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Mealey's Disability Insurance

  • January 21, 2026

    SSA To Court: Former DOGE Team’s Data Use Possibly Noncompliant With TRO

    BALTIMORE — The Social Security Administration (SSA) filed a notice in a federal court in Maryland stating that in December 2025 it made two Hatch Act referrals to the U.S. Office of Special Counsel and notified the U.S. Department of Justice of instances of use of SSA data “by the then-SSA DOGE [Department of Government Efficiency] Team” that were “potentially outside of SSA policy and/or noncompliant” with a temporary restraining order (TRO) entered in March 2025.

  • January 21, 2026

    Judge: Engineer Claiming COVID Vaccine Injury Is Due LTD Benefits

    SAN JOSE, Calif. — On de novo review, a California federal judge concluded that a mechanical engineer who said she was disabled by a COVID vaccine injury due to symptoms including fatigue and brain fog is entitled to retroactive long-term disability (LTD) benefits under the plan’s initial “regular occupation” standard.

  • January 20, 2026

    Judge Finds Factual Dispute On Intent-To-Defraud Question In Disability Case

    BALTIMORE — Partly denying an insurer’s motion for summary judgment in a case over an individual disability insurance (IDI) policy it wants to rescind because the pro se defendant didn’t disclose her full criminal history, a Maryland federal judge applied Maryland law and concluded that there is a material factual dispute regarding whether the insurer showed that the defendant “intended to defraud” it.

  • January 20, 2026

    11th Circuit Won’t Rehear LTD Preexisting Conditions Exclusion Case

    ATLANTA — Without substantive explanation, the 11th Circuit U.S. Court of Appeals denied an unanswered petition for en banc rehearing concerning a split panel’s ruling that it was unreasonable for a long-term disability (LTD) insurer to interpret a preexisting conditions exclusion in a way that the majority said means that “treatment for a headache during the lookback period converts any disease or condition that causes headaches into a preexisting condition.”

  • January 16, 2026

    Pa. Federal Judge Upholds Denial Of LTD Benefits For River Pilot With Long COVID

    PHILADELPHIA — Saying he is “constrained by” the arbitrary and capricious standard of review, a Pennsylvania federal judge on Jan. 15 upheld denial of long-term disability (LTD) benefits for a river pilot who was diagnosed with long COVID.

  • January 16, 2026

    Residual Disability Benefits Case Is Dismissed Under ‘Combined Period’ Provision

    NEW YORK — Dismissing a dentist’s suit alleging breach of contract and breach of the implied covenant of good faith and fair dealing, a New York federal judge agreed with the insurer defendants that the policy terms permitted termination of residual disability benefits at the dentist’s 65th birthday and did not promise lifetime benefits.

  • January 16, 2026

    Judge Applies ‘Regular Care’ Provision In Upholding LTD Benefits Termination

    CHICAGO — Finding on de novo review that a former Whole Foods worker who briefly obtained long-term disability (LTD) benefits because of back pain didn’t show “that he was under the ‘regular care of a physician’ as is required under the Plan,” an Illinois federal judge upheld termination of the benefits.

  • January 15, 2026

    2nd Circuit Affirms Arbitrary And Capricious Standard In LTD Benefits Case

    NEW YORK — Briefly upholding the trial court’s decision to use the arbitrary and capricious review standard in a long-term disability (LTD) benefits case, the Second Circuit U.S. Court of Appeals said in a Jan. 15 nonprecedential summary order that it affirmed the ruling for the reasons given in the lower court’s “detailed opinion and order.”

  • January 15, 2026

    LTD Claimant Takes Pre-Existing Condition Exclusion Fight To 9th Circuit

    SAN FRANCISCO — Arguing that the trial court made errors on de novo review including “expansively applying a pre-existing condition exclusion to bar coverage for a disability caused by post-coverage traumatic injuries” and “disregarding uncontroverted medical evidence,” an appellant claimant filed a Jan. 14 brief urging the Ninth Circuit U.S. Court of Appeals to reverse an order that upheld denial of her claim for long-term disability (LTD) benefits.

