Disability Benefits

Courts Examine 24 Month Mental Illness Limitation in Disability Claims

by Mark Debofsky | Nov 28, 2012 | Disability Benefits, Mental vs. Physical Disabilities

As the recent case of White v. Prudential Ins.Co., 2012 U.S.Dist.LEXIS 160773 (E.D.Pa. Nov. 9, 2012) illustrates, whether a disabling condition is psychiatric or physical is not easily determined. The plaintiff in this case, James White, worked as the chief operating officer, chief financial officer and director of risk management at Holt Oversight & Logistical Technologies. In 2007, White was seriously injured in a rollover car accident that occurred when his vehicle was struck by another car.

Court says surveillance an abuse of discretion in disability benefits case

by Mark Debofsky | Oct 3, 2012 | Disability Benefits

A federal court has ruled that an insurance company’s use of surveillance in denying a claim for disability benefits was an abuse of discretion. In Spooner v. Reliance Standard Life Insurance Co., 2021 WL 2720302 (E.D.N.Y. July 1, 2021), the plaintiff was a former account executive with a media company who stopped working due to chronic pain from fibromyalgia, a sleep disorder and a psychiatric condition.

2012 ERISA Advisory Council hearing on managing disability risks in an environment of individual responsibility

by Mark Debofsky | Aug 12, 2012 | Disability Benefits, ERISA

Executive Summary: I am an experienced practitioner in the field of representing claimants in disability benefit disputes. In my practice, I have encountered a number of problems with ERISA claims and litigation that need to be examined by the Department of Labor: ERISA claimants are denied the last word in claim appeals, which permits insurers […]

Ruling looks at professionals paying for two types of disability coverage

by Mark Debofsky | Jun 6, 2012 | Disability Benefits

A recent ruling from the 3rd U.S. Circuit Court of Appeals is a wake-up call to professionals who are paying both for disability insurance coverage at their place of work and also maintaining supplemental disability coverage purchased through a professional association. Fleisher v. Standard Ins.Co., 2012 U.S.App.LEXIS 9907 (3d Cir. May 17, 2012) ruled that […]

Several circuits remain divided over remand orders in ERISA cases

by Mark Debofsky | Mar 14, 2012 | Disability Benefits, ERISA

There is currently a circuit split as to whether district court rulings remanding Employee Retirement Income Security Act (ERISA) employee benefit claims to plan administrators are appealable. In Young v. Prudential Ins.Co. of America, 2012 U.S.App.LEXIS 3387 (11th Cir. Feb. 21, 2012), the 11th U.S. Circuit Court of Appeals held that a remand order is […]

Approach Clarifies Benefit Claim Determinations

by Mark Debofsky | Dec 21, 2011 | Disability Benefits

A recent opinion issued by the 1st U.S. Circuit Court of Appeals suggests a new approach for assessing the reasonableness of benefit claim determinations under the Employee Retirement Income Security Act (ERISA) abuse of discretion standard of review.