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Mealey's Disability Insurance

  • 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.”

  • December 11, 2025

    LTD Claimant Is Granted Limited Discovery Outside Administrative Record

    TAMPA, Fla. — Saying that the “parties agree to limit the scope of discovery to the issues identified in” Cerrito v. Liberty Life Assurance Co., a Florida federal magistrate judge granted a long-term disability (LTD) claimant’s request for discovery outside the administrative record in the Employee Retirement Income Security Act suit.

  • December 10, 2025

    Half The Requested Attorney Fees Awarded In LTD Case Remanded To Administrator

    SAN FRANCISCO — Finding that “the reversal of the determination of denial and the remand for consideration with a vocational analysis constitutes a sufficient degree of success to warrant attorney’s fees” in a case challenging termination of long-term disability (LTD) benefits under an any-occupation standard, a California federal magistrate judge awarded just half of the nearly $185,000 requested for attorney fees and declined to amend the judgment to award the benefits pending the determination on remand.

  • December 05, 2025

    1st Circuit Appeal Of LTD Benefits Termination Is Dropped Per Stipulation

    BOSTON — A claimant who unsuccessfully challenged a determination that she wasn’t entitled to long-term disability (LTD) benefits under an any-occupation standard despite being approved for Social Security Disability Income (SSDI) has dropped her appeal in the First Circuit U.S. Court of Appeals.

  • December 05, 2025

    11th Circuit Cites Social Media As Factor In Affirming Ruling For LTD Insurer

    ATLANTA — Saying in an unpublished per curiam opinion that the multiple physician reviews that a long-term disability (LTD) insurer obtained and the claimant’s “social media activity” and medical records constituted substantial evidence for terminating benefits under a group insurance policy’s any-occupation definition of disability, the 11th Circuit U.S. Court of Appeals affirmed summary judgment for the insurer.

  • December 03, 2025

    Expert Challenges In Suit Over NFL Disability Denials Draw Mixed Ruling

    BALTIMORE — Addressing three expert challenges in a putative class action concerning NFL disability benefits, a Maryland federal magistrate judge excluded one expert in full and one in part and declined to exclude the third.

  • November 21, 2025

    COMMENTARY: Testing The Boundaries Of Product Liability For AI Products: How To Hold An Insurance Company Liable For AI Errors

    By Jamie O’Neill and Abigail Damsky

  • November 24, 2025

    Split 11th Circuit Reverses In LTD Case Over Preexisting Conditions Exclusion

    ATLANTA — Reversing and remanding a ruling against a long-term disability (LTD) claimant, a split 11th Circuit U.S. Court of Appeals panel on Nov. 21 ruled that it was unreasonable for the 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.”

  • November 21, 2025

    11th Circuit Affirms Ruling Upholding Termination Of Litigator’s LTD Benefits

    ATLANTA — Upholding termination of long-term disability (LTD) benefits in a case that turned on a therapist’s notes, the 11th Circuit U.S. Court of Appeals said in an unpublished Nov. 20 opinion that although some of the notes are “troubling” because they report passive suicidal ideation, as a whole they do not show that the claimant “was unable to perform her duties as a commercial litigator.”

  • November 19, 2025

    Claimant Gets Judgment Exceeding $1M In LTD, Residual Disability Benefits Case

    ANN ARBOR, Mich. — Long-term disability (LTD) and residual disability insurers agreed to give up their right to appeal and pay a pediatric dermatologist more than $1 million in retroactive benefits, attorney fees and prejudgment interest under a stipulated final judgment that a Michigan federal judge approved.

  • November 19, 2025

    Judge Won’t Permit Discovery In LTD Dispute Where Claimant Declined Remand

    NEW YORK — A New York federal judge declined to remand a dispute over terminated long-term disability (LTD) benefits to the insurer for review on the merits, explaining that any remedy would be “premature” because she had not yet reviewed the termination decision, then in a memorandum endorsement denied the claimant’s subsequent request for discovery and cautioned that any attempt to increase the insurer’s legal fees “is likely to backfire.”

  • November 18, 2025

    W.Va. Federal Judge Mostly Denies Dismissal In Suit Over LTD Benefits

    HUNTINGTON, W.Va. — A West Virginia federal judge declined to dismiss a bad faith claim against a long-term disability (LTD) insurer and ruled that four out of five allegations as to violation of the West Virginia Unfair Trade Practices Act (UTPA) survive.

  • November 14, 2025

    Judge: Software Engineer With Long COVID Was Due LTD Benefits

    LOS ANGELES — After weighing the opinions of treating and reviewing physicians, a California federal judge concluded that a software engineer “was unable to perform the specific duties required by his job with reasonable continuity due to diagnosed symptoms of cognitive impairment, brain fog, and fatigue likely resulting from long-haul COVID-19” and therefore entitled to long-term disability (LTD) benefits.

  • November 14, 2025

    Parties File 9th Circuit Briefs In LTD Denial Appeal Involving Long COVID

    SAN FRANCISCO — Issues including assessing differing medical opinions and whether new reasons for denial of long-term disability (LTD) benefits were improperly raised during a bench trial are disputed in Ninth Circuit U.S. Court of Appeals briefs in the case of a former underwriter who says he was disabled by cognitive impairments and other symptoms he attributes to long COVID.

  • November 14, 2025

    ERISA Fiduciary Breach Claim Survives Dismissal In LTD Benefits Case

    KANSAS CITY, Kan. — Allowing both claims to proceed in a financial analyst’s challenge to termination of his long-term disability (LTD) benefits, a Kansas federal judge declined to dismiss what she concluded was an alternative theory of liability for alleged breach of fiduciary duty under the Employee Retirement Income Security Act.

  • November 10, 2025

    Partial Disability Claimant Wins Just Over $100,000 After Summary Judgment Ruling

    OAKLAND, Calif. — A long-term disability (LTD) claimant described by a California federal judge as having a “constellation of psychological and physical issues” was awarded retroactive partial disability benefits and interest totaling $100,849.01 pursuant to a stipulation the parties entered after she prevailed at summary judgment.

  • November 04, 2025

    LTD Insurer To 11th Circuit: Affirm Ruling In Dispute Involving Tax Returns

    ATLANTA — Arguing that the plan terms gave its claims administrator the discretion to determine what constitutes sufficient proof of disability, a long-term disability (LTD) insurer filed a Nov. 3 brief asking the 11th Circuit U.S. Court of Appeals to affirm summary judgment in its favor in a dispute involving interpretation of the term “work” and reject the claimant’s urging to take the position outlined in a report and recommendation the lower court declined to adopt.

  • November 03, 2025

    Federal Judge Skips LTD Claimant’s Fees Tangle With Her Own Attorneys

    NEW YORK — Declining to exercise ancillary jurisdiction over a fee issue that involves a retainer agreement, a New York federal judge said that doing so in the otherwise concluded case concerning long-term disability (LTD) benefits “would require the Court to decide entirely new claims and would not result in judicial economy.”