In this 2017 ERISA case, an ERISA claims administrator terminated a recipient’s long term disability benefits. The Court determined that substantial evidence supported the decision, including that treatment notes reflected continued improvement in the recipient’s anxiety and depression, and nothing in the record demonstrated that the medications she was using prevented her from working. The administrator was not required to personally examine the recipient because the plan did not require a personal examination, even if the disability was a mental illness. The administrator was not judicially estopped from arguing that the recipient was not disabled because that position was inconsistent with the position it took when it required her to apply for Social Security benefits, because the ERISA standard for disability benefits was different than that for SSA benefits. Therefore, the lower court’s judgment is affirmed.
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.
Latest Posts
Snapper v. Unum Life Ins. Co. of Am.
In this 2023 ERISA case, the Plaintiff, an attorney, began working for a law firm which had a long term disability policy through the Defendant insurance...
Snapper v. Unum Life Ins. Co. of Am.
Macnaughton v. Paul Revere Ins. Co.
In this 2023 ERISA case, the Plaintiff, a doctor, commenced this action against the Defendant insurer to recover unpaid benefits after an adverse benefits...
Macnaughton v. Paul Revere Ins. Co.
Pearson v. Group Long Term Disability Plan for Employees of Tyco Int’l (US), Inc.
In this 2008 ERISA case, the Plaintiff former employee filed suit against defendant long-term disability plan pursuant to ERISA to recover long-term...