Disability Plans

New Jersey Governor Proposes More Changes to State Workers'Pensions and Benefits
Excerpt:"Christie offered a broad outline but few specifics on his upcoming proposals, except for indicating -- in response to one of about a dozen audience questions -- that one bill would bar retired public workers from receiving a disability pension while working at another job seemingly requiring the same level of exertion."(CourierPostOnline.com/Courier-Post.)

New York Enacts Bill of Rights for Domestic Workers
Excerpt:"[The new law] amends New York Labor Law to entitle domestic workers to receive overtime pay, one day of rest per week or overtime pay when they work on their day of rest, and three days of paid time off after one year of employment."(Littler Mendelson P.C.)

[Guidance Overview] Hodgson Russ LLP - Employee Benefits Developments August 2010
Nice summaries of important recent ERISA cases. (Hodgson Russ)

[Guidance Overview] ERISA Long Term Disability Appeal Won Against Hartford
Excerpt:"The Hartford determined that she was disabled as of February of 2008 and began paying her benefits in July of 2008. In November of 2009, Hartford terminated her benefits claiming she was no longer disabled."(Attorneys Dell&Schaefer)

[Guidance Overview] Court Finds Worker Fired for Misconduct Can Get Disability Payments
Excerpt:"Ohio's 10th Appellate District Appeals Court determined that all evidence indicates the Lafonda Carson's infractions occurred prior to his injury and that the hospital he worked for presented no evidence that he violated work rules during the time he returned to work under light duty restrictions following his injury."(PLANSPONSOR.com)

[Guidance Overview] Court Rules That Physician's Extra Pay Is Overtime, and Is Therefore Excluded in Determining Amount of His Disability Benefit
Excerpt:"The Court analyzed the case by reviewing ReliaStar's conclusion that the $80,000 pay was overtime. In reviewing this conclusion, the Court applied a deferential standard, giving only some weight to ReliaStar's conflict of interest (as both plan administrator and benefit payor) since the plaintiff was unable to say how the conflict adversely affected ReliaStar's conclusion."(Stanley D. Baum of Fellheimer&Eichen LLP)

[Guidance Overview] Insurance Company Denies Long Term Disability Benefits to Woman with Fibromyalgia and CFS
Excerpt:"Based on the conclusions presented by the two doctors . . . hired to review [the medical files], Fort Dearborn denied [the] claim on November 15, 2004. A DRMS [a third party administrator] employee emailed [the] claim handler the same day the letter went out the following message,'I loved your 9 page denial letter.'"(Attorneys Dell&Schaefer)

[Guidance Overview] Supreme Court: Awarding Attorney's Fees in ERISA Cases, and, the Deferential Standard of Review (PDF)
Pages 5-7 of 8 pages. Excerpt:"In its second significant ERISA decision in as many months, the U.S. Supreme Court ruled in May that a court may award an ERISA litigant attorney's fees even if it does not actually'prevail'in its case."(Trucker Huss APC)

Multiemployer Plan Trustees Conflicted When Deciding Claims, Appeals Court Rules
Excerpt:"Giving weight to this conflict -- applying the Supreme Court's analysis in Glenn -- the appeals court found the trustees abused their discretion in denying disability benefits. The court rejected a 2009 Ninth Circuit finding that Taft-Hartley trustees have no conflict because both employers and unions are at the table . . . ."(Mercer LLC)

[Guidance Overview] Ninth Circuit Issues Ruling in Standard Insurance Co. v. Morrison on Discretionary Clause Issue
Excerpt:"The Ninth Circuit held that Morrison's practice of disapproving discriminatory clauses is specifically directed toward entities engaged in insurance and substantially affects the risk pooling arrangement between insured and insurer, more so than other laws that have been upheld by the U.S. Supreme Court; thus, the practice is saved from ERISA preemption."(Passion for Subro!)

