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Mealey's Disability Insurance

  • April 29, 2025

    Recommendation Favors Defendants’ Fee Bid In LTD Lawsuit Involving $30K Offer

    TAMPA, Fla. — Concluding in part that a rejected $30,000 offer of judgment made in 2021 was covered by a Florida fee-shifting statute, a Florida federal magistrate judge recommended granting a motion in which defendants in a cardiac surgeon’s lawsuit over denial of a disability benefits claim contend that they are entitled to attorney fees they estimate at $88,148.50.

  • April 28, 2025

    Former Surgeon, Insurer Stipulate To Dismissing Suit For LTD Benefits

    TYLER, Texas — After previously reporting that they were “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 on April 25 filed a joint stipulation of dismissal with prejudice in a Texas federal court.

  • April 28, 2025

    Claimant Files Appeal In LTD Documents Case After Insurer Wins Summary Judgment

    ATLANTA — A long-term disability (LTD) claimant is taking his case to the 11th Circuit U.S. Court of Appeals after a Florida federal judge sustained an insurer’s objections to a recommendation that competing summary judgment motions be resolved in the claimant’s favor in the dispute involving failure to submit income documents.

  • April 24, 2025

    Defendants Prevail In Suit Over STD, LTD Benefits; Notice Ruled Insufficient

    HARRISONBURG, Va. — Resolving three motions in favor of the defendants, a Virginia federal judge upheld denial of short-term disability (STD) benefits on the basis that the plan administrator “engaged in principled and reasoned decision-making while considering sufficient evidence,” also ruling that the claimant didn’t exhaust administrative remedies as to long-term disability (LTD) benefits and is now time-barred from doing so.

  • April 23, 2025

    LTD Claimant Prevails In Interpretation Dispute Over What ‘Insured Earnings’ Means

    NEW YORK — Following a bench trial on the stipulated record in a dispute over termination of long-term disability (LTD) benefits, a New York federal judge ruled for the claimant, saying in part on de novo review that “the term ‘insured earnings,’ as used in the Plan” does include earnings reported on a K-1 tax form.

  • April 16, 2025

    Federal Judge Finds ERISA Governs Group Disability Plan, Dismisses State Law Claims

    BOSTON — A Massachusetts federal judge granted an insurer’s motion for summary judgment, ruling that an employee’s long-term disability (LTD) insurance plan administered by her religious institute-affiliated employer is governed by the Employee Retirement Income Security Act and not exempt as a church plan, resulting in the dismissal of the coordinator’s state law claims without prejudice.

  • April 15, 2025

    NFL Plan To 5th Circuit: Let Fee Award Appeal Proceed In Disability Benefits Row

    NEW ORLEANS — Telling the Fifth Circuit U.S. Court of Appeals that the issues raised are not “grounds for dismissal” and that it “could not have forfeited an appeal of the new fee award and opinion before they existed, when the case was in the opposite posture,” the Bert Bell/Pete Rozelle NFL Player Retirement Plan on April 14 asked to be allowed to proceed with its appeal of an award of more than $1.25 million in attorney fees and costs to a former National Football League player.

  • April 15, 2025

    Engineer To 4th Circuit: Affirm Ruling In Long COVID Disability Benefits Case

    RICHMOND, Va. — Contending in part that de novo review was correctly applied because of an “inexcusable failure to issue a timely decision,” a long-term disability (LTD) benefits claimant urged the Fourth Circuit U.S. Court of Appeals to affirm a judgment that she is owed past-due benefits because long COVID symptoms have disabled her from working as an engineer.

  • March 20, 2025

    Insurer To 4th Circuit: Overturn Ruling In Long COVID Disability Benefits Case

    RICHMOND, Va. — Arguing that the lower court improperly applied de novo review and wrongly concluded that the claimant showed that she is disabled from working as an engineer because of long COVID symptoms, an insurer urged the Fourth Circuit U.S. Court of Appeals to reverse a judgment that the claimant is owed past-due long-term disability (LTD) benefits.

  • April 15, 2025

    Judge Upholds LTD Benefits Termination For Failure To Show No ‘Working’

    WORCESTER, Mass. — Upholding termination of long-term disability (LTD) benefits on de novo review, a Massachusetts federal judge ruled that an independent financial adviser didn’t meet his burden of showing that he had not been “working,” with that term defined as “engaging in activity regularly for wages or salary.”

  • April 14, 2025

    Dismissal Bid Fought In Dispute Over Disability Policy ‘Age 65’ Language

    PHOENIX — Arguing in part that the defendants’ “desired interpretation runs counter to the well-pleaded facts, the parties’ expectations, any reasonable consumer’s expectations, and decisional law,” a plaintiff on April 11 urged an Arizona federal court to deny dismissal of his putative class complaint over whether certain individual long-term disability (LTD) benefits must be paid through eligible insureds’ 65th birthdays.

  • 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.