Mealey's Disability Insurance

  • June 19, 2026

    Summary Judgment Denied On Exhaustion In LTD Case Due To Possible Ambiguities

    NEW YORK — Concluding that possible ambiguities in an insurer’s communications kept it from showing that the plaintiff failed to exhaust her administrative remedies, a New York federal judge on June 18 denied the defendant insurer’s motion for summary judgment in a suit over terminated long-term disability (LTD) benefits.

  • June 19, 2026

    California Federal Judge: STD Benefits Must Be Repaid Under Policy Provision

    SANTA ANA, Calif. — Granting summary judgment for an insurer on all claims in a putative class case involving disability benefits under a group occupational accident coverage (OAC) policy offered to independent contractors, a California federal judge ruled that the insurer is entitled to $75,446.71 in equitable restitution for short-term disability (STD) benefits it paid because the claimant also received a $40,000 settlement that falls under the policy’s nonduplication of workers’ compensation provision.

  • June 19, 2026

    Pennsylvania Panel Revives Breach Claim In Suit Over LTD Insurer Switch

    HARRISBURG, Pa. — Reviving a lawsuit over a long-term disability (LTD) insurance brokerage contract, the Pennsylvania Superior Court ruled in a nonprecedential decision that under a third-party beneficiary theory, the breach of contract allegations were sufficient “to survive preliminary objections.”

  • June 19, 2026

    Onset Date, Other Issues Are Raised In Suit For Retroactive Disability Payment

    TACOMA, Wash. — Arguing in part that she was wrongly denied disability income benefits for a nearly six-month period that corresponded closely with the start of her pregnancy, an anesthesiologist sued her insurer in a Washington federal court for alleged violations of the Washington Insurance Fair Conduct Act (IFCA), breach of contract and bad faith.

  • June 18, 2026

    Former NFL Player Asks Court To Seal Administrative Record In Disability Case

    NORFOLK, Va. — Asking a Virginia federal court to order that the administrative record in his suit over total and permanent (T&P) disability benefits “be filed and maintained under seal,” a former National Football League player who is currently a Virginia state senator argues in part that disclosure “would invite public speculation and media scrutiny concerning Plaintiff's mental and physical health, cause harm to his professional reputation entirely unrelated to the legitimate issues before this Court, and constitute an egregious invasion of privacy that no amount of legal remedy could adequately redress.”

  • June 17, 2026

    Judge Finds Triable Issue On Whether Probe Of LTD Benefits Claim Was Reasonable

    SAN JOSE, Calif. — Focusing on a claim for breach of the covenant of good faith and fair dealing and saying in part that “a finder of fact could draw contradictory inferences regarding the reasonableness of” the investigation, a California federal judge denied cross-motions for summary judgment in a suit over termination of long-term disability (LTD) benefits for a claimant whose diagnoses include postural orthostatic tachycardia syndrome (POTS), hypermobile Ehlers-Danlos syndrome and fibromyalgia.

  • June 16, 2026

    Arguing Lack Of Notice, LTD Claimant Asks 7th Circuit To Revive His Lawsuit

    CHICAGO — Asking the Seventh Circuit U.S. Court of Appeals to reverse a decision that upheld termination of his long-term disability (LTD) benefits under a “regular care of a physician” requirement, a former Whole Foods worker argues in his June 15 opening brief that the trial court was wrong both in concluding that the insurer cited the requirement during his administrative appeal and in ruling that under de novo review it could consider the requirement even if the insurer hadn’t cited it in the administrative appeal.

  • June 12, 2026

    Claimant Appeals LTD Ruling Involving ‘Reasonable Continuity’ Provision

    BOSTON — A plaintiff who unsuccessfully sought reinstatement of her long-term disability (LTD) benefits has filed a notice of appeal regarding a Massachusetts federal judge’s ruling that it was not arbitrary or capricious for the insurer to determine that she “could work pursuant to the Gainful Employment standard under the Plan, despite her illnesses and pain.”