  • January 14, 2026

    Washington Federal Judge Trims Attorney Fees In Remanded ERISA Disability Case

    SEATTLE — Addressing an opposed request for attorney fees totaling $239,390 in a long-term disability (LTD) benefits case involving long COVID that was remanded to the administrator for full consideration because of a “substantial” procedural error, a Washington federal judge on Jan. 13 reduced the hours and the blended hourly rate, concluding that the appropriate fee award in the Employee Retirement Income Security Act case is $112,050.

  • January 14, 2026

    Termination Of Investment Portfolio Manager’s LTD Benefits Is Upheld

    ALEXANDRIA, Va. — Upholding termination of long-term disability (LTD) benefits under a regular-occupation standard for an investment portfolio manager whom surveillance showed had played 20 rounds of golf in three months in late 2024 despite allegedly disabling back problems, a Virginia federal judge concluded that despite there being some support for his claim, the termination “was both the product of a deliberate, principled reasoning process, and supported by substantial evidence.”

  • January 09, 2026

    Judge Orders Remand, Ruling Denial Of POTS-Based LTD Claim ‘Unreasonable’

    NASHVILLE, Tenn. — Denying cross-motions for judgment on the administrative record under an abuse of discretion standard, a Tennessee federal judge ruled that a long-term disability (LTD) benefits denial was “procedurally unreasonable” and remanded for reconsideration of the claim filed by the plaintiff, who has postural orthostatic tachycardia syndrome (POTS) and numerous other ailments.

  • January 08, 2026

    New Jersey Federal Judge Rebuffs Challenge To Discovery Ruling In LTD Case

    NEWARK, N.J. — Denying a long-term disability (LTD) claimant’s challenge to a discovery ruling, a New Jersey federal judge rejected his arguments that a magistrate judge erred in determining that his short-term disability (STD) “claim file was not part of the administrative record for his LTD claim” and “in denying extra-record discovery concerning Defendant’s alleged conflict of interest.”

  • January 06, 2026

    7th Circuit Upholds Job Termination Under Contract’s Disability Clause

    CHICAGO — The Seventh Circuit U.S. Court of Appeals affirmed judgment for an employer in a job termination dispute with an orthopedic surgeon that hinged on “the meaning of the phrase ‘the procedures for being determined disabled’” in his employment contract, saying in a nonprecedential disposition that under Wisconsin law, the surgeon’s interpretation “is untenable.”

  • January 02, 2026

    Judge Denies Dismissal In LTD Case Involving Insurability Requirement

    SEATTLE — In separate but similar orders, a Washington federal judge denied dismissal motions filed by the sponsor and claim administrator of a long-term disability (LTD) plan in a case that involves a dispute regarding whether a claimant who paid premiums for more than a year but had not submitted an evidence of insurability (EOI) form was covered.

  • January 02, 2026

    Oklahoma Federal Judge Upholds Termination Of Longstanding LTD Benefits

    OKLAHOMA CITY — Observing that the case was not an easy one and that the arbitrary and capricious review standard was determinative, an Oklahoma federal judge affirmed termination of long-term disability (LTD) benefits under an any-occupation definition of disability for a former nurse who had received benefits for more than 15 years.

  • December 29, 2025

    10th Circuit Won’t Rehear Presuit Costs And Fees Case Concerning LTD Benefits

    DENVER — In an order issued without explanation nearly five months after the appellant filed a petition for panel rehearing that drew no response from the other party in the Employee Retirement Income Security Act case, the 10th Circuit U.S. Court of Appeals declined to revisit its rejection of a bid to make a long-term disability (LTD) insurer pay attorney fees and other costs for an administrative appeal that got benefits reinstated.

