Mealey's Disability Insurance : Mealey's : Legal News & Analysis

Mealey's Disability Insurance

April 14, 2025
Judge: LTD Administrator Didn’t Abuse Its Discretion In Long COVID Case

MADISON, Wis. — Upholding denial of long-term disability (LTD) benefits for a claimant who was diagnosed with long COVID, a Wisconsin federal judge said in part that “even when symptoms are subjective, functional limitations caused by those symptoms can be objectively measured, so it is not arbitrary and capricious to ask for objective evidence.”
April 11, 2025
Judge Orders LTD Benefits Retroactively Reinstated In Basis Switch Dispute

OAKLAND, Calif. — Rejecting the defendants’ request that the dispute instead be remanded to the insurer, a California federal judge who previously ruled that termination of a long-term disability (LTD) claimant’s benefits was an abuse of discretion has now directed that those benefits be retroactively reinstated.
April 09, 2025
Judge Considers Subjective Evidence, Rules For Disability Claimant

TACOMA, Wash. — A production line manager who points to receipt of a COVID-19 vaccine as the start of numerous symptoms that made him unable to work successfully challenged a disability insurer’s denial of his long-term disability (LTD) claim, with a Washington federal judge entering an April 8 judgment that he is entitled to relief including at least 24 months of benefits.
April 08, 2025
5th Circuit Affirms Ruling Against Disability Claimant In Any-Occupation Case

NEW ORLEANS — Saying in an unpublished April 7 opinion that the administrative record shows “no evidence” that the appellant “is still disabled,” the Fifth Circuit U.S. Court of Appeals upheld termination of long-term disability (LTD) benefits in the any-occupation case.
April 08, 2025
Disability Insurer Urges 11th Circuit To Affirm Any-Occupation Ruling

ATLANTA — Noting the role that social media posts played and arguing that the appellant’s evidence was not overlooked and the opinions of her doctors were not ignored, a disability insurer urges the 11th Circuit U.S. Court of Appeals to uphold its termination of benefits as “based on substantial evidence, including multiple medical reviews, an uncontested vocational assessment identifying alternative occupations, and inconsistencies in [her] self-reported physical tolerances.”
April 02, 2025
Federal Judge Denies Remand, Finds ERISA Preempts Disability Benefits Case

COLUMBUS, Ohio — A federal judge in Ohio ruled that a terminated employee’s amended complaint seeking damages relating to long-term disability (LTD) benefits cannot be remanded to an Ohio court because the claims are preempted by the Employee Retirement Income Security Actand establish federal question jurisdiction.
March 31, 2025
Grant Of Summary Judgment Recommeded On Contract Breach Claim In Disability Suit

BUFFALO, N.Y. — A New York federal magistrate judge on March 28 recommended that a disability claimant’s motion for summary judgment on a breach of contract claim be granted because the evidence shows that the claimant remained disabled; however, the magistrate judge recommended that the claimant’s motion be denied on a claim alleging breach of the covenant of good faith and fair dealing because questions of fact exist on whether the insurer’s termination of benefits was reasonable.
March 28, 2025
Judge: ERISA Safe Harbor Provision Saves Surgeon’s Disability Insurance Dispute

BALTIMORE — A federal judge in Maryland denied a disability insurer’s motion to dismiss an orthopedic surgeon’s amended complaint alleging breach of contract and bad faith in a disability benefits dispute, reasoning that the policy may fall under the Employee Retirement Income Security Act’s safe harbor provision.
March 26, 2025
Ex-NFL Player To 5th Circuit: Dismiss Fee Award Appeal In Disability Benefits Row

NEW ORLEANS — Arguing in part that “[i]t would be patently unfair to reverse [his] benefits award while citing his failures to properly appeal and then excuse the Plan’s own failures to properly appeal the Fee Award,” a former National Football League player filed a motion asking the Fifth Circuit U.S. Court of Appeals to dismiss the plan’s appeal of an award of more than $1.25 million in attorney fees and costs.
March 25, 2025
Deal Report Garners Stay In Former Surgeon’s Suit For LTD Benefits

TYLER, Texas — Saying in a March 24 notice that they “are working on finalizing” an unspecified settlement, the parties in a former surgeon’s suit for long-term disability (LTD) benefits and relief for alleged mishandling of her claim successfully asked a Texas federal court to stay all deadlines in the case for 60 days.
March 24, 2025
Judge Overrules Objections, Denies Dismissal In Former Surgeon’s Disability Case

TYLER, Texas — Saying that a disability insurer’s objections “are without merit,” a Texas federal judge on March 21 overruled them and adopted a report and recommendation in a suit where a former surgeon seeks long-term disability (LTD) benefits and relief for alleged mishandling of her claim, thereby denying a dismissal motion.
March 21, 2025
Union, Groups Granted TRO In Suit Seeking To Stop DOGE Access To SSA Systems

BALTIMORE — A federal judge in Maryland on March 20 granted a temporary restraining order (TRO) halting access to Social Security Administration (SSA) data for anonymous individuals associated with the Department of Government Efficiency (DOGE) while calling the individuals’ actions “a fishing expedition” and stating that the federal government has not “identified or articulated even a single reason for which the DOGE Team needs unlimited access to SSA’s entire record systems, thereby exposing personal, confidential, sensitive, and private information that millions of Americans entrusted to their government.”
March 19, 2025
Citing Cooperation Provision, Judge Rules For Insurer In LTD Benefits Row

