In this 2014 ERISA case, where a claimant was diagnosed with insulin-dependent diabetes mellitus, a claims-review fiduciary did not abuse its discretion under ERISA by denying his claim for long-term disability benefits. It was reasonable for the fiduciary to interpret the plan to require that the claimant show that the injury or sickness itself, independent of the loss of license, rendered him unable to perform his occupation. Substantial evidence supported the fiduciary’s determination that the claimant was not totally disabled because although his physician opined that the claimant would be unable to work as an over-the-road truck driver based on the Department of Transportation’s regulations, he identified no physical limitations on the claimant’s ability to do so as a direct result of his diabetes.
Judgment reversed, fee award vacated.
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.