Mealey's Disability Insurance

  • June 07, 2024

    LTD Benefits Cannot Be Offset By Social Security Retirement Benefits, Judge Says

    ALEXANDRIA, Va. — A disability insurer abused its discretion for a third time by ignoring the language of the disability policy and contending that a claimant’s monthly long-term disability (LTD) benefits amount should be offset by the amount of the claimant’s earned-income Social Security retirement benefits, a Virginia federal judge said after determining that the plan permits an offset only for Social Security benefits paid because of a claimant’s disability.

  • June 07, 2024

    Disability Claimant Says Any-Occupation Benefits Are Owed By Disability Insurer

    SAN DIEGO — A disability insurer abused its discretion in determining that a disability claimant is not disabled from performing the duties of any occupation based on symptoms related to the claimant’s diagnoses of fibromyalgia and ankylosing spondylosis because the medical evidence submitted by the claimant supports a finding that the claimant is disabled from performing the duties of any occupation, the claimant maintains in a June 6 complaint filed in California federal court.

  • June 07, 2024

    Oral Arguments Scheduled In Dispute Over Proof Of Continued Disability

    PHILADELPHIA — The Third Circuit U.S. Court of Appeals scheduled oral arguments for July 9 in a disability plan’s appeal of a district court’s ruling that the plan abused its discretion when it terminated a claimant’s long-term disability (LTD) benefits for failure to provide proof of a continued disability.

  • June 07, 2024

    Former NFL Player Files Notice Of Appeal After Dismissal Of Suit

    ATLANTA — A former National Football League player who claims that he is owed additional disability benefits filed a notice of appeal to the 11th Circuit U.S. Court of Appeals, seeking review of the lower court’s dismissal of his second amended complaint based on a finding that he failed to exhaust all administrative remedies and failed to show that exhaustion would be futile.

  • June 06, 2024

    Mental Illness Limitation Does Not Apply, Disability Claimant Says In Complaint

    PORTLAND, Maine — A disability plan participant filed suit in Maine federal court against a disability insurer, claiming that he is entitled to reinstatement of long-term disability (LTD) benefits because the insurer wrongfully applied the plan’s mental illness limitation when it terminated his LTD benefits.

  • June 06, 2024

    Disability Claimant, Insurer Stipulate To Dismissal After Reaching Settlement

    KNOXVILLE, Tenn. — A disability insurer and a disability claimant filed a joint stipulation of dismissal in Tennessee federal court following the settlement of the claimant’s long-term disability (LTD) benefits suit.

  • June 06, 2024

    Parties Settle Disability Benefits Suit Stemming From Long COVID Diagnosis

    MIAMI — A Florida federal judge ordered the parties in a long-term disability (LTD) benefits suit stemming from a claimant’s diagnosis with long COVID to file a joint stipulation of dismissal and administratively closed the case after the parties notified the court that they reached a settlement.

  • June 05, 2024

    Disability Claimant Seeks De Novo Review, Says Additional STD Benefits Are Owed

    TULSA, Okla. — A de novo standard of review should be applied to the review of the denial of a short-term disability (STD) claim because the disability plan administrator committed a number of procedural irregularities in handling the claimant’s second appeal of the denial of his claim, the claimant says in an opening brief filed in Oklahoma federal court.

  • June 05, 2024

    Ex-NFL Player Granted Extension To Petition High Court In Disability Suit

    WASHINGTON, D.C. — The deadline for a former National Football League player to file a petition for writ of certiorari in the U.S. Supreme Court was extended by a month, giving the former player until July 13 to seek review of the Fifth Circuit U.S. Court of Appeals’ ruling that he failed to prove that he is entitled to additional disability benefits under the NFL’s benefits plan.

  • May 22, 2024

    Complete Administrative Record Needed To Review Denial Of LTD Claim, Judge Says

    PORTLAND, Ore. — A disability claimant’s motion for judgment on the pleadings must be denied because the claimant submitted only portions of the administrative record, an Oregon federal judge said, noting that the complete administrative record, as reviewed by the plan administrator, is necessary to judicially review the plan administrator’s long-term disability (LTD) benefits decision.

  • May 21, 2024

    Insured Is Not Entitled To 2 Monthly Disability Payments, Massachusetts Panel Says

    BOSTON — A trial court properly found that an insured is not entitled to both total disability benefits and lifetime total disability benefits under a disability income policy because the policy clearly provides that lifetime total disability benefits are not payable until the maximum amount of total disability benefits is paid or until the insured’s 65th birthday, the Massachusetts Appeals Court said May 21 in affirming the trial court’s summary judgment order in favor of the insurer on breach of contract and bad faith claims.

  • May 21, 2024

    Insured Failed To Show Disability Insurer Acted With Reckless Disregard, Judge Says

    LOUISVILLE, Ky. — A Kentucky federal judge granted a disability insurer’s motion to dismiss an insured’s claims for violation of the Kentucky Unfair Claims Settlement Practices Act (KUCSPA) and breach of the covenant of good faith and fair dealing because the insured failed to show that the insurer acted with reckless disregard when it determined that the insured was entitled to only residual disability benefits and not total disability benefits.

