Cheney v. Std. Ins. Co., ERISA and Long Term Disability

This ERISA case, decided in 2018, is a case dealing with the limits on the ability of the court to “do what is right” rather than what the long term disability policy requires.

The Plaintiff/Insured was an attorney who had been with her firm for about 20 years and eventually became a partner. She began to suffer from a spinal disease that eventually lead to her having a three-level anterior cervical discectomy and fusion and removal of her C5 vertebra. She eventually was unable to work and submitted a long term disability claim, which was denied based on the fact that her coverage ended in December of the year before she stopped working. She brought an action before the district court. The district ruled in her favor and the Defendant appealed. The Court found that the district court, in reaching its decision, ignored certain policy provisions and made conclusions of fact without supporting evidence. A new trial was necessary because the district court failed to find when the Plaintiff had become disabled, to use as a basis of comparison all work that some licensed to practice law in Illinois may have performed, and to analyze the medical evidence in the proper light. The district court’s calculation of predisability earnings based on the last full year that the Plaintiff worked was not tenable because the Plaintiff made the consistent claim of December 20, 2011 as the date of the date of the beginning of her disability and then worked beyond that date. The Court found that the district court erred in interpreting the long term disability policy and made factual findings unsupported by the record evidence. Therefore, the district court’s judgment was vacated and the case was remanded for a new trial.

In previous blogs, we have examined the duties and responsibilities of both the Plaintiff and the Defendant in ERISA long term disability cases. Here, we have an example of the duty of the court in these cases. The district court overreached in what it did in its decision here, and it was quickly and decisively put back in line by the appellate court in a decision that was probably somewhat embarrassing for the lower court. Even the Courts are bound by the terms of the long term disability plans in these cases.

If you need assistance navigating your claim for short term or long term disability benefits under ERISA, or it is time to sue the insurance company, please do not hesitate to give Cody Allison & Associates, PLLC a call (844) LTD-CODY, (615) 234-6000. or send us an e-mail Cody@codyallison.com.  We provide representation nationwide and have successfully sued all the major insurance companies in many states. Our headquarters are located in Nashville, Tennessee.  We offer a free consultation and would love to speak with you.