Disability Benefits

News & Analysis as of

Disgorgement of Profits Not Available for Arbitrary and Capricious Benefits Denial – This Time

Wrongful denial of employee benefits will not expose plan fiduciaries to equitable remedies – such as disgorgement of profits – where restoration of benefits is adequate to make the claimant whole, says the Sixth Circuit in...more

Ninth Circuit Rules That Harmless Procedural Violation Does Not Alter Standard of Review

The Ninth Circuit held that a plan administrator’s failure to render a decision on a long-term disability benefits claim within the period mandated by the plan and ERISA did not alter the standard of review that the court...more

Claiming SSD benefits for non-mosaic Down syndrome

Down syndrome is a genetic disorder that affects mental, muscular and skeletal development. A small number of Down syndrome cases are mosaic, with the genetic abnormality only apparent in some cells....more

Sixth Circuit Rejects Claim that Disgorgement of Profits Is Appropriate Remedy in ERISA Benefit Denial Action

On March 5, 2015, the U.S. Court of Appeals for the Sixth Circuit, sitting en banc in the matter of Rochow v. Life Insurance Company of North America, 2015 WL 925794 (6th Cir. Mar. 5, 2015), reversed the finding of a prior...more

ERISA: 6th Circuit — Plop Plop, Fizz Fizz: Oh What A RELIEF It Is: No Disgorgement For Arbitrary Denial Of Benefits

Does an arbitrary and capricious denial of ERISA governed disability benefits create a right to disgorgement of profits? NO....more

Sixth Circuit Overturns the Lower Court’s Award of $3.8 Million in Alleged Profits Arising From a Denial of Benefits

The U. S. Court of Appeals for the Sixth Circuit, sitting en banc, has overturned the decision of a divided three-judge Sixth Circuit panel which had affirmed the district court’s award of $3.8 million of “disgorged” profits,...more

Breaching Fiduciary Cannot Seek Equitable Indemnity from Another Fiduciary

A California federal district court dismissed a plan fiduciary’s equitable indemnity claim because such claims are not available to a breaching fiduciary under ERISA. Plaintiff William Brown commenced a putative class action...more

Illinois worker still eligible for workers’ compensation after fired for theft

Disabling accidents are tragically common among warehouse workers in Illinois. According to the Bureau of Labor Statistics, more than 5 percent of full-time warehouse employees suffer a serious workplace injury every year....more

Court Holds That Physician’s State Law Claim For Disability Benefits Is Preempted by ERISA: Hershan v. Unum Group Corporation

A federal court has held that a radiologist’s state law contract claim for certain disability insurance benefits arose under a welfare benefit plan governed by ERISA and was therefore preempted by ERISA. In Hershan v. Unum...more

“Videoday” beim 8. Senat des BAG

Die Entscheidungen des 8. Senats des BAG zur heimlichen Videoüberwachung einer (vermeintlich) krankfeiernden Arbeitnehmerin (BAG v. 19.02.2015 – 8 AZR 1007/13) und zur Nutzung eines Imagefilms, in dem ein Ex-Arbeitnehmer als...more

Can you lose your SSD benefits?

Social Security Disability benefits are only awarded to people who suffer from long-term disabling conditions and, as a result, cannot work gainfully....more

Blindness and SSD benefits

Blind individuals in Illinois face myriad daily challenges, including supporting themselves financially. Blindness introduces unique medical expenses and often prevents gainful employment. ...more

Due Process Requires the Right to Cross-Examine a Workers' Compensation Applicant

On January 29, 2015, the Court of Appeal, Second Appellate District, ordered the publication of Ogden Entertainment Services v. WCAB (Ritzhoff), (B254082), previously a non-certified opinion that issued on December 31, 2014....more

Common errors found on Social Security Disability applications

Most people in Illinois know that the Social Security Disability denial rate is high. Unfortunately, lack of a legitimate disability is not always the reason for claim denial. Instead, denials often occur because of mistakes...more

WSIB Age Cut-off for Loss-of-Earnings Benefits not Discriminatory Against Older Workers: Court

Ontario’s Divisional Court has decided that the Workplace Safety and Insurance Act’s age cut-off for loss of earnings benefits for older workers did not violate the Canadian Charter of Rights and Freedoms....more

Who is “Disabled” under ABLE?

The recently-enacted federal ABLE statute provides a long-awaited vehicle for tax-exempt investing to meet future disability-related expenses of disabled individuals. Although new Section 529A of the Internal Revenue Code is...more

ERISA: 8th Circuit: Choice-Of-Law Provision Trumps Insurance Regulation Banning Discretionary Review

You already know that when a claimant brings suit alleging wrongful denial of ERISA-governed disability benefits, the first issue the court looks at is: what standard of review applies. If the plan or policy includes...more

Senate Approves QCD Tax Extender and ABLE Accounts – President Approval Expected Shortly

In two earlier blog posts we mentioned that the House had passed one bill to extend a number of tax breaks and had passed another bill, the ABLE Act, which would provide added benefits to individuals with disabilities....more

Financial Services Regulatory Bulletin - December 2014

In this issue: - CFPB Issues Final Rule on Regulation P: Annual Privacy Notices Can Be Delivered By Posting Online - ‘It Takes Hutzpah!’: D.C. Federal Judge Issues Stunning Rebuke of HUD Disparate Impact Rule...more

Increase Your Chances for Success: Preparing Your Form 24 Application

Whether to file a Form 24 Application is a decision based on the specific facts of each case. Once the decision is made to file a Form 24 Application, it is vital to properly prepare the Form 24 Application to ensure the...more

When is Filing a Form 24 Application Proper?

In North Carolina, if defendants are paying TTD benefits and have not timely and properly denied the compensability of the injured employee’s claim on a Form 61, or if the injured employee has not voluntarily returned to...more

Does a Request for Disability Benefits Qualify as a Request for an Accommodation of Leave Under the ADA?

Last month, the Sixth Circuit Court of Appeals answered this question in the negative and found that an employee’s request for long-term disability benefits did not amount to a request for a reasonable accommodation in the...more

Going Back To Work

The answer to this question depends on the circumstances you find yourself in. For some people, it makes absolute sense to go back to work. For others, going back to work exposes them to a very high chance that they’ll be...more

Taking A New Job

As with almost everything related to the law, an answer to a general question like this really depends on what’s going on in your case. Maybe you should. Maybe you shouldn’t. What we’re going to do here is talk about some...more

Additional Leave May Be Required Under ADA Even if Maximum Leave Is Exhausted

In Casteel v. Charter Communications, Inc., No. C13-5520 RJB (W.D. Wash. Oct. 23, 2014), a federal judge in Western Washington denied an employer’s motion for summary judgment on a failure-to-accommodate claim under the...more

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