[Guidance Overview] Fourth Circuit Determines That Insurer Abused Its Discretion In Terminating Employee's Long-Term Disability Benefits
Excerpt:"Based on its review of the administrative record, the Court said that MetLife's decision to terminate the benefits was not reasoned and principled, and was not supported by substantial evidence."(Stanley D. Baum of Fellheimer&Eichen LLP)

U.S. Supreme Court to Consider Remedy for Deficient SPD
Excerpt:"To recover benefits based on an inconsistency between an ERISA plan document and summary plan description (SPD), must participants show reliance on the SPD? Is it sufficient to show'likely harm'? Or can participants prevail without any showing of harm? The US Supreme Court will tackle these questions . . . ."(Mercer)

[Opinion] Text of Brief of Secretary of Labor As Amicus Curiae in Support of Barboza v. California Association of Firefighters
Excerpt:"Focusing exclusively on Barboza's claim for benefits, the district court dismissed his suit in its entirety for failure to exhaust. Count 2, however, is a fiduciary breach claim that seeks injunctive and other equitable relief under ERISA section 502(a)(3) to remedy the failure of the Plan fiduciaries to operate the Plan in compliance with ERISA's full and fair review requirement, as elaborated in the Secretary's claims regulation.'(U.S. Department of Labor)

[Guidance Overview] Conkright in the Courts ? A Summary Review
Excerpt:"Following Metropolitan Life Insurance Co. v. Glenn, . . . the U.S. Supreme Court's opinion in Conkright v. Frommert, . . . added another layer of protection for plan fiduciaries. Glenn held that a conflict of interest is but one factor to be considered by a reviewing court. Conkright held that a'single honest mistake'did not forfeit deference. Here's a quick look at how Conkwright has been applied in the short time since its decision."(Roy Harmon via Health Plan Law)

[Guidance Overview] Supreme Court Resolves ERISA Fee Dispute, Answering Some Questions and Raising Others
Excerpt:"Hardt will clearly change the law in those circuits that had imposed a prevailing-party requirement on parties seeking a fee award in ERISA cases. The decision may also influence other significant issues impacting attorney's fee awards, but as to these issues the Court's guidance is much less clear."(Proskauer Rose LLP)

The'Captivation'of Employee Benefits: How Captives Can Reduce Costs and Enterprise Risk (PDF)
26 pages. Excerpt:"The use of captives has steadily increased over the past several years -- and the list of potential applications keeps growing. During the past decade, many employers have reinsured their employee benefit plans (e.g., group term life and long-term disability) through captives. Although U.S. benefit reinsurance transactions have attractedthe most attention, there have been a number of transactions involving global benefits. Many companies are insuring all or a portion of their medical stop-loss coverage through captives."(Aon Consulting)

[Guidance Overview] Supreme Court Resolves Conflict on Awarding Attorney Fees in ERISA Cases in Hardt v. Reliance Standard Life
Excerpt:"Resolving a long-standing conflict in the Federal Circuits, the U.S. Supreme Court . . . has held that a party need not'prevail'in its Employee Retiree Income Security Act (ERISA) litigation for a court to award the party attorneys'fees; rather, the Court held that a party in an ERISA case is eligible for a fee award if it achieves'some degree of success on the merits'in the litigation."(Littler Mendelson P.C.)

[Guidance Overview] Supreme Court Changes Rules for Attorneys'Fees Awards Under ERISA; Increase in Fee Petitions Expected
Excerpt:"The Supreme Court's decision in Hardt may have inadvertently created more issues than it resolved. Importantly, the Supreme Court did not decide the question of whether a remand order to a plan administrator for further consideration qualifies, without more, as'some success on the merits'that entitles a claimant to fees under ERISA Section 502(g)(1)."(McDermott Will&Emery)

[Guidance Overview] Supreme Court Rules on Standard for Receiving Attorneys'Fees Under ERISA
Excerpt:"The Supreme Court acknowledged the five-factor test that lower courts use in deciding whether to award attorneys'fees but reasoned that the five-factor test was not required for'channeling'a court's discretion because the factors did not bear an obvious relation to ERISA ?502(g)(1) or to the Court's fee-shifting jurisprudence. However, in a footnote, the Court stated that judges are not precluded from using the five-factor test once they determine whether there has been some success on the merits."(Tax Management Inc.)