  • December 19, 2025

    5th Circuit Reverses Fee Award Because NFL Disability Claimant Didn’t Succeed

    NEW ORLEANS — Concluding that favorable factual findings are “a moral victory . . . insufficient to justify an award of attorney’s fees” and that the claimant here ultimately obtained no legal relief, the Fifth Circuit U.S. Court of Appeals on Dec. 18 reversed an award of more than $1.25 million to a former National Football League player who sued for a higher level of disability benefits than he was awarded, prevailed after a bench trial and then saw that favorable ruling reversed in a previous appeal.

  • December 18, 2025

    Disability Case Involving Long COVID Dismissed Under Governmental Exemption

    CHARLOTTESVILLE, Va. — An Employee Retirement Income Security Act lawsuit filed by a pro se former medical center employee who said he was wrongly denied long-term disability (LTD) benefits after long COVID and other issues including depression and anxiety rendered him unable to work has been dismissed by a Virginia federal judge, who ruled that the only claim fails because the center’s LTD plan is a governmental one exempt from ERISA.

  • December 17, 2025

    LTD Claimant Seeks Info Declaration, Other Relief In Suit Over Terminated Benefits

    PITTSBURGH — Among other things, a nurse who has been diagnosed with a chronic pain condition and is challenging termination of her long-term disability (LTD) benefits has sued seeking a declaration that, at a claimant’s request, an LTD insurer “has an obligation to provide information in its claim files that is relevant to a participant’s benefit claim regardless of whether an adverse decision has been made.”

  • December 16, 2025

    Discovery Is Among Issues In 6th Circuit Appeal Of Non-ERISA Disability Case

    CINCINNATI — Seeking reversal or at least remand of a decision upholding denial of her claim for long-term disability (LTD) benefits, a project director who stopped working because of symptoms she attributed to long COVID tells the Sixth Circuit U.S. Court of Appeals in her Dec. 15 opening brief that the trial court used the wrong standard of review and improperly denied her request for discovery and the appellees “acted arbitrarily by failing to consider critical treating-source medical opinions, relying on a materially inaccurate medical reviewer report, and dismissing [her] well-documented subjective symptoms.”

  • December 15, 2025

    Judge: Exhaustion Wasn’t Required For Fiduciary Breach Claim In Disability Case

    PHOENIX — Saying that a claim that an employer “breached its fiduciary duty by failing to inform” a disability claimant “of the consequences to his benefits of becoming a part-time employee . . . is not a disguised claim for benefits even if it results in a monetary award,” an Arizona federal judge declined to grant the employer summary judgment for failure to exhaust administrative remedies as to that claim.

  • December 15, 2025

    2nd Circuit Sets Argument In LTD Benefits Case Centered On Review Standard

    NEW YORK — Standard of review is the sole issue in an appeal where the Second Circuit U.S. Court of Appeals is scheduled to hear oral argument on Jan. 12 regarding a denial of long-term disability (LTD) benefits appeal that was upheld under the arbitrary and capricious review standard in the trial court; the parties dispute whether the insurer had discretionary authority and whether it complied with claim regulations.

  • December 15, 2025

    Florida Federal Judge Upholds ‘Any Occupation’ LTD Benefits Termination

    MIAMI — Finding that it was not arbitrary and capricious for the claim administrator of a long-term disability (LTD) plan to determine that a former software engineer “with a history of chronic back pain and lumbar degenerative disease” was not disabled under an “any occupation” definition, a Florida federal judge upheld termination of the benefit.

  • December 11, 2025

    Noting AI Fabrications, Other Issues, Judge Sanctions Pro Se Disability Claimant

    COLUMBUS, Ohio — Two days after the Sixth Circuit U.S. Court of Appeals denied a pro se litigant’s petitions for writs of mandamus in a dispute involving long-term disability (LTD) benefits, an Ohio federal judge on Dec. 10 issued an amended ruling designating him a vexatious litigant, dismissing his case without prejudice and imposing sanctions including a $1,500 penalty and a three-part filing restriction, highlighting “his repeated failure to appear” and “his (apparently ongoing) use of AI resulting in fabricated citations.”