown v. Life Insurance Company of North America, et al., No. 16-162, D. Ariz., 2018 U.S. Dist. LEXIS 9759).

  • February 2, 2018

    Disability Claimant’s Suit Dismissed; Nevada Not Proper Venue, Federal Judge Says

    LAS VEGAS — A Nevada federal judge on Jan. 24 dismissed a disability claimant’s suit against a disability insurer after determining that the claimant failed to prove that Nevada is the proper jurisdiction for the suit (Edgar Ortiz v. Reliance Standard Life Insurance Co., No. 17-580, D. Nev., 2018 U.S. Dist. LEXIS 11374).

  • January 31, 2018

    Disability Insurer Must Reimburse Claimant For Amount Of Offset Benefits

    MISSOULA, Mont. — A Montana federal judge on Jan. 30 reinstated a disability claimant’s long-term disability benefits and ordered the disability insurer to reimburse the claimant for the amount offset by the insurer after determining that a settlement received by the claimant was not subject to offset because the settlement was not for the same disability for which the claimant was receiving disability benefits (Dawn Rustad-Link v. Providence Health and Services, et al., No. 16-136, D. Mont., 2018 U.S. Dist. LEXIS 14928).

  • January 29, 2018

    Texas Federal Judge Dismisses Remaining Bias Claim In Gender Dysphoria Suit

    DALLAS — A Texas federal judge on Jan. 26 dismissed the remaining discrimination claim in a disability claimant’s suit seeking benefits under a short-term disability (STD) plan for breast augmentation surgery to treat the illness of gender dysphoria after determining that the claimant failed to prove that the employer discriminated against her under Title VII of the Civil Rights Act (Charlize Marie Baker v. Aetna Life Insurance Co., et al., No. 15-3679, N.D. Texas; 2018 U.S. Dist. LEXIS 12854).

  • January 29, 2018

    Disability Insurer’s Denial Of Claim Warranted Based On Pre-Existing Condition

    JACKSON, Miss. — A disability claimant is not entitled to long-term disability (LTD) benefits because the plan’s pre-existing condition limitation bars benefits because the claimant was treated for back pain within the plan’s look-back period, a Mississippi federal judge said Jan. 24 (Gary Bales v. Hartford Life & Accident Insurance Co., No. 15-790, S.D. Miss., 2018 U.S. Dist. LEXIS 11180).

  • January 25, 2018

    Panel Remands Disability Claim After Finding Questions Of Fact Exist Regarding Denial

    PHILADELPHIA — The Third Circuit U.S. Court of Appeals on Jan. 24 determined that a district court properly applied an abuse-of-discretion standard of review in a disability benefits dispute but remanded the suit after determining that questions of facts exist regarding the disability insurer’s decision not to conduct an independent medical evaluation and disregard of the claimant’s fatigue and pain complaints (Renee Killebrew v. The Prudential Insurance Company of America, No. 17-2137, 3rd Cir., 2018 U.S. App. LEXIS 1672).

  • January 25, 2018

    Disability Claimant Failed To Exhaust Administrative Remedies, 6th Circuit Says

    CINCINNATI — A claim alleging that a disability insurer violated the Employee Retirement Income Security Act when it offset a plan participant’s disability benefits was properly dismissed because the claim arose under the disability plan and the claimant was required to administratively exhaust the plan’s remedies or plead futility, neither of which the claimant did, the Sixth Circuit U.S. Court of Appeals said Jan. 23 (Oliver H. Barber III, et al. v. Lincoln National Life Insurance Co., No. 17-5588, 6th Cir., 2018 U.S. App. LEXIS 1560).

  • January 22, 2018

    Indiana Federal Judge Says Plan’s Denial Of Disability Benefits Must Be Affirmed

    SOUTH BEND, Ind. — Noting that an arbitrary and capricious standard of review applies in a disability benefits dispute based on a district court’s prior decision, an Indiana federal judge on Jan. 17 affirmed the disability insurer’s denial of benefits on the basis that there is rational support for the insurer’s denial of benefits (Donald Fessenden v. Reliance Standard Life Insurance Co., et al., No. 15-370, N.D. Ind., 2018 U.S. Dist. LEXIS 7754).

  • January 19, 2018

    District Court Erred By Reducing Attorney Fees, 1st Circuit Panel Determines

    BOSTON — The First Circuit U.S. Court of Appeals on Jan. 18 affirmed a district court’s ruling that a disability claimant is entitled to disability benefits but vacated the lower court’s calculation of attorney fees and prejudgment interest awarded to the claimant after determining that the court’s downward adjustment in the attorney fee award was not appropriate (Diahann L. Gross v. Sun Life Assurance Company of Canada, Nos. 16-2002, 16-1958, 1st Cir., 2018 U.S. App. LEXIS 1190).

  • January 18, 2018

    9th Circuit Panel Denies Petition For Rehearing In Disability Offset Suit

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Jan. 9 refused to reconsider its ruling that a disability plan administrator did not abuse its discretion in offsetting a claimant’s long-term disability (LTD) benefits to account for Social Security disability income (SSDI) benefits that she receives for her dependents (Susan Rene Jones v. Life Insurance Company of North America, et al., No. 16-16172, 9th Cir., 2018 U.S. App. LEXIS 565).

  • January 11, 2018

    Disability Plan Administrator Did Not Err In Terminating Claimant’s Benefits

    BIRMINGHAM, Ala. — A disability plan administrator did not act arbitrarily and capriciously in terminating a claimant’s short-term disability (STD) benefits because the medical evidence supports the plan administrator’s decision, an Alabama federal magistrate judge said Jan.  9, noting that the claimant’s benefits were extended for an additional seven months after the claimant’s second appeal (D’Anza Johnson v. AT&T Umbrella Benefit Plan No. 3, No. 15-1074, N.D. Ala., 2018 U.S. Dist. LEXIS 3379).

  • January 11, 2018

    Motion To Remand Denied; Disability Insurer Met Burden Of Proving Fraudulent Joinder

    BIRMINGHAM, Ala. — An Alabama federal judge on Dec. 21 denied a disability claimant’s motion to remand a suit seeking long-term disability benefits after determining that the disability insurer met its burden of proving that its insurance agents were fraudulently joined to defeat federal diversity jurisdiction (Glen L. Brawley, DMD v. Northwestern Mutual Life Insurance Co.  et al., No. 17-1513, N.D. Ala., 2017 U.S. Dist. LEXIS 210031).

  • January 10, 2018

    Insurer Entitled To Offset LTD Benefits Based On Social Security Awards

    NEW ORLEANS — A disability insurer was entitled to offset a claimant’s long-term disability (LTD) benefits based on his Social Security disability award and a separate award to his son for family Social Security disability benefits, a Louisiana federal judge said Dec. 19 in granting the insurer’s motion for summary judgment (John Jackson v. Aetna Life Insurance Co., No. 16-15837, E.D. La., 2017 U.S. Dist. LEXIS 208188).