Mealey's Disability Insurance
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May 09, 2025
Magistrate Would Dismiss STD Benefits Case As Moot But Let Claimant Seek Fees
CINCINNATI — Defendants that voluntarily reversed the challenged termination of short-term disability (STD) benefits and paid up after being sued could still be liable for attorney fees under the recommendation an Ohio federal magistrate judge issued in the Employee Retirement Income Security Act case.
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May 08, 2025
Employee Ineligible For Retroactive LTD Benefits, Federal Judge Says
TACOMA, Wash. — A Washington federal judge ruled that a former employee who retroactively filed a long term disability (LTD) claim after multiple diagnoses failed to prove that she was disabled under the terms of her policy on her employment termination date, rendering her ineligible for benefits and prompting the judge to grant the insurer’s motion for judgment, deny the former employee’s cross-motion and deny her request to supplement the administrative record
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May 07, 2025
5th Circuit Won’t Dismiss Attorney Fee Appeal In ERISA Disability Benefits Dispute
NEW ORLEANS — Without explanation, a Fifth Circuit U.S. Court of Appeals panel denied a former National Football League player’s motion to dismiss the Bert Bell/Pete Rozelle NFL Player Retirement Plan’s appeal of an award of more than $1.25 million in attorney fees and costs.
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May 02, 2025
LTD Insurer Wins Summary Judgment In Dispute Over Nervous Disorders Provision
TRENTON, N.J. — Citing the analysis in a nonprecedential 2009 Third Circuit U.S. Court of Appeals decision, a New Jersey federal judge upheld termination of long-term disability (LTD) benefits for a former clinical nurse instructor under a mental or nervous disorders provision.
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May 01, 2025
4th Circuit En Banc Majority Won’t Stay Injunction In DOGE, SSA Records Case
RICHMOND, Va. — A divided en banc Fourth Circuit U.S. Court of Appeals on April 30 denied a motion by the Social Security Administration (SSA) and other federal government agencies and officials to stay a preliminary injunction order pending appeal in a case over the Department of Government Efficiency’s (DOGE) access to SSA data.
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April 29, 2025
Recommendation Favors Defendants’ Fee Bid In LTD Lawsuit Involving $30K Offer
TAMPA, Fla. — Concluding in part that a rejected $30,000 offer of judgment made in 2021 was covered by a Florida fee-shifting statute, a Florida federal magistrate judge recommended granting a motion in which defendants in a cardiac surgeon’s lawsuit over denial of a disability benefits claim contend that they are entitled to attorney fees they estimate at $88,148.50.
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April 28, 2025
Former Surgeon, Insurer Stipulate To Dismissing Suit For LTD Benefits
TYLER, Texas — After previously reporting that they were “working on finalizing” an unspecified settlement, the parties in a former surgeon’s suit for long-term disability (LTD) benefits and relief for alleged mishandling of her claim on April 25 filed a joint stipulation of dismissal with prejudice in a Texas federal court.
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April 28, 2025
Claimant Files Appeal In LTD Documents Case After Insurer Wins Summary Judgment
ATLANTA — A long-term disability (LTD) claimant is taking his case to the 11th Circuit U.S. Court of Appeals after a Florida federal judge sustained an insurer’s objections to a recommendation that competing summary judgment motions be resolved in the claimant’s favor in the dispute involving failure to submit income documents.
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April 24, 2025
Defendants Prevail In Suit Over STD, LTD Benefits; Notice Ruled Insufficient
HARRISONBURG, Va. — Resolving three motions in favor of the defendants, a Virginia federal judge upheld denial of short-term disability (STD) benefits on the basis that the plan administrator “engaged in principled and reasoned decision-making while considering sufficient evidence,” also ruling that the claimant didn’t exhaust administrative remedies as to long-term disability (LTD) benefits and is now time-barred from doing so.
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April 23, 2025
LTD Claimant Prevails In Interpretation Dispute Over What ‘Insured Earnings’ Means
NEW YORK — Following a bench trial on the stipulated record in a dispute over termination of long-term disability (LTD) benefits, a New York federal judge ruled for the claimant, saying in part on de novo review that “the term ‘insured earnings,’ as used in the Plan” does include earnings reported on a K-1 tax form.
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April 16, 2025
Federal Judge Finds ERISA Governs Group Disability Plan, Dismisses State Law Claims
BOSTON — A Massachusetts federal judge granted an insurer’s motion for summary judgment, ruling that an employee’s long-term disability (LTD) insurance plan administered by her religious institute-affiliated employer is governed by the Employee Retirement Income Security Act and not exempt as a church plan, resulting in the dismissal of the coordinator’s state law claims without prejudice.
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April 15, 2025
NFL Plan To 5th Circuit: Let Fee Award Appeal Proceed In Disability Benefits Row
NEW ORLEANS — Telling the Fifth Circuit U.S. Court of Appeals that the issues raised are not “grounds for dismissal” and that it “could not have forfeited an appeal of the new fee award and opinion before they existed, when the case was in the opposite posture,” the Bert Bell/Pete Rozelle NFL Player Retirement Plan on April 14 asked to be allowed to proceed with its appeal of an award of more than $1.25 million in attorney fees and costs to a former National Football League player.