NEW BERN, N.C. — Noting that briefing focused on a preexisting condition provision, a North Carolina federal judge granted summary judgment in favor of an insurer that denied long term disability (LTD) benefits to a claimant who had multiple sclerosis on the other ground the insurer cited in its denial, violation of a claimant cooperation provision.
March 13, 2025
Judge Rules That Claimant With POTS Is Entitled To Disability Benefits

CHICAGO — Saying that many of the arguments an insurer made were “so weak as to call into question the good faith of its litigation position,” an Illinois federal judge overturned its determinations that postural orthostatic tachycardia syndrome (POTS) was an excluded pre-existing condition and that the claimant is not totally disabled from her own occupation, ruling that the human resources manager is entitled to long-term disability (LTD) benefits.
March 12, 2025
Judge Finds Factual Issue In LTD Benefits Calculation Dispute

KNOXVILLE, Tenn. — Calling the outcome “relatively uncommon,” a Tennessee federal judge denied competing motions for summary judgment and judgment on the record in a truck driver’s Employee Retirement Income Security Act suit over calculation of his long-term disability (LTD) benefits.
March 07, 2025
Disability Claimant Awarded $241K In Attorney Fees Based On Success On Appeal

PITTSBURGH — A disability claimant is entitled to attorney fees of $241,746 and costs of $8,277, a Pennsylvania federal judge said after determining that the claimant achieved success on the merits of his claim based on the Third Circuit U.S. Court of Appeals’ decision to vacate a summary judgment ruling in favor of the disability plan.
March 07, 2025
California Federal Judge Says Claimant Met Burden Of Proving She Is Disabled

SANTA ANA, Calif. — A disability claimant is owed more than $81,000 in long-term disability (LTD) benefits and is entitled to future LTD benefits because the claimant met her burden of proving by a preponderance of the evidence that she is disabled from performing the duties of any occupation as a result of ongoing cognitive and physical effects caused by chemotherapy treatment, a California federal judge said in granting judgment in favor of the claimant.
March 06, 2025
Magistrate Recommends Denying Dismissal Bid In Former Surgeon’s Disability Case

TYLER, Texas — Concluding that several issues raised could not properly be resolved at this stage, a Texas federal magistrate judge recommended denial of a dismissal motion in a suit where a former surgeon seeks long-term disability (LTD) benefits and relief for alleged mishandling of her claim.
March 06, 2025
Federal Judge Affirms Disability Insurer’s Decision In STD, LTD Benefits Row

LOUISVILLE, Ky. — Granting summary judgment for a disability insurer, a Kentucky federal judge ruled that “substantial evidence” supported termination of short-term disability (STD) benefits and that the claimant didn’t clearly establish the futility of filing a long-term disability (LTD) benefits claim.
March 06, 2025
Disability Insurer Says Judgment Was Proper; Claimant Is Capable Of Sedentary Work

ATLANTA — A district court’s judgment in favor of a disability insurer was correct because the evidence supports the lower court’s finding that the disability claimant is not disabled from performing the duties of any occupation and is capable of performing sedentary work, the insurer contends in an appellee brief filed in the 11th Circuit U.S. Court of Appeals.
March 06, 2025
Stay Of Mandate Pending Planned Petition Denied In Disability Benefits Suit

NEW ORLEANS — A Fifth Circuit U.S. Court of Appeals judge denied a motion in which a disability claimant and her husband sought to stay a mandate after denial of their request for rehearing in the case where a panel entered an unpublished opinion in favor of a disability insurer; the movants said they plan to petition the U.S. Supreme Court to grant certiorari.
March 05, 2025
11th Circuit Affirms Summary Judgment, Discovery Rulings Against STD Claimant

ATLANTA — Upholding discovery and summary judgment rulings for a disability insurer in a March 4 unpublished per curiam opinion, an 11th Circuit U.S. Court of Appeals panel rejected the claimant’s arguments that the lower court “did not properly apply [the appellate court’s] framework for evaluating” claims asserted under the Employee Retirement Income Security Act and should not have denied her request for “discovery outside the administrative record.”
March 05, 2025
Lower Court Properly Found Disability Claimant Failed To Meet Burden, Insurer Says

CHICAGO — A district court properly found that a disability claimant failed to satisfy her burden of proving that she remained disabled from working in a sedentary occupation as a result of symptoms related to fibromyalgia, a disability insurer says in an appellee brief filed in the Seventh Circuit U.S. Court of Appeals.
March 03, 2025
Choice-Of-Law Ruling Issued In Disability Insurance Suit In Federal Court

NEW HAVEN, Conn. — Granting an insurer’s motion for partial judgment on the pleadings in a suit challenging the discontinuation of long-term disability (LTD) benefits, a Connecticut federal judge ruled that the “tort, equity, and contract claims under the common law are not governed by California law” and that three California and North Carolina statutory claims fail as a matter of law.
February 27, 2025
9th Circuit Affirms ERISA Preemption Ruling In Disability Benefits Row

PHOENIX — Affirming judgment for a long-term disability (LTD) insurance provider in an unpublished memorandum disposition, a Ninth Circuit U.S. Court of Appeals panel agreed that the appellant’s agency had established an employee benefits plan governed by the Employee Retirement Income Security Act, so state law claims were preempted.