We use cookies on this site to enable your digital experience. By continuing to use this site, you are agreeing to our cookie policy. close

Mealey's Disability Insurance

  • March 22, 2019

    Termination Of LTD Benefits Was Arbitrary, Capricious, Judge Concludes

    ANN ARBOR, Mich. — A disability insurer’s termination of  long-term disability (LTD) benefits was arbitrary and capricious because the insurer improperly ignored favorable evidence submitted by the claimant’s treating physicians and selectively reviewed the medical evidence, a Michigan federal judge said March 20 (Christopher Carr v. Metropolitan  Life Insurance Co., No. 17-14101,  E.D. Mich., 2019 U.S. Dist. LEXIS 45421).

  • March 22, 2019

    Termination Of LTD Benefits Not Arbitrary, Capricious, Magistrate Judge Says

    PITTSBURGH — A Pennsylvania federal magistrate judge on March 15 recommended denying a disability claimant’s motion for summary judgment and granting the defendants’ motion for summary judgment because the decision to terminate the claimant’s disability benefits was not arbitrary and capricious (Gregory Addington v. Senior Vice President Human Resources Consol Energy Inc. et al., No. 17-444, W.D. Pa., 2019 U.S. Dist. LEXIS 43830).

  • March 21, 2019

    Termination Of Disability Benefits Was Proper; Claimant Failed To Provide Information

    LOUISVILLE, Ky. — A Kentucky federal judge on March 20 denied a disability claimant’s motion for judgment on the administrative record after determining that the disability insurer conducted a full and fair review and that the insurer was entitled to terminate the claimant’s benefits after the claimant failed to comply with its request for additional information (Emmanuel J. Quarles v. Hartford Life & Accident Insurance Co., No. 15-372, W.D. Ky., 2019 U.S. Dist. LEXIS 45908).

  • March 20, 2019

    Termination Of Disability Benefits Was Not Arbitrary And Capricious, Judge Says

    SAVANNAH, Ga. — A disability insurer’s termination of long-term disability (LTD) benefits was not arbitrary and capricious because the medical evidence supports the insurer’s conclusion that the claimant is not disabled from working in any gainful occupation, a Georgia federal judge said March 18 (Michelle Lord v. American General Life Insurance Company of Delaware, No. 17-167, S.D. Ga., 2019 U.S. Dist. LEXIS 43992).

  • March 19, 2019

    Termination Of Disability Benefits Was Improper Based On Claimant’s Restrictions

    RIVERSIDE, Calif. — A disability insurer’s termination of long-term disability (LTD) benefits was improper because the evidence shows that the claimant could not type for more than 60 minutes a day and her usual occupation required five to six hours of typing per day, a California federal judge said March 11 in entering judgment in favor of the claimant (Jennett Harlow v. Metropolitan Life Insurance Co., et al., No. 17-2091, C.D. Calif., 2019 U.S. Dist. LEXIS 40890).

  • March 19, 2019

    Ample Evidence Supports Denial Of LTD Benefits Under Any-Occupation Standard

    SAN FRANCISCO — A district court did not err in finding that a disability insurer’s denial of disability benefits under a plan’s any-occupation standard was justified because ample evidence in the record supports the insurer’s determination, the Ninth Circuit U.S. Court of Appeals said March 15 (Susan Beach v. Liberty Life Assurance Company of Boston, No. 17-16492, 9th  Cir., 2019 U.S. App. LEXIS 7817).

  • March 18, 2019

    Panel Affirms Disability Plan’s Denial Of Benefits; Decision Was Reasonable

    CHICAGO — The Seventh Circuit U.S. Court of Appeals on March 14 affirmed a district court’s finding that a disability plan’s denial of a claim for disability benefits was reasonable based on the medical evidence and the plan’s use of outside medical experts to evaluate the claim (Joseph Reinwand v. National Electrical Benefit Fund, et al., No. 18-2601, 7th Cir., 2019 U.S. App. LEXIS 7492).

  • March 18, 2019

    Denial Of STD Claim Was Not Unreasonable, Missouri Federal Judge Determines

    ST. LOUIS — The denial of a claim for short-term disability (STD) benefits was not unreasonable based on the evidence in the administrative record and based on the fact that the claimant’s treating physicians could not reach a consensus regarding the claimant’s functional capacity, a Missouri federal judge said March 14 (Jacqueline E. Presi v. Ascension Health Alliance, et al., No. 16-1857, E.D. Mo., 2019 U.S. Dist. LEXIS 41369).

  • March 14, 2019

    Federal Judge Says Bench Trial Is Necessary To Resolve Disability Benefits Dispute

    BALTIMORE — A Maryland federal judge on March 12 denied motions for summary judgment filed by both the plaintiff and defendant after determining that a bench trial is necessary before deciding whether a disability claimant is owed long-term disability (LTD) benefits under the plan’s any-occupation standard (Pamela Mantica v. Unum Life Insurance Company of America, No. 18-0632, D. Md., 2019 U.S. Dist. LEXIS 40007).

  • March 14, 2019

    Termination Of Disability Benefits Was Not Arbitrary, Capricious, Judge Says

    PITTSBURGH — A Pennsylvania federal judge on March 12 determined that a disability insurer’s termination of benefits was not arbitrary and capricious because the medical evidence supports the insurer’s finding that the claimant was not totally disabled from any occupation under the terms of the policy (Diane M. Litvinuk-Roach v. Reliance Standard Life Insurance Co., No. 18-276, W.D. Pa., 2019 U.S. Dist. LEXIS 38943).

