On February 11, 2013, a district court in Missouri allowed a Plaintiff to supplement the record on summary judgment with a favorable decision from an Administrative Law Judge finding the plaintiff disabled. The court found significant the fact that AT&T self-insured plan required the Plaintiff to file for disability benefits, helped with the application, and when the plaintiff received the favorable award attempted to recover over $40,000 as an offset to benefits it had already paid. Even though the ERISA Plan wanted to use the award as a basis to recover monies paid to the plaintiff, it did not want to consider the favorable findings of disability. This practice is not employed by self-insured ERISA plans but also employed by Unum, The Hartford, The Standard, LINA, and other disability carriers when they deny claims.
For more information view our denied claims page: https://www.burkeharvey.com/our-ltd-practice/denial-of-ltd-claim/