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Termination Of LTD Benefits Was Reasonable Based On Evidence, Judge Says
KANSAS CITY, Kan. - A disability insurer's termination of long-term disability (LTD) benefits based on its determination that the claimant was capable of performing a number of identified gainful occupations was reasonable and supported by substantial evidence, a Kansas federal judge said Feb. 5 in granting the insurer's motion for summary judgment (Andrew Scott v. Union Security Insurance Co., No. 17-2686, D. Kan., 2019 U.S. Dist. LEXIS 17853). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 12, 2019 Category: Medical Law Source Type: news

Plan Administrator Abused Discretion In Terminating LTD Benefits, Majority Says
SAN FRANCISCO - A long-term disability (LTD) plan administrator abused its discretion in denying LTD benefits under the plan's any-occupation standard because the plan administrator failed to properly consider restrictions placed on the claimant, a Ninth Circuit U.S. Court of Appeals panel majority said Jan. 18 (Jennifer Kott v. Agilent Technologies Inc. Disability Plan, No. 17-16584, 9th Cir., 2019 U.S. App. LEXIS 1768). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 12, 2019 Category: Medical Law Source Type: news

Disability Insurer Must Consider Actual Duties Of Claimant's Own Occupation
PHILADELPHIA - A disability insurer was required to consider the actual duties of a claimant's occupation rather than the duties of the occupation as performed in the national economy because the plan clearly defined the term "own occupation" as the work the claimant was performing immediately before the onset of the disability, the Third Circuit U.S. Court of Appeals said Feb. 7 in affirming a district court's opinion (Christopher Patterson v. Aetna Life Insurance Co., No. 17-3566, 3rd Cir., 2019 U.S. App. LEXIS 3902). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 12, 2019 Category: Medical Law Source Type: news

Disability Benefits Were Properly Denied Under Plan, 6th Circuit Panel Affirms
CINCINNATI - A disability claimant is not entitled to long-term disability (LTD) benefits because the plan's decision to terminate his benefits was reasonable based on a review of the medical evidence, the Sixth Circuit U.S. Court of Appeals said Jan. 22 in affirming a district court's decision in favor of the plan (Marc Jackson v. Blue Cross Blue Shield of Michigan Long Term Disability Program, No. 18-1542, 6th Cir., 2019 U.S. App. LEXIS 1978). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 12, 2019 Category: Medical Law Source Type: news

Federal Judge Permits Limited Extra Discovery In Disability Benefits Dispute
BIRMINGHAM, Ala. - An Alabama federal judge on Jan. 9 granted a disability claimant's motion to conduct discovery as it pertains to the insurer's conflict of interest because additional discovery will help the court in its review of the insurer's denial of a claim for waiver-of-life-premium (Carol H. Stewart v. Hartford Life& Accident Insurance Co., No. 17-1423, N.D. Ala., 2019 U.S. Dist. LEXIS 3647). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

Disability Claimant Cannot Supplement Record To Include Letter Awarding Benefits
BAY CITY, Mich. - A disability claimant cannot supplement the administrative record to include a letter from the disability insurer awarding her benefits because the letter was issued after the district court determined that the claimant is not entitled to an award for attorney fees and costs, a Michigan federal judge said Dec. 10 in denying the claimant's motion (Kimberly J. Guest-Marcotte v. Life Insurance Company of North America, et al., No. 15-10738, E.D. Mich., 2018 U.S. Dist. LEXIS 208252). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

Bad Faith Claim Barred By Statute Of Limitations, Federal Judge Determines
SAN DIEGO - A California federal judge on Dec. 10 dismissed a disability claimant's bad faith claim after determining that the claim is barred by the applicable two-year statute of limitations because accrual of the bad faith claim began when the insurer issued its initial benefits determination and not when the insurer issued its decision on appeal (Frank L. Pavel v. Unum Life Insurance Company of America, et al., No. 18-1778, S.D. Calif., 2018 U.S. Dist. LEXIS 209019). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