Body'Wear-and-Tear'Claims Reflect Aging of American Workforce
Excerpt:"Research by The Hartford Financial Services Group, Inc. finds workers'frameworks are showing wear and tear. Nearly one in four employees on a short-term disability claim were unable to work due to a disabling illness impacting their skeleton or muscles, specifically backs, knees and feet, according to an analysis of nearly 750,000 short-term disability claims. A press release said employees who were age 50 and older accounted for 40 percent of back and spine claims."(PLANSPONSOR.com)

[Guidance Overview] Supreme Court Holds that ERISA Does Not Impose'Prevailing Party'Requirement for Award of Attorneys'Fees (PDF)
2 pages. Excerpt:"Eight of the justices joined the opinion, which was issued only four weeks after oral argument. Justice John Paul Stevens agreed that ERISA does not impose a'prevailing party'requirement and that the District Court acted within its discretion in granting attorneys'fees to Hardt, however, Justice Stevens indicated he would not have followed Ruckelshaus (from which he dissented) without further analysis of the text, structure and history of ERISA."(Sutherland Asbill&Brennan LLP)

[Guidance Overview] Supreme Court Holds ERISA-Based Attorneys'Fees Available
Excerpt:"On May 24, 2010 the U. S. Supreme Court held that a party does not need to be a'prevailing party'in order to be eligible for an attorneys'fees award under the Employee Retirement Income Security Act of 1974 (ERISA). In reaching this decision, the Court relied on the statutory language of the applicable statute, which does not include any'prevailing party'requirement, and noted that Congress is able to impose limitations on the availability of attorneys'fees when it deems fit. Hardt v. Reliance Standard Life Insurance Company."(Fisher&Phillips LLP)

U.S.Supreme Court Sets New ERISA Attorneys'Fees Standard
Excerpt:"Justice Clarence Thomas, writing for the high court in Hardt v. Reliance Standard Life Insurance Co., ruled that the person only has to achieve'some degree of success on the merits (of the case)'and not meet the higher standard of being a'prevailing party'to be eligible for the attorneys'fees award at the court's discretion."(PLANSPONSOR.com)

[Opinion] Supreme Court Rejects'One Strike and Out'Rule for Deference to Plan Administrator's Decisions.
Excerpt:"The disposition by the lower courts should have made this an easy decision. Whatever the intricacies of trust law, requiring the plan to ignore the time value of money was without basis. The dissent makes an attempt to defend it, but the case should have been remanded to fashion a more reasonable remedy."(Steptoe&Johnson LLP)

[Guidance Overview] Ninth Circuit Upholds Ban of Discretionary Clauses
Excerpt:"For fully insured plans, this is another indication that state regulations banning discretionary clauses will survive ERISA preemption challenge. Bear in mind that these regulations, in states adopting them (often based upon the NAIC model act) will apply to disability plans as well as health plans. The consequence will be de novo review of claim denials with augmented discovery in many cases."(Roy Harmon via Health Plan Law)

U.S. Supreme Court Denied Certiorari in ERISA Preemption Case
Excerpt:"The 9th Circuit held that the commissioner's practice of disapproving any insurance contract containing a discretionary clause is not preempted by ERISA."(LawMemo)

More Employers Institute Waiting Period of at Least Seven Days Before Short-Term Disability Coverage Is Effective
Excerpt:"The latest BLR Employee Fringe Benefit Survey found that 77 % of respondents report their organization requires a waiting period of at least seven days up from 65% in late 2006. Generally, the BLR poll found, seventy-seven percent said their companies offer short-term disability, and 82% offer long-term disability."(PLANSPONSOR.com)