  • March 13, 2019

    Panel Denies Request To Supplement Record In Disability Benefits Suit

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on March 12 denied a disability claimant’s motion to supplement the record on appeal with documents from her Social Security Disability Insurance (SSDI) claim because the Social Security Administration’s (SSA) award of benefits was based on a different definition of disability than the “any occupation” definition relied on by the plan (Alice McBurnie v. Life Insurance Company of North America, No. 17-55915, 9th Cir., 2019 U.S. App. LEXIS 7254).

  • March 12, 2019

    Disability Plan Clearly Required Evidence Of Good Health, Judge Says

    GULFPORT, Miss. — Reconsideration of the denial of a disability claimant’s motion for summary judgment is not warranted because the disability plan clearly requires applicants to provide evidence of good health to obtain coverage if they failed to enroll in the disability plan within 31 days of eligibility, a Mississippi federal judge said March 11 in denying the disability claimant’s motion for reconsideration (Jason Ward v. Aetna Life Insurance Co., No. 17-331, S.D. Miss., 2019 U.S. Dist. LEXIS 38196). 

  • March 8, 2019

    Disability Plan Administrator Considered All Evidence Before Denying Claim

    DETROIT — A disability plan administrator did not act arbitrarily or capriciously in denying a claim for long-term disability (LTD) benefits because the plan administrator reviewed all of the medical evidence before reasonably concluding that the claimant was not totally or permanently disabled, the Michigan Court of Appeals said Feb. 21 (Amy Clements v. University of Michigan Regents, No. 341114,  Mich. App., 2019 Mich. App. LEXIS 323).

  • March 8, 2019

    Denial Of Disability Benefits Claim Was Not Abuse Of Discretion, Judge Determines

    LITTLE ROCK, Ark. — The denial of a claim for long-term disability (LTD) benefits was not an abuse of discretion because the plan’s independent medical experts and the claimant’s treating physicians all determined that the claimant was capable of performing work that would pay at least half of the claimant’s pre-disability earnings, an Arkansas federal judge said Feb. 20 (Spencer L. Davis v. AT&T Umbrella Benefit Plan No. 3, No. 18-341, E.D. Ark., 2019 U.S. Dist. LEXIS 26655).

  • March 8, 2019

    Additional Discovery Is Warranted In Disability Benefits Suit, Judge Says

    SEATTLE — A Washington federal judge on March 6 granted a disability claimant’s motion to compel additional discovery after determining that additional discovery into the credibility of the disability insurer’s previous and current medical reviewers is necessary because the insurer relied on a fake doctor’s report in denying the initial claim for benefits (Penelope Benis v. Reliance Standard Health Insurance Co., No. 18-164, W.D. Wash., 2019 U.S. Dist. LEXIS 36008).

  • March 7, 2019

    Disability Benefits Reinstated; Termination Was Arbitrary, Capricious, Judge Says

    NASHVILLE, Tenn. — A Tennessee federal judge on March 5 reinstated a disability claimant’s benefits after determining that the insurer acted arbitrarily and capriciously in terminating the  benefits because the evidence does not support a finding that the claimant is capable of earning 50 percent of his pre-disability salary as required by the plan (Gary Carty v. Metropolitan Life Insurance Co., et al., No. 15-1186, M.D. Tenn., 2019 U.S. Dist. LEXIS 35992).

  • March 5, 2019

    Disability Claimant’s Suit Dismissed For Failure To File Within 180 Days

    ST. LOUIS — A disability claimant’s suit alleging wrongful denial of short-term disability (STD) benefits must be dismissed because the claimant failed to file the suit within 180 days after the denial of her appeal as required by the plan, a Missouri federal judge said March 4 (Tiffany Ausler v. Aetna Life Insurance Co., No. 18-315, E.D. Mo., 2019 U.S. Dist. LEXIS 33486).

  • March 5, 2019

    Denial Of STD Benefits Was An Abuse Of Discretion, Federal Judge Determines

    SAN DIEGO — A disability plan’s termination of short-term disability (STD) benefits was an abuse of discretion because the plan failed to consider the claimant’s subjective reports of pain related to her diagnosis of multiple sclerosis and erroneously concluded that the claimant’s symptoms had improved, a California federal judge said March 4 in remanding for an award of STD benefits and for a determination on the claimant’s entitlement to long-term disability (LTD) benefits (Lizbeth Valdez v. AT&T Umbrella Benefit Plan No. 1, No. 16-2613, S.D. Calif., 2019 U.S. Dist. LEXIS 34159).

  • March 1, 2019

    Disability Claimant Is Not Entitled To Benefits Under Any-Occupation Standard

    PHILADELPHIA — A district court did not err in finding that a disability claimant is not entitled to long-term disability (LTD) benefits under a plan’s any-occupation standard because the medical evidence supports the plan’s determination that the claimant was capable of performing full-time sedentary work, the Third Circuit U.S. Court of Appeals said Feb. 28 (Thomas P. Kelly Jr. v. The Penn Mutual Life Insurance Co., et al., No. 18-1162, 3rd Cir., 2019 U.S. App. LEXIS 6199).

  • February 28, 2019

    Denial Of Short-Term Disability Benefits Was Not Arbitrary, Capricious

    CLEVELAND — A disability insurer’s denial of short-term disability (STD) benefits was not arbitrary and capricious because the denial was supported by substantial evidence, an Ohio federal judge said Feb. 21 (Christopher Draper v. Aetna Life Insurance Co., No. 18-1321, N.D. Ohio, 2019 U.S. Dist. LEXIS 27672).