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Mealey's Disability Insurance

  • October 03, 2025

    LTD Claimant’s Bid To Supplement Record Under Vega Is Denied

    LAFAYETTE, La. — Rejecting the plaintiff’s reliance on Vega v. Nat'l Life Ins. Servs., a Louisiana federal judge denied her attempt to supplement the record in her suit over termination of long-term disability (LTD) benefits with documents she tried to submit to the insurer months after it had closed the administrative appeal she had filed pro se.

  • October 02, 2025

    Judge Rules For Insurer That Cut Off LTD Benefits Under Any-Occupation Standard

    WILMINGTON, Del. — Upholding termination of long-term disability (LTD) benefits under an any-occupation standard for a claimant who has multiple sclerosis (MS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), a Delaware federal judge said in part that a final determination by independent appeal evaluator IMEDECS is not new evidence.

  • September 29, 2025

    Disability Insurer Wins Breach Of Contract Case Under South Carolina Law

    SPARTANBURG, S.C. — Applying South Carolina law, a South Carolina federal judge ruled that a disability insurer is entitled to judgment because a physician who attempted to claim benefits nearly seven years after the onset of his alleged disability didn’t sufficiently allege compliance with notice and proof of loss requirements.

  • September 25, 2025

    Former CEO Wins Retroactive LTD Benefits In Case Involving Occupational Duties

    CHATTANOOGA, Tenn. — Finding in part that the former leader of a software company sufficiently showed “that the important duties of the average CEO include working sixty hours a week or more with frequent travel,” a Tennessee federal judge on Sept. 24 ordered that his long-term disability (LTD) benefits be reinstated retroactively through March 2021.

  • September 25, 2025

    LTD Insurer Wins On Setoff, But Claimant Gets Attorney Fees Of Over $460K

    NEW YORK — After a second bench trial on the stipulated record in a case challenging termination of long-term disability (LTD) benefits, a New York federal judge resolved calculation issues largely in favor of the insurer and resolved an attorney fee dispute in favor of the claimant.

  • September 23, 2025

    Claimant With Back Pain Is Due LTD Benefits Under ‘Regular Occupation’ Standard

    EUGENE, Ore. — Saying in part that reviewers “discredited Plaintiff’s subjective symptom testimony of chronic pain in contradiction to objective medical evidence in the record without providing a reasonable explanation,” an Oregon federal judge ruled that a desk worker was entitled to benefits during the plan’s “regular occupation” period but that the question of whether she was disabled under the subsequent “any occupation” period “is not properly before the court.”

  • September 23, 2025

    Magistrate Judge OKs Attorney Fees In Case Where She Ordered LTD Claim Remanded

    SAN FRANCISCO — Saying in part that the balance of the considerations outlined in Hummell v. S.E. Rykoff & Co. supports the request, a California federal magistrate judge granted the requested $139,770 in attorney fees and costs in a long-term disability (LTD) case where she previously concluded “that the plan did not follow the administrative rules or apply the correct plan definition” and remanded “without ordering reinstatement of the policy or an award of retroactive payments.”

  • September 19, 2025

    LTD Claimant Urges 1st Circuit To Reverse Ruling That Hinges On ‘Working’

    BOSTON — Arguing in part that a long-term disability (LTD) plan’s use of “working” is ambiguous and therefore must be construed in his favor, an independent financial adviser filed an appellant brief urging the First Circuit U.S. Court of Appeals to reverse summary judgment against him, to order that his benefits be reinstated and to award him interest and attorney fees and costs.

  • September 17, 2025

    Panel Rehearing Bid Fails In LTD Benefits Dispute Involving Jury Verdict

    ATLANTA — In a per curiam order issued without explanation in a dispute where a federal jury sided with a long-term disability (LTD) insurer, the 11th Circuit U.S. Court of Appeals denied a petition for panel rehearing, letting stand its ruling vacating a judgment of nearly $450,000 for the insurer on its unjust enrichment claim but upholding dismissal of a breach of contract counterclaim.

  • September 17, 2025

    Anticutback, Fiduciary Breach Claims Are Dismissed In Disability Benefits Case

    CHICAGO — Saying in part that he rejected an “attempt to shift gears and do an about face,” an Illinois federal judge dismissed two claims in an Employee Retirement Income Security Act challenge to a multiemployer benefit plan amendment under which the end of a Social Security Administration (SSA) disability award results in termination of disability pension benefits.

  • September 16, 2025

    Federal Judge Reduces Fees Insurer Must Pay In LTD Case To Just Over $314,000

    MINNEAPOLIS — Saying in part “that counsel claims quite a large number of hours for tasks that likely could and should have taken less time,” a Minnesota federal judge who ordered that a long-term disability (LTD) claimant be paid a total of $741,085.31 in retroactive benefits and prejudgment interest also granted reduced attorney fees of $314,440.29 and reduced costs of $2,698.15.

  • September 11, 2025

    Judge: Specific Diagnosis Not Required To Prove Disability Under Plan Terms

    ANN ARBOR, Mich. — Saying in part that the Employee Retirement Income Security Act “does not require that a plaintiff show a particular etiology to prove they are disabled,” a Michigan federal judge dismissed breach of contract claims but otherwise ruled in favor of a pediatric dermatologist who challenged termination of her long-term disability (LTD) and residual disability benefits.

  • September 10, 2025

    Judge: Integration Brought Owners-Only LTD Policy Under ERISA

    SAN JOSE, Calif. — Dismissing bad faith and breach of contract claims that a PricewaterhouseCoopers LLP (PwC) equity owner who unsuccessfully sought long-term disability (LTD) benefits because of symptoms he attributed to long COVID asserted under California law, a California federal judge concluded that when “an employer integrates a pre-existing” policy that is not governed by the Employee Retirement Income Security Act “into a broader ERISA-governed plan, the non-ERISA policy becomes a part of the ERISA plan and is subject to the requirements and preemptive effect of ERISA.”

