Disability Benefits

The Standard Reversed for Ignoring Medical Evidence and Improper Denial

Marcin v. Reliance Standard Life Ins. Co., No. 16-7125, 2017 WL 2818648 (June 30, 2017). Affirming the judgement of the district court, the United States Court of Appeals for the District of Columbia held that Reliance Standard Life Insurance Company acted unreasonably when it failed to properly consider the downward progression of one of its…

Read More

Sixth Circuit Allows Lawsuit to Continue Despite ERISA Requirment

On October 2, 2015, in Waskiewicz v. UniCare Life & Health Ins. Co., the Sixth Circuit reversed a district court’s granting of summary judgment in favor of Ford’s ERISA Plan because the insured, who suffered from major depression and gender identity disorder, failed to provide notice of her disability to the Plan after she suffered…

Read More

Sixth Circuit Continues to Give Meaning to “Equitable Relief”

On June 18, 2015, the Sixth Circuit in Pearce v. Chrysler Group LLC Pension Plan, 2015 WL 3797385, found that a retirement plan participant could state an equitable claim under ERISA for supplemental pension benefits until he became eligible for Social Security benefits, notwithstanding the fact he was terminated prior to receiving the benefits and the…

Read More

Eleventh Circuit Vacates Prior Decision on ERISA Fiduciary

The Eleventh Circuit revisited its holding in Pruitt v. SunTrust Banks, Inc., No. 14-13207 (11th Cir. June 30, 2015), a putative ERISA class action brought against ERISA fiduciaries by plan participants, concerning certain investments in the plan.  The district court had dismissed the case based on ERISA’s borrowed six-year statute of limitations.  In related proceedings,…

Read More

Seventh Circuit Reaffirms Requirement to Exhaust Administrative Remedies

In Orr v. Assurant Employee Benefits (7th Cir. May 19, 2015) the district court dismissed a lawsuit for life insurance benefits because the plaintiffs did not first exhaust their administrative remedies.  On appeal, the Seventh Circuit affirmed noting that the denial letter plaintiffs received informed them of their right to seek review and included a copy of USIC’s Life…

Read More

LINA Must Consider Evidence Developed in a Claimant’s Social Security File

Having Required a Claimant to go through the SSI process, the Eleventh Circuit Finds that LINA Must consider evidence Developed in a claimant’s Social Security File. Melech v. LINA, decided January 6, 2014, is an important decision for claimants under ERISA policies because the Court acknowledged that a claims administrator – in this case LINA…

Read More

Good News for ERISA Claimants that Suffer from Fibromyalgia, Chronic Fatigue Syndrome, or an Autoimmune Disease?

Is the Recent Opinion of Williams v. United of Omaha, 2013 U.S. Dist. LEXIS 141563 (N.D.Ala.)  (September 30, 2013) a Breath of Fresh Air for ERISA Claimants that Suffer from Fibromyalgia, Chronic Fatigue Syndrome, or an Autoimmune Disease?  ERISA claimants suffering from fibromyalgia, chronic fatigue syndrome, or autoimmune diseases that are difficult to diagnosis, often…

Read More

Not all ERISA Plan Administrator’s Determinations are Equal

The recent decision of the Fifth Circuit in Porter v. Lowe’s Co., decided September 24, 2013, once again demonstrates that benefit determinations can be difficult to overturn under the ERISA regime because of built in deference to those determinations.  In this case, the District Court reversed the Plan Administrator’s denial of benefits concluding that the…

Read More