  • June 11, 2026

    9th Circuit Sets Argument In LTD Denial Appeal Involving Long COVID

    PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals has scheduled oral argument for July 7 in the case of a former underwriter who says he was disabled by cognitive impairments and other symptoms he attributes to long COVID; issues in the appeal include assessing differing medical opinions and whether new reasons for denial of long-term disability (LTD) benefits were improperly raised in the lower court.

  • June 11, 2026

    8th Circuit Affirms Decision Denying Disability Benefits Under NFL Plan

    ST. LOUIS — Affirming dismissal of an Employee Retirement Income Security Act claim that a pro se former football player asserted regarding NFL total and permanent (T&P) disability benefits, the Eighth Circuit U.S. Court of Appeals issued a one-paragraph unpublished opinion saying briefly that it found “no basis for” reversing the lower court’s conclusion that the claim was time-barred.

  • June 10, 2026

    Judge OKs Denial Of LTD Benefits Under Regular- Occupation Standard

    HOUSTON — Upholding denial of long-term disability (LTD) benefits on de novo review, a Texas federal judge said that the plaintiff’s work history and approach to his illness and symptoms undercut his claims that he was unable to perform the material and substantial duties of his regular occupation and that the medical professionals who reviewed his claim “described ample bases for their” contrary conclusions.

  • June 05, 2026

    Judge: Physician With Migraines, Cognitive Issues Is Disabled From Any Occupation

    DENVER — Resolving competing summary judgment motions in favor of a family physician who challenged termination of her long-term disability (LTD) benefits, a Colorado federal judge concluded that the insurer failed to refute the evidence that the physician was disabled under an “any-occupation” standard; the judge noted that the evidence included “a vocational report, a functional abilities evaluation, correspondence and records from her treatment providers, and neuropsychological assessments.”

  • June 02, 2026

    ‘Rescoring’ Settlement In NFL Benefits Lawsuit Wins Preliminary Approval

    BALTIMORE — A Maryland federal judge on June 1 gave preliminary approval to a class settlement that would resolve a suit former NFL players filed over the use of “race-based demographic adjustments” in “scoring neuropsychological tests” used to determine whether they receive disability and related benefits; the parties said the deal is designed to ensure that such “adjustments play no role in the Plans’ benefit determinations, whether prospectively or retroactively.”

  • May 22, 2026

    Judge Will Enforce Settlement Agreement In ERISA Disability Benefits Suit

    CHATTANOOGA, Tenn. — Granting a disability insurer’s motion to enforce a confidential settlement agreement in an Employee Retirement Income Security Act suit over termination of benefits, a Tennessee federal judge found that the claimant acted in bad faith and that the insurer is entitled to “reasonable attorney fees.”

  • May 22, 2026

    11th Circuit Sets Argument In LTD Benefits Case Involving Tax Returns

    ATLANTA — The 11th Circuit U.S. Court of Appeals has scheduled oral argument for June 26 in a dispute over long-term disability (LTD) benefits that involves interpretation of the term “work,” whether passive income counts as earnings and what constitutes sufficient proof of disability; in the challenged ruling, a federal judge granted summary judgment in favor of the insurer, sustaining its objections to a report and recommendation in favor of the claimant and adopting only the parts it didn’t object to.

  • May 21, 2026

    LTD Insurer Urges 2nd Circuit To Affirm Ruling That Followed Hearing

    NEW YORK — Urging the Second Circuit U.S. Court of Appeals to affirm denial of long-term disability (LTD) benefits for a corporate finance attorney who claimed that she became unable to do her job after her vehicle was rear-ended at a traffic light, the LTD insurer argued that the trial court’s ruling was correct and noted that the judge said he would have reached the same result even under the de novo review that the claimant contends was required.