  • September 10, 2025

    LTD Claimant Urges 11th Circuit To Reverse Summary Judgment In Tax Returns Row

    ATLANTA — Urging the 11th Circuit U.S. Court of Appeals to take the position outlined in a report and recommendation that the lower court declined to adopt, a deaf engineer who received long-term disability (LTD) benefits for about a decade before they were terminated due to his refusal to provide personal tax returns argues in part that the insurer isn’t entitled to interpret the term “work” because it is not ambiguous.

  • September 10, 2025

    Insurer Faulted For Terminating LTD Benefits In Case Involving Fatigue, COVID

    TRENTON, N.J. — Citing “procedural irregularities and substantive errors” in an insurer’s handling of a long-term disability (LTD) claim for an individual whose diagnoses include myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID, a New Jersey federal judge issued an unpublished opinion directing that the claimant receive about seven months of retroactive benefits and that her claim be remanded for a determination as to whether she remained eligible after her administrative appeal was denied.

  • September 08, 2025

    8th Circuit Affirms Ruling Against Short-Term Disability Claimant

    ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on Sept. 5 briefly affirmed summary judgment against a short-term disability (STD) claimant in an unpublished per curiam opinion, saying in part that the insurer “did not abuse its discretion by relying on the opinions of its nurse consultants over those of [claimant Monty] Jones’s counselor” and was not “required to provide an independent medical examination (IME) of Jones before deciding his claim.”

  • September 04, 2025

    Review Standard Is Focus Of 2nd Circuit Briefing In Appeal Of LTD Benefits Denial

    NEW YORK — Standard of review is the sole issue in a Second Circuit U.S. Court of Appeals challenge to a ruling upholding denial of long-term disability (LTD) benefits, with the insurer arguing in its answering brief first that it had discretionary authority under the plan and second that there are no grounds to disregard that grant because it complied with claim regulations.

  • September 04, 2025

    Judge: Immunocompromised Doctor Deserves LTD Benefits Due To COVID-19 Risk

    WINSTON-SALEM, N.C. — Following a bench trial on the administrative record regarding a clinical anesthesiologist with chronic lymphocytic leukemia (CLL) whose unsuccessful disability claim was based on his risk of exposure to COVID-19, a North Carolina federal judge concluded on de novo review that the anesthesiologist is entitled to retroactive long-term disability (LTD) benefits, prejudgment interest and the costs of the suit.

  • September 03, 2025

    Ruling Challenge Was A New Claim, 7th Circuit Affirms Denial Of LTD Benefits

    CHICAGO — Affirming summary judgment against a professional musician whose long-term disability (LTD) claim was denied under policy terms because she was not an active, full-time employee when she said long COVID symptoms made her unable to work, the Seventh Circuit U.S. Court of Appeals on Sept. 2 said the information submitted in her administrative appeal “in effect requested coverage for a different loss, and that meant she was submitting a new claim.”

  • September 02, 2025

    Judge Trims Attorney Fees, Prejudgment Interest Rate In LTD Lawsuit

    NEW YORK — Saying in part that the requested 21.8% prejudgment interest rate “is far outside the norm in this District,” a New York federal judge awarded modified amounts totaling $230,083.65 for attorney fees and $139,497.54 for prejudgment interest in a long-term disability (LTD) case in which the claimant won $928,954.90 in retroactive benefits.

  • September 02, 2025

    Record With Settlement Info On Former MLB Pitcher’s Deal In PTD Case Is Sealed

    LOS ANGELES — A California judge agreed to seal the written record of court proceedings that contained some terms of a settlement agreement that former Major League Baseball pitcher Matthew S. Garza entered in a suit over a permanent total disability (PTD) insurance policy under which he claimed he was due a $10 million benefit.

  • August 28, 2025

    1st Circuit: Insurer Didn’t Abuse Its Discretion In Ending LTD Benefits

    BOSTON — Saying in part that “[t]he administrative record supportably shows that” a marketing executive who had been awarded long-term disability (LTD) benefits based on chronic back pain “could meet every enumerated physical demand by the time” those benefits were terminated, the First Circuit U.S. Court of Appeals on Aug. 27 upheld summary judgment for an insurer.

  • August 25, 2025

    Parties Stipulate To Dismissing LTD Case Filed Over Commission Calculations

    NEW HAVEN, Conn. — Without substantive explanation, an insurer and disability claimant stipulated to dismissal with prejudice of a suit in Connecticut federal court challenging the discontinuation of long-term disability (LTD) benefits, with “all parties to bear their own costs and attorneys’ fees.”

  • August 25, 2025

    11th Circuit Skirts Exhaustion Issue, Won’t Revive Case Over NFL Disability Benefits

    ATLANTA — Affirming dismissal on two alternate grounds without deciding whether the appellant exhausted his administrative remedies, the 11th Circuit U.S. Court of Appeals in a per curiam Aug. 22 opinion declined to revive a former NFL player’s suit over total and permanent (T&P) disability benefits that he argued he should have been awarded under a 2006 application.

  • August 20, 2025

    LTD Recipient Amends Complaint Over IRA Rollover Offset

    BILLINGS, Mont. — Following a Montana federal court ruling that the Employee Retirement Income Security Act governs the long-term disability (LTD) policy at issue and preempts the previously asserted state law claims, a plaintiff who is challenging an offset that reduced his monthly benefit filed a second amended complaint making a single ERISA claim for recovery of plan benefits.