Newsletter RSS

Mealey's Disability Insurance

  • August 14, 2025

    11th Circuit Affirms Ruling For Insurer In LTD Dispute Involving Sedentary Work

    ATLANTA — Affirming a ruling for an insurer that terminated long-term disability (LTD) benefits based on its determination that the claimant is capable of performing sedentary work, the 11th Circuit U.S. Court of Appeals in an unpublished per curiam opinion issued Aug. 13 concluded that the claimant didn’t show that the lower court erred.

  • August 12, 2025

    Suit Over Airline’s LTD Plan Is Voluntarily Dismissed After Resolution Report

    FORT WORTH, Texas — A putative class complaint that a disabled pilot filed over a May 2024 plan revision that he alleged resulted in underpayment of long-term disability (LTD) benefits was voluntarily dismissed without prejudice on Aug. 11 after the defendants told the Texas federal court in a dismissal motion that the pilot’s union had already gotten the issues resolved through a Railway Labor Act (RLA) dispute-resolution process.

  • August 08, 2025

    Extra-Record Discovery On Purported Conflict Of Interest Is Denied In LTD Row

    NEWARK, N.J. — Concluding that discovery requests “are not only unjustified under the conflict of interest exception to the” Employee Retirement Income Security Act “record rule, but not proportional to the needs of this case,” a New Jersey federal magistrate judge denied a pharmacist’s request to allow discovery beyond the administrative record in her suit challenging termination of her long-term disability (LTD) benefits.

  • August 07, 2025

    Judge Upholds STD Benefits Termination Under Arbitrary And Capricious Standard

    TULSA, Okla. — Rejecting an argument for de novo review, an Oklahoma federal judge upheld termination of short-term disability (STD) benefits in a case where the claimant said he was unable to work because of depression and memory loss.

  • July 31, 2025

    Judge Affirms Insurer’s ‘Incarceration’ Interpretation In LTD Benefits Row

    PITTSBURGH — Saying, “On the record before it, this Court finds that the term ‘incarceration’ is ambiguous, as it could mean post-conviction penal confinement or it could simply mean confinement,” a Pennsylvania federal judge on July 30 upheld termination of long-term disability (LTD) benefits under arbitrary and capricious review upon concluding that interpreting the term to mean confinement was within the insurer’s discretionary authority.

  • July 31, 2025

    Federal Judge Upholds LTD Benefits Termination Under Residency Provision

    SEATTLE — Addressing cross-motions for judgment on the record on de novo review of a long-term disability (LDT) benefits dispute, a Washington federal judge upheld termination of benefits under an international residency provision despite the fact that the COVID-19 pandemic hit during the time at issue.

  • July 28, 2025

    5th Circuit Rules That LTD Benefits Termination Was Sufficiently Supported

    NEW ORLEANS — In an unpublished per curiam opinion noting that the challenged termination of long-term disability (LTD) benefits “was supported by reports from at least four healthcare professionals,” the Fifth Circuit U.S. Court of Appeals affirmed judgment for an insurer in a case over whether the claimant was able to perform any gainful sedentary occupation.

  • July 28, 2025

    11th Circuit Nixes LTD Insurer’s Unjust Enrichment Jury Victory Under Florida Law

    ATLANTA — Issuing a mixed ruling in a dispute where a federal jury sided with a long-term disability (LTD) insurer, the 11th Circuit U.S. Court of Appeals ordered the trial court to vacate a judgment of nearly $450,000 for the insurer on its unjust enrichment claim but upheld dismissal of a breach of contract counterclaim.

  • July 25, 2025

    In Advisory Opinion, DOL Tackles ERISA Question Regarding LTD Plan

    WASHINGTON, D.C. — In one of its first advisory opinions issued under President Donald J. Trump, the U.S. Department of Labor (DOL) took the view that the self-funded long-term disability (LTD) plan of a mutual benefit corporation for California firefighters “does not constitute an employee welfare benefit plan within the meaning of” part of the Employee Retirement Income Security Act — with a caveat. 

  • July 22, 2025

    Ruling Policy Limitation Enforceable, 9th Circuit Upholds LTD Claim Denial

    SAN FRANCISCO — Issuing an unpublished memorandum disposition affirming that the preexisting conditions limitation (PECL) “is enforceable as applied” in the denial of a long-term disability (LTD) benefits claim, the Ninth Circuit U.S. Court of Appeals did not reach a dispute regarding the applicable standard of review.

  • July 15, 2025

    Benefits To Be Reinstated For Claimant In Migraine Disability Lawsuit

    SAN FRANCISCO — On de novo review of the termination of long-term disability (LTD) benefits for an employment law firm partner diagnosed with vestibular migraine and tinnitus, a California federal judge found in favor of the claimant and directed that the benefits be retroactively reinstated.

  • July 15, 2025

    9th Circuit Revives Breach Claim In Disability Row Involving COVID Risk

    SAN FRANCISCO — In an unpublished July 14 memorandum disposition, the Ninth Circuit U.S. Court of Appeals revived a breach of contract claim, but not a bad faith claim, in a suit an oral surgeon filed after unsuccessfully seeking disability benefits on the grounds that his comorbid conditions and inability to access recommended personal protective equipment (PPE) made it necessary to close his practice early in the COVID-19 pandemic.

  • July 15, 2025

    ‘Sheer Number’ Of AI-Faked Cites Noted In Defense Fee Declaration In Disability Case

    SANTA ANA, Calif. — In a July 14 defense fee declaration submitted at the direction of a California federal judge who imposed sanctions on a plaintiffs’ attorney for faked citations attributed to artificial intelligence, a disability insurer’s attorney said, “The sheer number of non-existent cases . . . was exponentially more than we have identified in any other cases discussing AI-generated and/or hallucinated cases.”

