An aspect of Employee Retirement Income Security Act benefits litigation that distinguishes it from other civil litigation is that discovery in ERISA cases is only stingily granted. Although, as will be shown below, that appears to be changing. There is no statutory basis for limiting discovery in ERISA cases, nor do the Federal Rules of […]
Employee Retirement Income Security Act civil procedure often departs in significant respects from the normal civil procedure utilized uniformly by federal courts in all civil actions in accordance with the Federal Rules of Civil Procedure. One aspect of ERISA civil procedure that is especially questionable despite its near-uniform acceptance by the federal judiciary is the […]
In Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989), the U.S. Supreme Court ruled that benefit claims under the ERISA law should be evaluated under principles of trust law, which allows discretionary authority to be vested in trustees to determine eligibility to receive benefits and to interpret the plan documents. At the […]
Navigating the disability benefit claim process can be overwhelming, and the challenges don’t necessarily end once your initial disability claim is approved. Understanding when and why an insurer can terminate your disability benefits can be confusing. Learning […]
Disability benefit cases governed by the Employee Retirement Income Security Act are not only about whether someone qualifies for benefits, but often involve benefit terminations. While many courts have confronted that situation, the guidelines for assessing ongoing disability benefit claims have varied, especially under a deferential standard of judicial review.
On Jan. 29, a judge in the U.S. District Court for the District of Rhode Island recently wrote an opinion in a sort of “man bites dog” Employee Retirement Income Security Act case, Verizon Sickness & Accident Disability Benefit Plan v. Rogers.[1] Rather than the typical scenario of a participant in an employee benefit plan […]
After winning summary judgment in the trial court, plaintiff Linda Ellis suffered a crushing defeat in the 5th U.S. Circuit Court of Appeals, which rejected her claim for disability coverage.Ellis v. Liberty Life Assurance Company of Boston, 2004 U.S.App.LEXIS 24199 (5th Cir., Nov. 19). Ellis was a loan officer for Chase Manhattan Bank until 1999, […]
In order to prevent a double-recovery of benefits when claimants qualify to receive both Social Security and disability insurance payments, most group insurers include provisions in their policies that reduce the insurance payment by the amount of Social Security benefits received by the claimant. In addition, since Social Security adjudications often follow the disability insurance […]
DeBofsky & Associates recently won a significant court ruling on the ERISA standard of review.
The Patient Protection and Affordable Care Act[1] made a number of significant changes to health insurance coverage in the U.S. One of the most important provisions of the law, which is also known as Obamacare, was a requirement that patients whose benefits are denied are entitled to independent external review. The implementing regulation[2] requires that […]
The COVID-19 pandemic has wrought a previously unfathomable level of casualties and economic disruption in the United States and worldwide in just a few short weeks. Since mid-March, 16.9 million Americans have filed jobless claims, and one out of every 10 U.S. workers who had employment prior to the pandemic is now jobless. Many people with […]
The availability of health insurance coverage for treatment of mental health conditions recently took a huge step forward with the entry of judgment by the U.S. District Court for the Northern District of California in Wit v. United Behavioral Health.[1] After the issuance of a ruling in 2019 finding United Behavioral Health, or UBH — a UnitedHealth Group […]