In this 2017 case, where an ERISA claims administrator terminated a recipient’s long-term disability benefits, substantial evidence supported the decision, including that treatment notes reflected continued improvement in her anxiety and depression, and nothing in the record demonstrated that the medications themselves prevented her from working. The administrator was not required to personally examine her because the plan did not require a personal examination, even if the disability was mental illness. The administrator was not judicially estopped from arguing the recipient was not disabled because that position was inconsistent with the position it took when it required her to apply for SSA benefits, paid for her SSA representation, and benefitted from her receiving those benefits, because the ERISA standard for disability benefits was different than that for SSA benefits.
Judgment 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
The Supreme Court Decision in Metropolitan Life v. Glenn
The case below examines the conflict of interest a plan administrator may have in the denial or payment of benefits under a long-term disability plan. If...
Oakley v. Remy International, Inc.
In this 2010 Middle District of Tennessee Case, the only connection between Tennessee and the putative class action filed under the Labor Management...
Oakley v. Remy International, Inc.
Exhaustion of Remedies
Below is an example of a provision in a long-term disability policy that can act as a "roadblock" to making a successful claim through the courts. In this...