Court misses the mark on disability
A decision by the U.S. District Court for the Southern District of New York reveals a court’s flawed analysis of disability.
Articles
Updates on the latest in benefits news and practical pointers for your benefits-related issues.
Ruling gives benefits, but not lawyer fees
Hopkins v. Prudential Insur.Co. of America, 2006 WL 1343432 (N.D. Ill., May 12). Plaintiff, an employee of Bank One Corporation, challenged his disability insurer’s invocation of a preexisting condition exclusion to deny him long-term disability benefits. Hopkins was first employed by Bank One in 1999, and elected long-term disability insurance coverage when he commenced employment. […]
Court Tries to End Discretion Debate
In 1989, the Supreme Court issued Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989), which permitted the inclusion of language in employee benefit plans (including insurance policies) that would trigger a deferential standard of court review in ERISA cases.
Remand didn’t help where Plan was at fault
The plaintiff, a loan originator, originally became disabled in 1993 due to an ankle injury. Although her ankle improved, she was also involved in a serious car accident, and her benefits were continued until 1996 when Hartford cut off the benefit payments even though she continued to suffer from pain, fatigue, problems with memory and […]
Decision Begins to Explain Problems With ERISA Litigation
Dennis Paese, a long-time employee and director of labor relations for Sequa Corporation, was severely injured in a car accident. Paese v. Hartford Life and Accident Insur. Co., 2006 U.S.App.LEXIS 13007 (2d U.S. Circuit Court of Appeals May 24,2006).
Attorney’s fees not enough to deter bad denials
The plaintiff commenced this action seeking injunctive relief under the ERISA statute after Prudential terminated her benefit claim for the third time. Perkins v. Prudential Insur. Co. of America, 417 F.Supp.2d 1149 (C.D.Cal. March 1, 2006). Perkins initially became disabled in 1997; after Prudential denied her claim, litigation resulted in an award of benefits. Another […]
Benefit payment decisions should not be left up to the Insurers
It is fascinating how far Judge Richard A. Posner has come. Posner wrote the opinion in Rud v. Liberty Life Assur.Co.,438 F.3d 772 (7th Cir. 2006). However, in Van Boxel v. The Journal Co. Employees’ Pension Trust, 836 F.2d 1048, 1052 (7th Cir. 1987), he wrote:
Conflicted Over Conflicts of Interest
Editor’s note: This is the first of two parts. The second will run on Tuesday. Rud v. Liberty Life Assur.Co.,438 F.3d 772 (7th Cir. 2006). After injuring his back in a fall, the plaintiff filed a disability claim under his employer-sponsored group disability insurance plan. Although benefits were paid under an initial 24 month ”own […]
Case shows it’s not ‘all or none’ for disability
Giddens v. Equitable Life Assur. Society of the U.S., 2006 U.S.App.LEXIS 8970 (11th Cir. April 12, 2006). The plaintiff, a dentist, purchased two ”own occupation” disability policies from Equitable. Both policies contained provisions for total disability as well as residual (partial) disability. The issue before the court was whether Allen Giddens was totally or partially […]
Court tackles ‘church plan,’ ‘self-reporting’ case
A decision by the U.S. District Court for the Western District of Wisconsin tackled a thorny issue in ERISA law concerning church plan self-reporting.
Court too Quick to Allow in Report
Parkman v. Prudential Insur. Co. of America, 2006 U.S.App.LEXIS 5131 (8th Cir., March 1). The plaintiff, who worked at a ”medium” duty job for Armstrong World Industries, sought disability benefits after experiencing thumb and elbow problems, along with acute lumbar spasms.
Courts differ over weighing pain credibility
Johnson, an accounting clerk for Wells Fargo, applied for disability benefits due to rheumatoid arthritis, which caused her significant pain, stiffness and diminished manual dexterity. She originally received intermittent short-term disability leave from 2000 through 2002 before applying for long-term disability due to the rheumatoid arthritis, along with fibromyalgia, which was also diagnosed. MetLife had […]