Despite significant medical advances in recent years, many debilitating impairments remain impossible to diagnose through imaging such as x-ray or MRI, electrodiagostic testing, or blood tests. Consequently, due to potential uncertainty as to the legitimacy of such conditions, disability insurers have adopted policy provisions that purport to limit payments for conditions such as fibromyalgia, chronic […]
After suffering a back injury as the result of a car accident in 2000, Sonya Pettaway, an employee of the National Academy of Sciences, filed for and received disability benefits from Teachers Insurance and Annuity Association (TIAA). However, 24 months later, the policy definition of disability changed. Instead of disability being defined as the inability […]
Because the ERISA statute lacks a statute of limitations, courts have had difficulty in determining both the applicable limitations period and affixing a date upon which the limitation period accrues. Wise v. Verizon Communications, Inc., 2010 U.S.App.LEXIS 7244 (9th Cir. April 8, 2010) promotes certainty on these issues. In Wise, the plaintiff, Nancy Wise, was […]
Conflict of interest in the administration of benefit claims is a topic that has long concerned Judge William Acker Jr. of the Northern District of Alabama. Blankenship v. Metropolitan Life Insurance Co., Civ. No. 08-AR-0639-S (N.D. Ala., Dec. 30) is merely the latest in a series of rulings critical of the manner in which courts […]
The arbitrary and capricious standard of review gives employers such broad discretion to interpret benefit plan provisions that a literal reading of the plan can be overridden according to Wallace v. Johnson & Johnson, 2009 U.S.App.LEXIS 22529 (1st U.S. Circuit Court of Appeals, Oct. 14). Wallace, who spent 14 years as a manager with Johnson […]
Functional capacity evaluations are frequently used in disability insurance evaluations. While some courts have deemed such testing reliable, Alfano v. Cigna Life Ins.Co. of N.Y., 2009 U.S.Dist.LEXIS 7688 (S.D.N.Y. Jan. 30), offers an object lesson as to why courts need to be careful in assessing such tests. The plaintiff in Alfano worked in an administrative […]