Florida Federal Judge Says It Is Not Clear If Preemption Applies In Disability Suit
FORT MYERS, Fla. - A Florida federal judge on Dec. 12 denied a motion to dismiss state law claims alleged against two disability insurers because it is not clear from the pleadings that the policies are governed by the Employee Retirement Income Security Act and that the state law claims would therefore be preempted (Marcus Allen, M.D. v. First Unum Life Insurance Co., et al., No. 18-69, M.D. Fla., 2018 U.S. Dist. LEXIS 209454). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

Disability Claimant Fails To Allege Plan Was Improperly Amended, Panel Says
CINCINNATI - A district court did not err in granting judgment in favor of a disability insurer and a plan administrator because the claimant failed to allege in the district court that the plan was improperly amended, the Sixth Circuit U.S. Court of Appeals said Jan. 3 (David Moore v. Metropolitan Life Insurance Co., et al., No. 18-5325, 6th Cir., 2019 U.S. App. LEXIS 239). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

Disability Suit Remanded; Wrong Standard Of Review Applied, Panel Says
SAN FRANCISCO - The Ninth Circuit U.S. Court of Appeals on Jan. 4 reversed and remanded a judgment entered in favor of a disability insurer after determining that a district court erred in applying the abuse of discretion standard of review rather than the de novo standard of review (Robert Gordon v. Metropolitan Insurance Co., No. 17-16821, 9th Cir., 2019 U.S. App. LEXIS 292). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

Final Denial Of Disability Claim Never Issued, Federal Judge Says
SAN FRANCISCO - A disability insurer did not issue a final denial of a claim for total disability benefits, a California federal judge said Jan. 4 in granting the insurer's motion for summary judgment in a breach of contract and bad faith suit filed by an insured (Sunil Srinivasan, DDS v. Continental Assurance Co., et al., No. 18-4371, N.D. Calif., 2019 U.S. Dist. LEXIS 1894). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

District Court Failed To Address All Alleged Procedural Irregularities
SAN FRANCISCO - A majority of a Ninth Circuit U.S. Court of Appeals panel on Jan. 4 reversed and remanded a district court's ruling in favor of a disability plan and the plan administrator after determining that the district court failed to address all of the procedural irregularities that allegedly occurred during the claim review process (Leslie Hoffman v. Screen Actors Guild Producers Pension Plan, No. 16-56663, 9th Cir., 2019 U.S. App. LEXIS 284). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

Insurer Reasonably Found That Disability Was Caused By Depression, Anxiety
ST. LOUIS - A disability insurer reasonably concluded that a claimant's disability was caused by depression and anxiety rather than fibromyalgia because the objective medical records did not support the claimant's complaints of physical pain, the Eighth Circuit U.S. Court of Appeals said Jan. 9 (Marianne Thiry v. United of Omaha Life Insurance Co., et al., No. 17-3288, 8th Cir., 2019 U.S. App. LEXIS 613). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

LTD Benefits Must Be Reinstated, New York Federal Judge Determines
NEW YORK - A disability claimant's long-term disability (LTD) benefits must be reinstated because the claimant met her burden of proving that she is disabled from performing the duties of any occupation, a New York federal judge said Dec. 11 in granting the claimant's motion for judgment on the administrative record (Christine Thoma v. The Fox Long Term Disability Plan, et al., No. 17-4389, S.D. N.Y., 2018 U.S. Dist. LEXIS 209077). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news

Claimant Met Burden; Additional LTD Benefits Owed, Federal Judge Says
SALT LAKE CITY - A disability claimant is entitled to an additional eight months of long-term disability (LTD) payments because the claimant proved by a preponderance of the evidence that his disability prevents him from working in his occupation as an attorney, a Utah federal judge said Dec. 10 (Ralph Dewsnup v. Unum Life Insurance Company of America, No. 17-126, D. Utah, 2018 U.S. Dist. LEXIS 208688). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 15, 2019 Category: Medical Law Source Type: news