[Official Guidance] IRS Publishes Interim Report on Colleges and Universities Compliance Project; Useful Compensation Data (PDF)
79 pages. Part VI of the report contains charts showing the distribution of specific types of benefits provided to one or more of the organization's 6 highest-paid officers, directors, trustees or key employees, including life, disability, long-term care contributions; split-dollar life insurance; loans/credit extension (forgiveness of debt/interest); severance or change of control payments; personal use of organization vehicles; and expense reimbursement (non-accountable plan). Also shows participation in specific types of deferred compensation plans, and describes general compensation policies. (Internal Revenue Service)

[Opinion] The Latest Uncertainty in Benefit Claim Litigation ? The Proper Scope of Conflict Discovery After Glenn (PDF)
Pages 7-10 of 17 pages. Excerpt:"Proskauer's Perspective: We would not quibble with the notion that some limited discovery into conflict considerations may be warranted in some circumstances after Glenn. But we are concerned with how far some courts have gone. They seem to have forgotten that individual benefit claims are, in many respects, like administrative review proceedings and that, to treat them like full-blown federal court litigation for discovery purposes undercuts ERISA's goal of resolving such claims inexpensively and expeditiously."(Proskauer Rose LLP)

[Opinion] Supreme Court Rules That'Single Honest Mistake'Does Not Justify Stripping Administrator of Judicial Deference
Excerpt:"The ruling in Frommert hopefully will encourage the creation of ERISA plans by eliminating at least one deterrent: the specter of courts having the final say regarding how a plan should be administered and how benefits thereunder should be paid. We also hope that the decision will achieve the other results intended by the Court: reducing the complexity and costs of ERISA litigation, and protecting the statute's underlying principles of uniformity, predictability, and efficiency."(Proskauer Rose LLP)

Disability Insurance Coverage Harder to Get and Many Companies Have Ceased to Offer It to Employees
Excerpt:"A new survey by the Life Foundation shows 84 percent of Americans strongly agree they should insure their cars, and 80 percent feel it's critical to have homeowner's insurance. Yet only 48 percent believe that it's imperative to have disability insurance if they have a job."(Pittsburgh Post-Gazette)

[Opinion] ERISA Attorney Fees: An Unadulterated Rant on Conkright and Hardt
Excerpt:"[T]he smart money is that the Court will say that Hardt is entitled to ask for fees even though not receiving a Judgment for the benefits because a remand to the plan administrator is a substantive, not procedural, remedy. Then we'll all be able to go on with our daily lives as before."(Pension&Benefits Blog)

[Guidance Overview]'Clear Repudiation Rule'Applied in Determination That Benefits Claim Was Time-Barred
Excerpt:"The district court in Bryer v. Metro. Life Ins. Co. applied the'clear repudiation rule'to find that the plaintiff's claims were time-barred. The disability plan that covered the plaintiff [provides] for an increase in benefits that he did not receive according to the complaint . . . ."(Roy Harmon via Health Plan Law)

[Guidance Overview] No Deference to Plan's Decision When Discretionary Authority Given in SPD But Not in Long-Term Disability Plan Document
Excerpt:"[In] Jobe v. Med. Life Ins. Co. . . . (8th Cir. 2010) . . . [the] court concluded that the insurance policy for the plan (which did not contain a grant of discretionary authority) conflicted with the SPD (which purported to grant discretion, but which also stated that the policy would prevail if the two documents conflicted)."(Employee Benefits Institute of America)

[Guidance Overview] CLASS Program to Offer Benefits Under Health Care Reform Law
Excerpt:"Employers can choose whether to participate in the program, which will provide cash benefits and other services to working adults with functional limitations expected to last at least 90 days."(Mercer)