  • July 15, 2025

    Summary Judgment Denied In Disability Benefits Row Involving Notice, Cognition

    BUFFALO, N.Y. — Admitting a declaration that was not part of the administrative record and concluding in part “that procedural irregularities call into question the fairness and clarity of the decision-making process,” a New York federal magistrate judge denied cross-motions in a disability benefits case that involves late notice and a claimant who reportedly has cognitive issues after receiving treatment including radiation for an aggressive form of brain cancer.

  • July 14, 2025

    Colorado Federal Judge Upholds Denial Of Attorney’s COVID-Linked LTD Claim

    DENVER — Ruling against an attorney who unsuccessfully sought long-term disability (LTD) benefits because of fatigue and cognitive issues attributed to long COVID-19, a Colorado federal judge concluded that denial of the claim was not arbitrary and capricious; among other things, the judge said she “cannot conclude that Defendant failed to engage in a meaningful dialogue with Plaintiff.”

  • July 14, 2025

    As Recommended, Disability Claimant Wins Summary Judgment On Contract Breach Claim

    BUFFALO, N.Y. — A claimant who sought summary judgment on three of five counts in his suit over termination of disability benefits was granted it on a single breach of contract claim, with a New York federal judge briefly overruling the defendants’ objections to a report and recommendation he adopted; the ruling leaves claims including breach of the covenant of good faith and fair dealing pending.

  • July 14, 2025

    11th Circuit Sets Argument In Exhaustion Appeal Involving NFL Disability Plan

    ATLANTA — The 11th Circuit U.S. Court of Appeals has scheduled oral argument for Aug. 13 in an appeal where a former NFL player who argued that he should have been awarded total and permanent (T&P) disability benefits a decade earlier than he was seeks reversal of a dismissal ruling that was based on failure to exhaust administrative remedies.

  • July 10, 2025

    Order Vacated, Case Dismissed In LTD Benefits Row Involving COVID Risk

    SAN FRANCISCO — After vacating an August 2024 order and judgment that were in favor of a pediatrician who sought long-term disability (LTD) benefits based on her high risk of exposure to COVID-19, a California federal judge dismissed the case with prejudice pursuant to the parties’ stipulation.

  • July 09, 2025

    California Federal Magistrate Rules Claimant Eligible For 2 Years Of LTD Benefits

    SAN FRANCISCO — In a decision that involved weighing the opinions of numerous doctors, a California federal magistrate judge ruled that a claimant who held a “demanding managerial” role before saying that anxiety, depression and atypical autism made her unable to work is entitled to long-term disability (LTD) benefits “for the two-year mental disorder benefit period” and is eligible to seek attorney fees.

  • July 09, 2025

    10th Circuit Won’t Award Attorney Fees For Presuit Appeal In LTD Benefits Row

    DENVER — Affirming dismissal of a case filed under the Employee Retirement Income Security Act, the 10th Circuit U.S. Court of Appeals on July 8 rejected a bid to make a long-term disability (LTD) insurer pay attorney fees for an administrative appeal that got benefits reinstated.

  • July 08, 2025

    Judge Upholds Denial Of ‘Any Occupation’ LTD Benefits On De Novo Review

    MINNEAPOLIS — Upholding denial of long-term disability (LTD) benefits under an “any gainful occupation” standard on de novo review, a Minnesota federal judge said in part that the denial “was in lockstep with” restrictions on the claimant at the time and that a treating physician’s efforts to retroactively “walk back” those restrictions “do not change things.”

  • July 08, 2025

    Judge Says LTD Plan Must Take Another Look At Denial After Deadline Snafu

    SEATTLE — Ruling that equitable estoppel bars an untimeliness argument against a long-term disability (LTD) claimant who was given an incorrect administrative appeal deadline, a federal judge in Washington concluded that the correct remedy is remand “to the LTD plan administrator for review based on the full record, including the now-available post-denial medical information and literature involving long COVID.”

  • July 03, 2025

    California Federal Judge Sanctions Lawyer For AI-Faked Cites In Disability Case

    SANTA ANA, Calif. — A California federal judge imposed sanctions including a $500 payment on a plaintiff’s attorney who told the court that he “failed to scrutinize and oversee the preparation of” memoranda “filed with erroneous case citations that were invented by AI”; the breach of contract suit over termination of total disability benefits is headed toward a jury trial after the judge last month granted summary judgment for the insurer on a bad faith claim.

  • July 01, 2025

    Connecticut Federal Judge Upholds LTD Termination Under ‘Any Occupation’ Standard

    NEW HAVEN, Conn. — Closing a lawsuit filed by a shop fabricator with rheumatoid arthritis and granting judgment in favor of a long-term disability (LTD) insurer, a Connecticut federal judge said that “although this may be a case where a contrary determination would also be supported by substantial evidence,” overall “there was substantial evidence to support [the insurer’s] determination that Plaintiff was not disabled under the ‘Any Occupation’ definition.”

  • July 01, 2025

    Judge Rules For Claimant In LTD Row Involving Own-Occupation Duties

    CHATTANOOGA, Tenn. — Ruling on de novo review for a long-term disability (LTD) claimant who has neck and back pain, a Tennessee federal judge ordered retroactive reinstatement of her benefits in the case, resolving issues including what the duties of her regular occupation as a hospital chief clinical officer (CCO) are.