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April 15, 2025
Engineer To 4th Circuit: Affirm Ruling In Long COVID Disability Benefits Case
RICHMOND, Va. — Contending in part that de novo review was correctly applied because of an “inexcusable failure to issue a timely decision,” a long-term disability (LTD) benefits claimant urged the Fourth Circuit U.S. Court of Appeals to affirm a judgment that she is owed past-due benefits because long COVID symptoms have disabled her from working as an engineer.
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March 20, 2025
Insurer To 4th Circuit: Overturn Ruling In Long COVID Disability Benefits Case
RICHMOND, Va. — Arguing that the lower court improperly applied de novo review and wrongly concluded that the claimant showed that she is disabled from working as an engineer because of long COVID symptoms, an insurer urged the Fourth Circuit U.S. Court of Appeals to reverse a judgment that the claimant is owed past-due long-term disability (LTD) benefits.
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April 15, 2025
Judge Upholds LTD Benefits Termination For Failure To Show No ‘Working’
WORCESTER, Mass. — Upholding termination of long-term disability (LTD) benefits on de novo review, a Massachusetts federal judge ruled that an independent financial adviser didn’t meet his burden of showing that he had not been “working,” with that term defined as “engaging in activity regularly for wages or salary.”
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April 14, 2025
Dismissal Bid Fought In Dispute Over Disability Policy ‘Age 65’ Language
PHOENIX — Arguing in part that the defendants’ “desired interpretation runs counter to the well-pleaded facts, the parties’ expectations, any reasonable consumer’s expectations, and decisional law,” a plaintiff on April 11 urged an Arizona federal court to deny dismissal of his putative class complaint over whether certain individual long-term disability (LTD) benefits must be paid through eligible insureds’ 65th birthdays.
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April 14, 2025
Judge: LTD Administrator Didn’t Abuse Its Discretion In Long COVID Case
MADISON, Wis. — Upholding denial of long-term disability (LTD) benefits for a claimant who was diagnosed with long COVID, a Wisconsin federal judge said in part that “even when symptoms are subjective, functional limitations caused by those symptoms can be objectively measured, so it is not arbitrary and capricious to ask for objective evidence.”
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April 11, 2025
Judge Orders LTD Benefits Retroactively Reinstated In Basis Switch Dispute
OAKLAND, Calif. — Rejecting the defendants’ request that the dispute instead be remanded to the insurer, a California federal judge who previously ruled that termination of a long-term disability (LTD) claimant’s benefits was an abuse of discretion has now directed that those benefits be retroactively reinstated.
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April 09, 2025
Judge Considers Subjective Evidence, Rules For Disability Claimant
TACOMA, Wash. — A production line manager who points to receipt of a COVID-19 vaccine as the start of numerous symptoms that made him unable to work successfully challenged a disability insurer’s denial of his long-term disability (LTD) claim, with a Washington federal judge entering an April 8 judgment that he is entitled to relief including at least 24 months of benefits.
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April 08, 2025
5th Circuit Affirms Ruling Against Disability Claimant In Any-Occupation Case
NEW ORLEANS — Saying in an unpublished April 7 opinion that the administrative record shows “no evidence” that the appellant “is still disabled,” the Fifth Circuit U.S. Court of Appeals upheld termination of long-term disability (LTD) benefits in the any-occupation case.
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April 08, 2025
Disability Insurer Urges 11th Circuit To Affirm Any-Occupation Ruling
ATLANTA — Noting the role that social media posts played and arguing that the appellant’s evidence was not overlooked and the opinions of her doctors were not ignored, a disability insurer urges the 11th Circuit U.S. Court of Appeals to uphold its termination of benefits as “based on substantial evidence, including multiple medical reviews, an uncontested vocational assessment identifying alternative occupations, and inconsistencies in [her] self-reported physical tolerances.”
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April 02, 2025
Federal Judge Denies Remand, Finds ERISA Preempts Disability Benefits Case
COLUMBUS, Ohio — A federal judge in Ohio ruled that a terminated employee’s amended complaint seeking damages relating to long-term disability (LTD) benefits cannot be remanded to an Ohio court because the claims are preempted by the Employee Retirement Income Security Actand establish federal question jurisdiction.
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March 31, 2025
Grant Of Summary Judgment Recommeded On Contract Breach Claim In Disability Suit
BUFFALO, N.Y. — A New York federal magistrate judge on March 28 recommended that a disability claimant’s motion for summary judgment on a breach of contract claim be granted because the evidence shows that the claimant remained disabled; however, the magistrate judge recommended that the claimant’s motion be denied on a claim alleging breach of the covenant of good faith and fair dealing because questions of fact exist on whether the insurer’s termination of benefits was reasonable.
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March 28, 2025
Judge: ERISA Safe Harbor Provision Saves Surgeon’s Disability Insurance Dispute
BALTIMORE — A federal judge in Maryland denied a disability insurer’s motion to dismiss an orthopedic surgeon’s amended complaint alleging breach of contract and bad faith in a disability benefits dispute, reasoning that the policy may fall under the Employee Retirement Income Security Act’s safe harbor provision.
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March 26, 2025
Ex-NFL Player To 5th Circuit: Dismiss Fee Award Appeal In Disability Benefits Row
NEW ORLEANS — Arguing in part that “[i]t would be patently unfair to reverse [his] benefits award while citing his failures to properly appeal and then excuse the Plan’s own failures to properly appeal the Fee Award,” a former National Football League player filed a motion asking the Fifth Circuit U.S. Court of Appeals to dismiss the plan’s appeal of an award of more than $1.25 million in attorney fees and costs.