U.S. Supreme Court Hears Oral Arguments in ERISA Fees Case
Excerpt:"In Hardt v. Reliance Standard Life Insurance Co., the court heard arguments on whether whether ? 502(g)(1) of [ERISA] provides a district court discretion to award reasonable attorney's fees only to a prevailing party, and whether a party is entitled to attorney's fees when she persuades a district court that a violation of ERISA has occurred, successfully secures a judicially-ordered remand requiring a redetermination of entitlement to benefits, and subsequently receives the benefits sought on remand."(Jurist)

Employers Say Benefit Costs Trump Employee Retention
Excerpt:"For the first time since 2006, controlling benefit costs edge out employee retention as the top concern facing employers . . . .'"(Employee Benefit Adviser; free registration required)

[Guidance Overview] Fifth Circuit Upholds Summary Judgment for Plaintiff's Claim for Disability Benefits, Based on Insurer's Failure to Consider Social Security Administration's Determination That Plaintiff Is Disabled
Excerpt:"In Schexnayder v. Hartford Life and Accident Insurance Company, No. 08-30538 (5th Cir. 2010), the plaintiff, Kelvin Schexnayder, sued Hartford Life and Accident Insurance Company . . . under ERISA for long terms disability benefits. The district court granted summary judgment to the plaintiff, holding that Hartford abused its discretion in denying the benefits."(Stanley D. Baum of Fellheimer&Eichen LLP)

[Guidance Overview] IRS HEART Changes for Employers (PDF)
Excerpt:"The Heroes Earnings Assistance and Relief Tax Act of 2008 (HEART) provided tax breaks and incentives for military personnel and affected how employers treat the wages and benefits of employees on military leave. In Notice 2010-15, the IRS addresses various HEART provisions, including those affecting differential wage payments, survivor and disability retirement benefits and certain plan distributions."(Buck Consultants)

[Guidance Overview] No Disability Extension for Employee Who Failed to Give Timely Notice of SSA Determination
Excerpt:"EBIA Comment: This case highlights that courts may strictly enforce the notice obligations imposed on qualified beneficiaries in order to receive the 11-month disability extension under COBRA. But keep in mind that plan administrators may be limited in their ability to enforce such provisions unless qualified beneficiaries have been informed, through the plan's SPD or COBRA initial notice, about the plan's notice deadlines and procedures."(Employee Benefits Institute of America)

[Opinion] Two Different Understandings of What Discretionary Review Means
Excerpt:"I have written before on this blog, on numerous occasions, about courts sometimes engaging in a more searching level of discretionary review that, in essence, is not discretionary review at all, at least in the manner it has long been traditionally understood. The common belief, and applied in that way by many and probably mostcourts over the years, is that discretionary - sometimes called arbitrary and capricious - review means that an administrator's decision in a long term disability case . . . ."(Stephen Rosenberg of The McCormack Firm, LLC)

Reish&Reicher ERISA Controversy Report, March 2010 (PDF)
Articles include'Issues In Terminating Defined Benefit Plans','IRS Audits and Bonding for 401(k) Plans', and'The Litigation Benefits of a Self-FundedDisability Plan."(Reish&Reicher)

Promoting Financial Protection in the Event of an Employee's Disability
Excerpt:"Principal Financial Group Inc. in Des Moines, Iowa noted that more than half of new sales last year included a combination of employer-paid and voluntary benefits, with fewer than 100 of the 60,000 company requests for benefit changes involving people switching from employer-paid benefits entirely to voluntary benefit programs."(Employee Benefit Adviser; free registration required)

Workers with Depression, Although Treated, Have More Disability Absences, According to Study
Excerpt:"Depressed workers who are already receiving treatment are twice as likely as their'healthy'counterparts to use short-term disability and disability leave, according to an article published in the February issue of the Journal of Occupational and Environmental Medicine."(Wolters Kluwer)

[Guidance Overview] Sixth Circuit Rules That Equitable Lien Does Not Attach to Social Security Benefits
Excerpt:"[U]nder 42 U.S.C. ? 407(a) (generally prohibiting alienation or attachment of future Social Security payments), courts are not permitted to place a lien directly on Social Security benefits themselves. The equitable lien in this case must therefore be limited to a specifically identifiable fund (the overpayments themselves) within Hall's general assets. The Plan cannot have a claim to Hall's Social Security benefits prior to the point at which they are in her possession. Thus, the Court concluded that the lien in question, imposed directly on Hall's Social Security benefits, is not permitted."(Passion for Subro!)

