Newsletter RSS

Mealey's Disability Insurance

  • April 21, 2026

    Citing Objective Evidence Requirement, 11th Circuit Affirms LTD Ruling

    ATLANTA — Affirming that termination of long-term disability (LTD) benefits survives under the de novo standard of review, the 11th Circuit U.S. Court of Appeals said in an unpublished opinion that the appellant “did not provide proof in the form of objective medical evidence, as required by the plan, that he continued to be unable to lift up to fifty pounds as his job required.”

  • April 21, 2026

    Federal Judge Orders Revised Discovery Report In Suit Over Stopped LTD Benefits

    ABERDEEN, S.D. — Ordering the parties to file a revised discovery report in a suit challenging termination of long-term disability (LTD) benefits, a South Dakota federal judge referenced an allegation that the defendant “hired an attorney to” help the plaintiff pursue Social Security Disability Insurance (SSDI) benefits, saying that such an act “may imply a preference for insureds to seek and obtain SSDI in lieu of plan benefits” and could not be proved from the administrative record.

  • April 17, 2026

    6th Circuit Nixes Bid To Maintain Disability, Health Benefits Pending Appeal

    CINCINNATI — Denying a request to require maintenance of disability and health insurance benefits via an injunction pending appeal, the Sixth Circuit U.S. Court of Appeals concluded that the appellant has not shown “any irreparable harm that he will suffer without an injunction.”

  • April 16, 2026

    Judge Issues Mixed Ruling In ERISA Case Involving STD Benefits

    SAN JOSE, Calif. — Finding in part that the defendants “abused their discretion by ignoring all the evidence provided by Plaintiff’s treating physicians,” a California federal magistrate judge issued a mixed ruling in an Employee Retirement Income Security Act suit filed by a former software engineer who challenged the termination of his benefits under two short-term disability (STD) plans and argued that he was also entitled to long-term disability (LTD) benefits.

  • April 16, 2026

    Judge Affirms Arbitrator’s Award Of LTD Benefits In Dispute Involving Union

    JOHNSTOWN, Pa. — Enforcing an arbitrator’s award of long-term disability (LTD) benefits that followed the plan administrator’s denial of the claim, a Pennsylvania federal judge ruled that the dispute fell within the bounds of an arbitration clause in a collective bargaining agreement (CBA) between the claimant’s employer and a union and that “the arbitrator properly focused his merits analysis to the Agreement’s terms.”

  • April 13, 2026

    En Banc 4th Circuit Vacates Injunction In Suit Over DOGE Access To SSA Records

    RICHMOND, Va. — A divided en banc Fourth Circuit U.S. Court of Appeals on April 10 vacated a trial court’s April 2025 preliminary injunction — an injunction that was stayed by the U.S. Supreme Court in June 2025 — in a suit by a union and two groups representing a combined 7 million Americans who challenged access to Social Security Administration (SSA) records provided to individuals working for U.S. DOGE Service and U.S. DOGE Service Temporary Organization(together, DOGE).

  • April 13, 2026

    Judge: LTD Claimant Didn’t Show Physical Cause For Debilitating Symptoms

    FORT WAYNE, Ind. — On de novo review, an Indiana federal judge granted judgment in favor of a long-term disability (LTD) insurer that terminated benefits once the coverage allotted for mental conditions expired, ruling that the claimant failed to prove that a physical condition caused her debilitating symptoms.

  • April 10, 2026

    Judge Deems LTD Claimant Cognitively Disabled Under Any-Occupation Standard

    SACRAMENTO, Calif. — Following de novo review that focused on a neuropsychological evaluation and a functional capacity evaluation (FCE), a California federal judge overturned the termination of a registered nurse’s long-term disability (LTD) benefits under an any-occupation definition of disability.

  • April 09, 2026

    Appellant Seeks 2nd Circuit Revival Of ‘Combined Period’ Disability Benefits Case

    NEW YORK — Arguing that a residual disability provision used to terminate his benefits at age 65 is ambiguous and that he “plausibly alleged a reasonable alternative reading of the Policies” under which he would be entitled to lifetime benefits, a dentist filed an opening brief urging the Second Circuit U.S. Court of Appeals to reverse dismissal of a suit in which he asserted claims for breach of contract and breach of the implied covenant of good faith and fair dealing.

  • April 08, 2026

    Claim For Recalculated LTD Benefits Survives Dismissal In ‘Earnings’ Row

    CHICAGO — Saying in part that a long-term disability (LTD) insurer “cannot represent to a claimant that his administrative remedies have been exhausted, then argue in litigation that the claimant failed to exhaust those remedies” in a dispute over the LTD benefits calculation, a Chicago federal judge dismissed a fiduciary breach claim but ruled that a claim for recalculated benefits survives.

  • April 02, 2026

    Choice-Of-Law Rule Resolves Review Standard Dispute In LTD Case

    OAKLAND, Calif. — Resolving a standard of review disagreement by applying the federal choice-of-law rule, a California federal judge determined that “Massachusetts law applies and . . . California’s prohibition on discretionary clauses does not” so he will assess the denial of the plaintiff’s claim for long-term disability (LTD) benefits for abuse of discretion rather than de novo.

  • April 01, 2026

    LTD Benefits Termination After 11 Years Is Ruled Error In Case Involving MS

    OAKLAND, Calif. — Ruling in favor of a plaintiff with multiple sclerosis (MS) who received long-term disability (LTD) benefits for more than 11 years before they were terminated, a California federal judge concluded on de novo review that “the preponderance of the evidence shows that” the former national account sales manager “could not perform any gainful occupation that requires sedentary occupational demands because of physical symptoms of MS in his legs” at the time of the termination.