  • May 21, 2026

    2nd Circuit Briefing Wraps Up In ‘Combined Period’ Disability Benefits Case

    NEW YORK — Briefing before the Second Circuit U.S. Court of Appeals has concluded in a disability benefits appeal centered on a residual disability provision, with the appellees arguing in their answering brief that the trial court correctly concluded that the provision was not ambiguous and permitted termination of the benefits at age 65, and the beneficiary contending in his reply brief that the parties’ “competing interpretations demonstrate that the Provision is susceptible to more than one reasonable meaning, which is sufficient to establish ambiguity under New York law.”

  • May 21, 2026

    Magistrate Would Resolve LTD Suit In Claimant’s Favor Over Migraines

    MIAMI —  On de novo review, a Florida federal magistrate judge recommended summary judgment in favor of a long-term disability (LTD) claimant who “sufficiently supported her claim with both objective and subjective evidence of disabling migraines,” adding that “the record is less clear on whether symptoms associated with” postural orthostatic tachycardia syndrome (POTS) and “post-concussive cognitive impairments” were disabling.

  • May 20, 2026

    LTD Beneficiary Scores Partial Win In Covered Earnings Calculation Case

    LOS ANGELES — Coming down on one side of “a split of authority” by concluding that an employee welfare benefit plan appointment of claim fiduciary form (ACF) “is a Plan document,” a California federal judge gave a long-term disability (LTD) beneficiary a win on one of the three issues she raised in the dispute over her covered earnings.

  • May 19, 2026

    Kentucky Federal Judge Denies Fees Motion In LTD Case Sent Back To Insurer

    LOUISVILLE, Ky. — A Kentucky federal judge who previously said that the plaintiff in a long-term disability (LTD) case appeared to be “eligible to receive a fee award because she has achieved some degree of success on the merits by virtue of the remand order” ultimately awarded her $450.37 in costs but denied her request for $20,921 in attorney fees; the judge also denied the plaintiff’s motion to reopen the case, saying that it “was filed prematurely.”

  • May 19, 2026

    8th Circuit Affirms Rulings In Employment, Disability Benefits Lawsuit

    ST. LOUIS — Issuing an unpublished opinion concerning a pro se appellant who accused an employer “of lying about when it fired him” and insurers “of not paying all the” disability benefits he was owed, the Eighth Circuit U.S. Court of Appeals affirmed dismissal of his claims against the employer and summary judgment in favor of the insurers.

  • May 18, 2026

    Judge OKs Limited Discovery In Disability Pension Case Involving Amendment

    CHICAGO — 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, an Illinois federal judge denied the defendants’ motion to stay discovery and granted the claimant’s request to pursue limited discovery outside the administrative record.

  • May 15, 2026

    Montana Federal Judge Lets LTD Benefits Offset For Pension Rollover Stand

    BILLINGS, Mont. — Granting summary judgment in favor of a long-term disability (LTD) insurer that reduced, or “offset,” the plaintiff’s monthly check because of a pension rollover, a Montana federal judge ruled in part that the doctrine of contra proferentem — under which ambiguous contract terms must be construed against the insurer — doesn’t apply because “no genuine ambiguity exists after applying ordinary contract interpretation principles.”

  • May 13, 2026

    California Federal Judge Rules That N.C. Law Applies To Disability Benefits Case

    SAN FRANCISCO — Rejecting a claimant’s argument that under California law the de novo standard of review should apply even though the insurer is afforded discretion under the policy, a California federal judge granted partial summary judgment for the defendant in a suit challenging denial of long-term disability (LTD) benefits, ruling that “the choice of law to be applied is North Carolina and the standard of review is abuse of discretion.”

  • May 12, 2026

    LTD Claimant To Get Retroactive Benefits In Case Involving Notice, Cognition

    BUFFALO, N.Y. — On de novo review following a bench trial, a New York federal magistrate judge ruled that a claimant is entitled to retroactive long-term disability (LTD) benefits and prejudgment interest, concluding that “the cognitive effects of” brain cancer treatment left the claimant “unable to give notice of her long-term disability claim at the time that she stopped working in December 2009” and that “she gave notice ‘as soon as reasonably possible’ after her husband discovered the policy in September 2021.”