There has been a growing number of rulings relating to health insurance denials involving mental health treatment. A recent example is Jamie F v. Unitedhealthcare Insur. Co., 2020 WL 4249200 (N.D. Cal., July 23), which involved a claimant who had a long history of being treated for several mental illnesses including anorexia nervosa, depression, anxiety, obsessive-compulsive […]
This month marks thirtieth anniversary of the passage of the Americans with Disabilities Act of 1990 (“ADA”), 42 U.S.C. § 12101 et seq., a landmark piece of civil rights legislation that prohibits discrimination on the basis of disability. The ADA requires that people with disabilities be granted equal access to employment, public services, and public accommodations. […]
Employee benefit claimants are frequently surprised by the limited remedies to them under the Employee Retirement Income Security Act. However, a recent U.S. Supreme Court ruling in Liu v. U.S. Securities and Exchange Commission,[1] might open the door to additional remedies. Although many ERISA claims involve benefits provided under disability, life or health insurance policies, […]
An aspect of Employee Retirement Income Security Act benefits litigation that distinguishes it from other civil litigation is that discovery in ERISA cases is only stingily granted. Although, as will be shown below, that appears to be changing. There is no statutory basis for limiting discovery in ERISA cases, nor do the Federal Rules of […]
Protecting LGBTQ rights is of great importance for this country, and the legal issues related to transgender healthcare can be particularly complicated. Many employer-sponsored healthcare plans now explicitly cover transgender-related healthcare. Part of the reason is likely economic. According to the Williams Institute, there are currently just under 1.4 million Americans who identify as transgender, […]
Mark D. DeBofsky is a name partner of DeBofsky Sherman Casciari Reynolds P.C. — on the web at debofsky.com. He handles civil and appellate litigation involving employee benefits, disability insurance and other insurance claims and coverage issues. He can be reached at [email protected] While most ERISA claims are heard in federal court, claims for benefits […]
The scope and breadth of the Employee Retirement Income Security Act’s statutory preemption of state laws that relate to employee benefit plans[1] has confounded the courts since ERISA was enacted in 1974. In recent years, a battle front has emerged over the power of local governments to ensure universal health care for workers. The U.S. District […]
This country is suffering from a retirement crisis, unlike any other in its history. According to the Economic Policy Institute, nearly half of all American families have no retirement savings. For those that do, the savings are minimal. In 2016, the median retirement account balance for working-aged families was $7,800, while the median account balance […]
The civil rights movement made the abolition of all forms of discrimination a matter of public policy. Notwithstanding the tremendous strides that have been made to redress discrimination of all types, one group that continues to be subjected to long-standing stigmatization and social isolation are those who suffer from mental illness. The high watermark of […]
Mark D. DeBofsky is a name partner of DeBofsky Sherman Casciari Reynolds P.C. — on the web at debofsky.com. He handles civil and appellate litigation involving employee benefits, disability insurance and other insurance claims and coverage issues. He can be reached at [email protected] What is “objective” evidence? A recent ruling from the 6th U.S. Circuit […]
Is exhaustion of administrative remedies in challenging Employee Retirement Income Security Act-governed benefit denials required as a precondition to filing a lawsuit? A concurring opinion in Wallace v. Oakwood Healthcare Inc.[1] by U.S. Circuit Judge Amul Thapar of the Sixth Circuit raises provocative questions about the administrative exhaustion doctrine in ERISA cases and suggests that other […]
The COVID-19 crisis has disrupted our lives, our livelihoods and the national economy. The response to the pandemic has in many respects brought out the best in all of us, but it has also led to widespread confusion about personal insurance benefits. Some issues have been resolved, while other issues are certain to arise, as […]