It is all but common knowledge that group insurance carriers tend to delay and deny long-term disability claims. When even the most obviously valid claims can present difficulties for policyholders, claims involving less clear-cut illnesses like post-traumatic stress and other emotional difficulties can be nearly impossible to prove for purposes of obtaining long-term disability benefits.
It has been unclear historically whether insurance carriers need to consider specific occupational duties and the workers emotional and mental ability to fulfill those duties when denying long-term disability claims. However, a recent case seems to look favorable for policyholders.
A recent case against United of Omaha Life Insurance
In a case involving a truck driver seeking long-term disability for mental health problems, the US District Court for the Southern District of Ohio recently granted the plaintiff’s petition for summary judgment on the administrative record (and denied the defendant’s same petition).
The plaintiff in the case was a truck driver. He had been in a serious accident with a bus while working, which worsened his already present anxiety and other emotional problems that made it unsafe for him to continue driving.
The defendant, United Omaha Life Insurance Co., had denied the plaintiff’s claim for long-term disability benefits.
Ultimately, the court found that the defendant could not rightfully ignore a claimant’s mental capacity to safely perform his or her job or ignore the federal regulations that codified the mental health requirements to fulfill the driver’s duties.
What does this mean for you?
While this precedent will not control over the entire country, it is a positive development for anyone seeking long-term disability benefits for mental health issues. If you have anxiety, depression or other mental health issues that could compromise your ability to perform your work safely, this could give you a much greater chance of obtaining your much-needed long-term disability benefits.