Disability Benefits Are Difficult to Navigate for Someone with SD, but not Impossible
Although it may be difficult, individuals with S&D can still obtain disability benefits with the right legal guidance.
Author: Mark Debofsky
1st Circuit ERISA Benefit Ruling Misapplies Review Standard
How should federal courts conduct a de novo review of Employee Retirement Income Security Act benefit claims? One approach was delineated by the U.S. Court of Appeals for the Seventh Circuit in 2009 in Krolnik v. Prudential Insurance Company of America.[1] There, the court pronounced the phrase “de novo review” as “misleading” and explained the de novo review standard […]
8th Circuit Denies Undocumented Worker’s Employer Health Benefits
Are undocumented employees entitled to the same employer-sponsored benefits as their co-workers? According to a recent ruling from the 8th U.S. Circuit Court of Appeals, apparently not. In Avera McKennan v. Meadowvale Dairy Employee Benefit Plan, 2020 WL 5085954 (8th Cir., Aug. 28), the appeals court ruled that a hospital (Avera) was unable to recoup significant […]
ERISA ruling shows daunting review standard for claimants
The most critical issue in Employee Retirement Income Security Act benefits litigation is the standard of judicial review applied by the courts. Under the deferential arbitrary and capricious standard of review, the court reviews a claim record compiled by the insurance company[1] to determine whether a claim denial was “downright unreasonable”[2] and not merely wrong. Because […]
Health Benefit Ruling Raises Reviewer Neutrality Questions
The Patient Protection and Affordable Care Act[1] made a number of significant changes to health insurance coverage in the U.S. One of the most important provisions of the law, which is also known as Obamacare, was a requirement that patients whose benefits are denied are entitled to independent external review. The implementing regulation[2] requires that […]