  • May 14, 2024

    Life Insurance Benefit Not Available Based On Failure To Prove Total Disability

    PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals on May 13 affirmed a district court’s finding that a life insurance waiver-of-premium benefit was properly terminated because the claimant failed to show that he was totally disabled from working in any occupation as required by the life insurance plan to retain the waiver-of-premium benefit.

  • May 10, 2024

    Claim For Disability Benefits Is Time-Barred, 5th Circuit Panel Says In Affirming

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on May 9 affirmed the dismissal of a disability claimant’s breach of contract suit because the claimant failed to filed suit within three years of the initial denial of her claim, as required by the plan at issue, and failed to file suit within four years of the denial of her appeal pursuant to the four-year statute of limitations under Texas law for breach of contract suits.

  • May 10, 2024

    Attorney Says Termination Of Disability Benefits Was Arbitrary, Capricious

    PHILADELPHIA — A disability insurer acted arbitrarily and capriciously when it terminated an attorney’s long-term disability (LTD) benefits because the insurer failed to consider the actual duties of the claimant’s occupation when it determined that the claimant was no longer disabled from her own occupation as an attorney, the attorney says in a complaint filed in Pennsylvania federal court.

  • May 08, 2024

    Spinal Conditions Continued To Render Claimant Disabled, Calif. Federal Judge Says

    LOS ANGELES — Following remand from the Ninth Circuit U.S. Court of Appeals, a California federal judge found that additional long-term disability (LTD) benefits are owed to a disability claimant because the medical evidence shows that the claimant’s degenerative spinal conditions continued to render him disabled following the claimant’s recovery from a cardiac procedure.

  • May 07, 2024

    Disability Claimant Failed To Show Longer Shift Was Essential Duty Of Occupation

    CHICAGO — The Seventh Circuit U.S. Court of Appeals on May 6 affirmed a district court’s ruling that a disability claimant failed to show that the denial of a long-term disability (LTD) benefits claim was arbitrary and capricious because the claimant failed to show that working a longer shift was an essential duty of his occupation with his current employer.

  • May 07, 2024

    Claimant Files Complaint, Says LTD Benefits Owed For Long COVID Diagnosis

    PHOENIX — A denial of long-term disability (LTD) benefits was arbitrary and capricious and an abuse of discretion because the disability insurer failed to properly consider the restrictions and limitations set by the claimant’s treating physicians as a result of the claimant’s diagnosis with long COVID, the claimant contends in a complaint filed in Arizona federal court.

  • May 03, 2024

    Ophthalmologist’s Disability Suit Settled; Parties File Stipulation Of Dismissal

    ROANOKE, Va. — A disability claimant and disability insurer filed a stipulation of dismissal in Virginia federal court after reaching a settlement pertaining to the claimant’s long-term disability (LTD) benefits.

  • May 03, 2024

    Disability Claimant Seeks Rehearing Of Preexisting Condition Exclusion Ruling

    PASADENA, Calif. — A disability claimant filed a petition for panel rehearing and rehearing en banc in the Ninth Circuit U.S. Court of Appeals, contending that rehearing is warranted because the Ninth Circuit panel’s decision that a long-term disability (LTD) policy’s preexisting condition exclusion bars coverage creates an intracircuit conflict with a prior ruling of the Ninth Circuit.

  • May 03, 2024

    Disability Insurer Files Notice Of Settlement In LTD Benefits Suit

    KNOXVILLE, Tenn. — Less than a week after filing a notice of appeal to the Sixth Circuit U.S. Court of Appeals of a Tennessee federal judge’s ruling entered in favor of a disability claimant, the disability insurer notified the district court that it reached a settlement with the disability claimant.

  • May 03, 2024

    Disability Insurer Awarded More Than $11,000 In Costs In Bad Faith Benefits Suit

    FRESNO, Calif. — A California federal magistrate judge awarded a disability insurer more than $11,000 in costs that the insurer incurred in successfully defending a breach of contract and bad faith suit lodged against it by an oral surgeon who stopped working to reduce the risk of contracting COVID-19 and suffering complications from the virus based on his comorbid conditions of asthma and hypertension.

  • May 02, 2024

    Disability Claimant Failed To Show Any Error In District Court’s Benefits Ruling

    WASHINGTON, D.C. — The District of Columbia Circuit U.S. Court of Appeals granted a motion for summary affirmance filed by the Pension Benefit Guaranty Corp. (PBGC), named as the statutory trustee for a disability benefits plan, because the disability claimant failed to demonstrate any error in a district court’s ruling in favor of the PBGC.

  • May 02, 2024

    Disability Insurer, Claimant Settle Dispute Over Policy’s Monthly Benefit Rider

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals entered an order staying a disability claimant’s appeal and directing the parties to file a joint status report following the disability insurer’s filing of a notice of a settlement between the parties.

  • April 25, 2024

    Question Of Fact Exists About Disability Insurer’s Knowledge Of Pension Benefits

    OPELIKA, Ala. — An Alabama federal judge denied a motion for judgment on the pleadings filed by a disability claimant after determining that it is not clear whether the applicable six-year statute of limitations bars the disability insurer’s suit seeking to recover an overpayment of long-term disability (LTD) benefits because a question of fact exists regarding when the disability insurer learned that the claimant failed to disclose her receipt of pension benefits.