[Guidance Overview] 6th Circuit Says ERISA Lien Can't Be Put on Future Social Security Disability Benefits
Excerpt:"In Hall v Liberty Life Assurance Co of Boston, the 6th Cir. held that the an ERISA plan couldn't put an equitable lien on future Social Security benefits to recover overpayment of benefits paid from a long-term disability policy."(Michigan Lawyers Weekly)

The Odds of a Disability Are Themselves Odd
Excerpt:"Welcome to the disability insurance funhouse, where the odds of an injury or illness that would keep you out of work for more than three months range wildly, depending on where you look for guidance. . . . So what are the actual odds? They're not clear-cut, as you may have guessed. But let's start with what they aren't."(The New York Times; free registration required)

[Guidance Overview] Discovery of Disability Claims Administrator's Personnel Records Permitted on Question of Bias
Excerpt:"The plaintiff sought performance reviews of the insurance carrier's employees involved in evaluation of the claim in dispute, namely: the'performance evaluations or performance reviews for each of [Unum's] employees [who were involved in the evaluation of Plaintiff's claim] . . . for the years 2005, 2006, and 2007.'"(Health Plan Law blog by Attorney Roy Harmon III)

[Guidance Overview] ERISA's Exemption for Governmental Plans and Right to Jury Trial, According to the Tenth Circuit Court
Excerpt:"The 10th Circuit Court of Appeals recently issued a decision addressing two ERISA issues: (1) what constitutes a'governmental plan;'and (2) the right to trial by jury. These issues were addressed in the case of Shirley Graham v. Hartford Life and Accident Insurance Company, 589 F.3d 1345 (10th Cir. 2009), decided December 29, 2009. This was an appeal out of the Northern District of Oklahoma."(Law Office of Shawn E. McDermott, LLC)

[Guidance Overview] Disability Benefit Change Requires Stronger Proof of Available Work
Excerpt:"A Pennsylvania appellate court has ruled that an employer must provide evidence of actual job openings when trying to prove a worker receiving disability payments can get other employment."(PLANSPONSOR.com)

[Opinion] Disability Insurers, False Claims and Social Security Benefits
Excerpt:"Here's a story worth reading, about a case worth paying attention to, namely the pending First Circuit appeal . . . concerning whether a long term disability insurer - namely Unum - engages in false claims when it instructs beneficiaries to also apply for Social Security disability benefits. Simply put, group long term disability plans routinely require participants applying for LTD benefits to also seek social security benefits, if they qualify, and the plans are structured so that the LTD benefits are off set by the amount of social security benefits received."(Stephen Rosenberg of The McCormack Firm, LLC)

[Guidance Overview] Post-Glenn Template for Analysis of Permissible Discovery
Excerpt:"'In sum, limited discovery beyond the administrative record will be allowed but controlled. Such discovery must focus on the Defendants'structural conflict of interest.Dandridge v. Raytheon Co., 2010 U.S. Dist. LEXIS 5854 (D.N.J. 2010)'This recent district court opinion addresses the scope of discovery in a claim for benefits case determined under an arbitrary and capricious standard of review. The court take a comprehensive survey of the law and, as a result, the opinion provides a helpful template for analysis of the issue."(Roy Harmon III via Health Plan Law)

