Does the absence of a definitive diagnosis preclude an award of disability benefits? Courts have resoundingly answered that question in the negative, finding that a diagnosis is less important than findings relating to impairment.
What is full-time work? The issue is important because eligibility to receive critical benefits such as health and life insurance is dependent on the employee meeting certain active at work requirements in the applicable benefit plan. A recent ruling from a federal court in California focused on this issue and took […]
The availability of health insurance coverage for treatment of mental health conditions recently took a huge step forward with the entry of judgment by the U.S. District Court for the Northern District of California in Wit v. United Behavioral Health.[1] After the issuance of a ruling in 2019 finding United Behavioral Health, or UBH — a UnitedHealth Group […]
Employee Retirement Income Security Act civil procedure often departs in significant respects from the normal civil procedure utilized uniformly by federal courts in all civil actions in accordance with the Federal Rules of Civil Procedure. One aspect of ERISA civil procedure that is especially questionable despite its near-uniform acceptance by the federal judiciary is the […]
There has been a growing volume of litigation relating to disability benefit claims brought by former professional football players.
A recent example is the ruling issued by a federal court in California in Dimry v. Bert Bell/Pete Rozelle NFL Player Retirement Plan, 2020 WL 5526607 (N.D. Cal., Sept. 15). This ruling was the second time the court had to address Charles Dimry’s disability claim. The court had previously overturned a benefit denial (2018 WL 1258147 (N.D. Cal., March 12, 2018) and ordered the plan to reconsider its initial benefit denial; however, the plan reaffirmed its refusal to award benefits. In this decision, once again, the court found the denial was arbitrary and capricious.