Author: Mark Debofsky

Disability benefits turn on symptoms over diagnosis

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. Symptoms of fatigue, pain, and compromised cognition can be characteristic of many illnesses that can be difficult to diagnose or treat. […]

UnitedHealth ERISA ruling exposes faults in health coverage

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 […]

ERISA ruling shows reluctance for disability claim remand

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 […]

Ex-NFL players’ disability case remanded yet again

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 […]