[Guidance Overview] First Circuit Permits ? 502(a)(3) Recoupment Claim Despite Failure to Identify'Specific Account'Holding Funds
Excerpt:"The First Circuit adds further impetus to a trend away from requiring a specifically identifiable fund as a prerequisite for'equitable relief'under 29 U.S.C. ? 502(a)(3). Though the context in Cusson was that of a recoupment claim under the terms of a long term disability policy, the decision will likely influence opinions in other contexts, such as ERISA health plan reimbursement claims."(Roy Harmon III via Health Plan Law)

Work Ability and the Social Insurance Safety Net in the Years Prior to Retirement
Excerpt:"Questions persist about how well Social Security Disability Insurance, workers'compensation, Supplemental Security Income, and veterans'benefits protect people who are unable to work. This study examines disability benefit receipt, income, and poverty status for a sample of Americans as they age. The results underscore the precarious financial state of most people approaching traditional retirement age with disabilities. Fewer than half of people who meet our disability criteria ever receive disability benefits in their fifties or early sixties. Poverty rates for those who do are more than three times as high after benefit receipt than before disability onset."(Urban Institute)

[Guidance Overview] Participant Files too Late to Pursue Interference of Benefits Claim
Excerpt:"A former retirement plan participant claiming he was terminated to prevent him from becoming vested in the plan has made his complaint too late. The U.S. District Court for the Western District of Michigan said that although Employee Retirement Income Security Act (ERISA) ? 510 does not have its own statute of limitations, courts should'apply the limitations period for the most analogous state law claim.'"(PLANSPONSOR.com)

Sixth Annual Workplace Class Action Litigation Report
Excerpt:"[The Report] by Seyfarth Shaw LLP analyzes class action and collective action court rulings of 2009 involving claims against employers in federal and state courts. The key class action and collective action settlements over the past year are also analyzed, both in terms of gross settlement dollars in private plaintiff and government-initiated lawsuits, as well as injunctive relief provisions in consent decrees. The report analyzes 715 decisions in its comprehensive analysis of class action litigation rulings."(Seyfarth Shaw LLP)

[Guidance Overview] Disability Plan Benefit Denial Overturned (For Now)
Excerpt:"In Majeski v. Metropolitan Life Insurance Co., No. 09-1930 (7th Cir. Dec. 29, 2009), the plaintiff, Kirsten Majeski, had been employed by Metropolitan Life Insurance Company ('MetLife'), and had participated in MetLife's Short Term Disability Plan (the'Plan'). The case centers on the decision of MetLife, as plan administrator, to reject Majeski's claim for short-term disability benefits . . . ."(Workplace Prof Blog)

Court Overturns Denial of Paralyzed Worker's Benefits
Excerpt:"An Aetna Life Insurance Co. diving accident investigation was insufficient to deny a paralyzed man benefits under an employee health policy's accidental death and personal loss provision, a federal appeals court ruled Tuesday."(Business Insurance)

Trends and Innovations in Disability Income Insurance (PDF)
16 pages. Excerpt:"These stories exemplify the impact that disability insurers are having in the lives of workers who have suffered debilitating illnesses and injuries. In addition to providing disability income benefits, disability insurers help employees with disabilities access the medical, behavioral health, and social services they need. Disability insurers also work with employers and supervisors to modify work environments and schedules so that workers can return to the jobs they love."(America?s Health Insurance Plans)

[Guidance Overview] Seventh Circuit Overturns Plan Administrator's Benefit Denial, Since the Plan Administrator Ignored Important Evidence Submitted by Participant
Excerpt:"In Majeski v. Metropolitan Life Insurance Co., No. 09-1930 (7th Cir. 2009), the plaintiff, Kirsten Majeski, had been employed by Metropolitan Life Insurance Company ('MetLife'), and had participated in MetLife's Short Term Disability Plan (the'Plan'). The case centers on the decision of MetLife, as plan administrator, to reject Majeski's claim for short-term disability benefits, after determining that Majeski had failed to submit enough evidence to support her claim."(Stanley D. Baum of Fellheimer&Eichen LLP)