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May 2016 Archives

How to Interpret the "Each and Every Duty" Requirement in a Disability Insurance Policy

Many disability insurance policies require a showing of an inability to perform each and every regular job duty.  Does that mean you can't be considered disabled if you are unable to perform some but not all of the required job duties? In most jurisdictions, the answer is yes - you need not prove an inability to perform every single job duty in order to receive benefits. 

When Can A Social Security Determination Be Admitted into Evidence in an ERISA Long-Term Disability Benefit Case?

Because federal courts generally consider the scope of their review of an ERISA benefit denial as being limited to review of a record, what happens if significant material evidence such as a Social Security determination becomes available only after the claim appeals are exhausted.  If the standard of judicial review is arbitrary and capricious, it may be tough luck of the claimant.  Majeski v. Metropolitan Life Ins.Co., 590 F.3d 478 (7th Cir. 2009); White v. Airline Pilots Assn., 364 F.Supp.2d 747 (N.D.Ill. 2005); Groth v. Centurylink Disability Plan, 2016 WL 1621724 (S.D. Ohio April 25, 2016).  And in situations where the evidence could have been obtained and presented earlier, the courts will not allow the evidence later - Alford v. DCH Foundation Group Long-Term Disability Plan, 311 F.3d 955 (9th Cir. 2002).  Thus, we counsel all of our clients as to the need to obtain whatever expert support is necessary during the claim process. 

DeBofsky, Sherman & Casciari, PC