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Disability Benefits Denial of Benefits

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - August 2024

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This month’s Friday Five explores decisions from around the country discussing differences between the scope of discovery and ability to add documents to the record on a claim for review challenging the denial of LTD...more

Marshall Dennehey

Residual Functional Capacity to Perform Sedentary Work Leads to Denial of Social Security Benefits

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Ferraro v. O’Malley, 2024 WL 920056 - The plaintiff was involved in a motor vehicle accident that caused her to be out of work for six months. While the plaintiff did continue working after her alleged disability onset date,...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - April 2024

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This month’s Friday Five covers the treatment of job-related stress in assessing an attorney’s disability, the requirements surrounding the qualifications of a medical professional to review a claimant’s medical records in...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - March 2024

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This month’s Friday Five covers cases relating to an alleged conflict of interest leading to discovery, two courts’ opposite treatments of subjective pain complaints, a decision that claims of fraud and misrepresentation were...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - February 2024

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This month’s Friday Five explores decisions regarding the transfer of an ERISA action that was filed in a state where an insurer did not maintain sufficient minimum contacts, an award of attorneys’ fees, costs, and...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - January 2024

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On Halloween, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a $100,000 settlement under the Health Insurance Portability and Accountability Act (HIPAA) with Doctors’...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - December 2023

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This month’s Friday Five explores a decision ordering an IME prior to a ruling on summary judgment motions, the extent claims reporting records can be sealed, the scope of ERISA preemption in the context of removal, and two...more

Seyfarth Shaw LLP

Ninth Circuit Clarifies De Novo Review Standard and Newly-Raised Arguments in ERISA Litigation

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Recently, the Ninth Circuit addressed and further clarified the requirement of a “full and fair review” in the context of a long-term disability benefit case under the Employee Retirement Income Security Act (ERISA). In...more

Robinson+Cole ERISA Claim Defense Blog

Second Circuit Clarifies That Reclassification of Health Status That Limits Scope of Disability Benefits Does Not Constitute...

In Ruderman v. Liberty Mut. Grp., Inc., No. 21-817, 2022 WL 244086 (2d Cir. Jan. 27, 2022), the U.S. Court of Appeals for the Second Circuit ruled that reclassification of a claimant’s disability from one that is...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Fifth Circuit Holds Amputation Not An Accident Under AD&D Policy Where Employee’s Underlying Medical...

In Byerly v. Std. Ins. Co., 2021 U.S. App. LEXIS 2937 (5th Cir. Feb. 2, 2021), the Fifth Circuit determined that a claimant, whose leg was amputated after he stubbed his toe, did not suffer a qualifying loss under his group...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: District Court Finds Reduction in Monthly LTD Benefit Due to IRA Rollover Appropriate Under Plan Terms

In DeBold v. Liberty Life Assur. Co. of Bos., 2021 U.S. Dist. LEXIS 120153 (D. Mass, June 28, 2021), a district court held that an ERISA plan administrator could reduce an insured's monthly long-term disability (LTD) benefit...more

Saul Ewing LLP

The Friday Five: Five Current ERISA Litigation Highlights - July 2021

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This month’s Friday Five covers cases relating to the exhaustion of administrative remedies set forth only in a denial of benefits letter, the scope of information required to be provided to medical reviewers, whether...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

Ninth Circuit Affirms District Court May Consider Social Security Administration Ruling That Was Not Before the Plan Administrator

In Perez v. Lincoln Nat'l Life Ins. Co., 2021 U.S. App. LEXIS 1495 (9th Cir. Jan. 20, 2021), the Ninth Circuit held that a district court reviewing a denial of disability benefits under ERISA may consider a Social Security...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

Sixth Circuit Upholds Denial of LTD Benefits by Decision Makers Employed by Another Entity Within the Plan Administrator's...

In Davis v. Hartford Life & Accident Life Ins. Co., 2020 U.S. App. LEXIS 36360 (6th Cir. Nov. 19, 2020) the Sixth Circuit held that a district court properly applied the abuse of discretion standard when reviewing the denial...more

Littler

Disability Benefits Policy Language Warrants Arbitrary and Capricious Standard of Review Despite Enactment of Anti-Discretionary...

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A federal court in New Jersey recently applied the arbitrary and capricious standard of review for a denial of benefits claim despite the enactment of an anti-discretionary statute in Minnesota, which governed the benefit...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - March 2021

As we look ahead to 2021, we start our second edition of Hinshaw's LHD/ERISA Advisor by reporting on key cases that closed out 2020. Through The Advisor, our team of attorneys nationwide strive to report on legal developments...more

Jackson Lewis P.C.

U.S. Supreme Court: Courts Can Review Railroad Retirement Board’s Refusal To Reopen Claims

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In a 5-4 decision, the U.S. Supreme Court has ruled that federal courts can review decisions by the U.S. Railroad Retirement Board denying claimants’ requests to reopen prior benefits denials. Salinas v. U.S. R.R. Ret. Bd.,...more

Faegre Drinker Biddle & Reath LLP

Supreme Court Decides Salinas v. Railroad Retirement Board

On February 3, 2021, the U.S. Supreme Court decided Salinas v. United States Railroad Retirement Board, No. 19–199, holding that a refusal by the U.S. Railroad Retirement Board to reopen a prior benefits determination is...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020

As we enter the final months of 2020, this is a time to reflect on a year of unprecedented challenges. Although Covid-19 changed our lives in many ways, it did not halt new legal developments in the life, health and...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: District Court Holds Breach of Contract Claims are Time-Barred

Plaintiff Gene Myers (“Plaintiff”), a physician, made a claim for individual disability insurance (IDI) benefits under an individual disability policy arising from low back injury caused by wearing a heavy leaded gown worn...more

Carlton Fields

ERISA Disability Plan Insurers Score Important Circuit Court Victories

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In recent months, circuit courts across the country have supported insurers’ discretion to deny long-term disability benefits (LTD) under ERISA. Since the beginning of the year, disability plan insurers have prevailed in the...more

Morrison & Foerster LLP - Left Coast Appeals

This Week at the Ninth: Long Arms and Sore Backs

This week, the Ninth Circuit explains when courts have personal jurisdiction over foreigners who contract with U.S.-based businesses, and whether severe pain can qualify as a disability under the Longshore and Harbor Workers’...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Court Applies "Reasoned Approach" in Upholding Insurer's Denial of LTD Claim

In Creed v. Hartford Life & Acc. Ins. Co., 2020 U.S. Dist. LEXIS 17613, (S.D. Ohio February 4, 2020), the court applied a "reasoned explanation" approach to hold that the evidence supported an insurer's decision to deny an...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Eleventh Circuit Rules Against Insurer in LTD Case

In Kaviani v. Reliance Std. Life Ins. Co., 2020 U.S. App. LEXIS 3006 (11th Cir. Jan. 31, 2020), the Eleventh Circuit held that an insurer had failed to give sufficient credence to a claimant's self-reports of pain and...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Ninth Circuit Affirms Judgment for Unum Life In ERISA Disability Benefits Case

In Western v. Unum Life Insurance Company of America, 798 F.App'x 154, 2020 U.S. App. LEXIS 8362 (9th Cir. March 17, 2020), the Ninth Circuit affirmed Unum Life's determination that an aerospace engineer diagnosed with...more

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