  • March 23, 2026

    LTD Claimant Files 7th Circuit Appeal In ‘Regular Care’ Provision Case

    CHICAGO — A former Whole Foods worker who said he had to stop working because of back pain has gone to the Seventh Circuit U.S. Court of Appeals to challenge a ruling that upheld termination of his long-term disability (LTD) benefits on the grounds that he didn’t show “that he was under the ‘regular care of a physician’ as is required under the Plan.”

  • March 20, 2026

    After Remand For IME, Disability Claimant Gets Benefit Termination Overturned

    CHATTANOOGA, Tenn. — A Tennessee federal judge who previously ordered further factual development in a suit over a long-term disability (LTD) claim that involves a mental illness limitation, pain and the headache condition occipital neuralgia on March 19 granted judgment on the administrative record, ruling on de novo review that the claimant was disabled under the policy’s any gainful occupation definition as of March 2021 and is entitled to continuing benefits.

  • March 20, 2026

    On De Novo Review, Judge Affirms LTD Denial Under Preexisting Exclusion

    MINNEAPOLIS — Using the de novo standard of review because of an Oregon regulation prohibiting discretionary clauses, a Minnesota federal judge affirmed denial of long-term disability (LTD) benefits, explaining that because the claimant’s “disability was based on her low back pain and she was treated for low back pain during the lookback period, the pre-existing condition exclusion squarely applies.”

  • March 19, 2026

    Judge Upholds LTD Insurer’s Decision To End Benefits After Limitation Period

    SANTA ANA, Calif. — Finding on de novo review that a long-term disability (LTD) claimant “has not adequately demonstrated he is disabled under the Policy after the 24-month mental disorder limitation period expired,” a California federal judge upheld termination of the benefits under a usual-occupation standard.

  • March 18, 2026

    LTD Insurer To 9th Circuit: Affirm Preexisting Condition Exclusion Ruling

    SAN FRANCISCO — Describing the ruling at issue as “plausible, logical and supported by the record,” an insurer urged the Ninth Circuit U.S. Court of Appeals to affirm an order that upheld its denial of long-term disability (LTD) benefits under a preexisting condition exclusion.

  • March 18, 2026

    2nd Circuit Finds No Clear Error In LTD Ruling Involving Purported Long COVID

    NEW YORK — Saying in part that it found no error “in the district court’s decision to assign minimal weight to [the claimant]’s self-reported symptoms and to focus, instead, on the paucity of objective record evidence supporting her claimed inability to work,” the Second Circuit U.S. Court of Appeals issued a March 17 summary order affirming judgment for a long-term disability (LTD) plan administrator that denied a claim that was based on a nurse practitioner’s purported symptoms of long COVID.

  • March 17, 2026

    Judge: Nurse Is Physically Disabled Under LTD Plan’s Terms, Deserves Benefits

    PHOENIX — Using “heightened skepticism” because of a structural conflict of interest and “procedural irregularities,” a judge sitting by designation in an Arizona federal court ruled that a registered nurse is due long-term disability (LTD) benefits because the insurer’s failure to view her “conditions and symptoms in the aggregate was a consequential factor that amounted to an abuse of discretion.”

  • March 16, 2026

    Judge: Short-Term Disability Plan Is Payroll Practice Exempt From ERISA

    BOSTON — Concluding that the “payroll practice exception” applies, a Massachusetts federal judge dismissed a suit concerning a self-insured short-term disability plan (STDP) for lack of subject matter jurisdiction on the grounds that the plan is not governed by the Employee Retirement Income Security Act.

  • March 16, 2026

    Former Transactional Attorney Wins LTD Case In Massachusetts Federal Court

    BOSTON — Calling the insurer’s determination “arbitrary and capricious in multiple respects,” a Massachusetts federal judge largely granted summary judgment in favor of a former attorney who challenged termination of her long-term disability (LTD) benefits.

  • March 12, 2026

    Former NFL Player Sues Over Denial Of His Claim For Disability Benefits

    NORFOLK, Va. — Claiming that his application for total and permanent (T&P) disability benefits didn’t get “a full and fair review” and that “the lasting effects of his injuries . . . render him substantially unable to engage in any occupation or employment for remuneration or profit” under the applicable definition, former National Football League player Aaron R. Rouse sued the NFL Player Disability and Survivor Benefit Plan in a Virginia federal court on March 11 for retroactive and continuing benefits.

  • March 12, 2026

    Suit Involving Cousin’s Purported Disability Fraud Is Dismissed As Untimely

    DALLAS — Without substantive explanation, a Texas federal judge overruled objections and accepted a report and recommendation to dismiss as untimely a lawsuit involving fraud and bad faith claims in which the pro se plaintiff challenged a roughly two-decade-old termination of long-term disability (LTD) benefits and alleged that a cousin fraudulently used her identity to file a successful disability claim.

  • March 09, 2026

    Massachusetts Panel Reverses Ruling For Claimant In Disability COLA Dispute

    BOSTON — Disagreeing with a lower court’s conclusion that policy language is ambiguous, a Massachusetts Appeals Court panel reversed judgment on a breach of contract claim for a disability income recipient who challenged the fact that benefits under a cost-of-living adjustment (COLA) rider stopped accruing after her 65th birthday.

  • March 05, 2026

    On De Novo Review, LTD Claimant Is Found To Be Physically Disabled

    MADISON, Wis. — Granting each side a partial victory, a Wisconsin federal judge decided on de novo review that a long-term disability plan (LTD) administrator must pay benefits because physical impairments rendered the claimant disabled under an own-occupation standard, but the administrator is allowed to recover overpayment caused by the claimant’s receipt of Social Security Disability Insurance (SSDI) benefits.