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 […]
A recent ruling from the U.S. Court of Appeals for the Sixth Circuit, Zuke v. American Airlines, Inc., 2016 WL 1258220 (6th Cir. March 31, 2016)(unpublished), was extremely critical of an insurer’s termination of disability payments that had been ongoing for thirteen years due to the claimant’s severe degenerative arthritis of the claimant’s entire spine.
Most disability benefit claim decisions focus on medical issues and often overlook the equally critical need to perform an accurate vocational evaluation. The recent case of Mackey v. Liberty Life Assurance Company of Boston, 2016 WL 915271 (W.D. Ark., March 7), is a singular exception. This case involved Brenda Mackey, a former registered nurse who […]
A recent case involving the FedEx disability program, Mason v. Federal Express Corp., 2016 WL 706163 (D. Alaska February 22, 2016), illustrated how exposure of conflicts of interest in a claim determination affects a court’s review of the evidence. The case involved Maurice Mason, a FedEx employee who suffered from an auto-immune disorder known as […]
A recent ruling from a federal court in Kentucky raised serious concerns about the validity of vocational assessments performed by disability insurance companies.
In Bishop v. Aetna Life Insurance Co., 2016 WL 591765 (E.D. Ky., Feb. 12, 2016), the court overturned a denial of disability benefits after finding that Aetna improperly disregarded a Social Security determination and that its vocational assessment was markedly flawed and biased.
Two lessons taught by a recently decided case from Indiana are that insurers need to fairly and independently assess disability claims and must consider the co-morbidity of multiple physical and psychological impairments.