Representative Victories
“Berg v. Lincoln National Life Insurance Company”
Barbara Berg, disabled by complex regional pain syndrome, was initially granted LTD benefits by Lincoln, which were later terminated despite her receiving SSA disability benefits. The ERISA Law Center challenged the termination, arguing Lincoln ignored crucial medical evidence and SSA findings. The court ruled in Berg’s favor, reinstating her benefits due to Lincoln’s failure to adequately address the persuasive evidence from Berg’s doctor and the SSA, highlighting the ERISA Law Center’s effective advocacy.
“Khan v. Provident Life & Accident Insurance Company”
Dr. Khan, a neurologist suffering from granulomatosis with polyangiitis, was initially denied disability benefits by Provident Life & Accident Insurance Company. The ERISA Law Center represented Dr. Khan, challenging the denial based on the unanimous medical opinions supporting his disability and his approval for SSDI benefits. The court ruled in favor of Dr. Khan, compelling Provident to pay both “own occupation” and “any occupation” benefits. The decision underscored the validity of Dr. Khan’s subjective symptoms and criticized Provident for disregarding them.
“Entz v. Standard Insurance Company”
Tisha Entz, a teacher diagnosed with Chronic Lyme Disease, was denied LTD benefits by Standard Insurance despite her disability retirement under CalSTRS. The ERISA Law Center sued Standard, and the court ruled in Entz’s favor, acknowledging Standard’s breach of fiduciary duty and the substantial medical evidence supporting her disability. Entz was awarded her LTD benefits, confirming her total disability under the policy.
“Lyttle v. United of Omaha Life Insurance Company”
Matthew Lyttle, a chemist with terminal cancer, had his long-term disability claim denied by United of Omaha Life Insurance. After his death, the ERISA Law Center continued the case for his widow, successfully arguing in court that United of Omaha failed to consider Lyttle’s severe medication side effects and work absences. The court ruled in favor of Lyttle, highlighting the insurer’s inadequate review of his medical condition.
“Barnett v. Southern California Edison Company Long Term Disability Plan”
Mr. Barnett’s long-term disability benefits, terminated by Southern California Edison in 2009, were reinstated in 2016 after persistent legal efforts by the ERISA Law Center. Following an unsuccessful appeal in 2010 and an initial unfavorable ruling in 2013, the 9th Circuit Court of Appeals reversed the decision in 2015, leading to a favorable ruling from the district court, which included the award of attorney’s fees. This case highlights the ERISA Law Center’s relentless advocacy in securing disability benefits for their clients.
“Dunda v. Aetna Life Insurance Company”
Ms. Dunda, disabled by chronic back pain, had her long-term disability benefits terminated by Aetna after six years. The ERISA Law Center challenged this in court, arguing Aetna failed to conduct a full and fair review and improperly demanded “objective support” for her condition. The court ruled in Ms. Dunda’s favor, ordering the retroactive reinstatement of her benefits and agreeing with the ERISA Law Center that Aetna’s review was arbitrary and capricious.
“Green v. Sun Life Assurance Company”
Ms. Green, a former pharmaceutical representative at Daiichi Sankyo, Inc., suffering from occipital neuralgia, neck pain, depression, and anxiety, had her long-term disability claim denied by Sun Life. Despite an appeal and a Social Security Administration (SSA) disability determination in her favor, Sun Life again rejected her claim. The ERISA Law Center successfully challenged this in court, emphasizing Sun Life’s disregard for SSA’s findings and the Administrative Law Judge’s opinion. The court criticized Sun Life for its arbitrary decision-making and remanded the case for further review, leading to a settlement favorable to Ms. Green.
“Boxell v. Plan for Group Ins. of Verizon Communications”
In a follow-up to the Boxell case, Ms. Boxell’s long-term disability claim with MetLife for Verizon Communications was revisited. The ERISA Law Center submitted new evidence, leading to the retroactive reinstatement of her benefits. A contentious debate over attorney’s fees ensued, with MetLife contesting Ms. Boxell’s entitlement and seeking reimbursement for an overpayment. Ultimately, the court awarded Ms. Boxell $90,285.49 in fees and costs, while MetLife received only $2,796.75, underscoring the ERISA Law Center’s effective advocacy.
“Mossler v. Aetna Life Insurance Company”
Mr. Mossler, a former senior vice-president at City National Bank, became disabled from conditions like fibromyalgia and spinal stenosis and was denied LTD benefits by Aetna despite being awarded Social Security Disability benefits. With the ERISA Law Center’s help, his case highlighted his credible medical evidence and challenged Aetna’s demand for objective evidence for fibromyalgia. The district court ruled in his favor, recognizing the inadequacy of Aetna’s review and the non-sedentary nature of his job, leading to the approval of his LTD benefits.
“Wong v. Aetna Life Insurance Company”
Ms. Wong, a former regional facility manager at Hobart West Group, experienced severe pain after childbirth, leading to an inability to work. Although Aetna initially provided her with LTD benefits for nearly five years, they later terminated these benefits. Despite this, she received Social Security Disability benefits retroactively. Ms. Wong then sued Aetna with help from the ERISA Law Center, and the district court ruled in her favor, finding that Aetna had abused its discretion in terminating her benefits.
“Smith v. Hartford Life & Accident”
Ms. Smith, a former bank executive debilitated by co-morbid conditions after hand surgeries and depression, initially received disability and life insurance waiver of premium (WOP) benefits from Hartford. These benefits were later terminated, although she was awarded Social Security Disability benefits. The ERISA Law Center appealed the denial, successfully reinstating her LTD benefits but not the WOP benefits. Following litigation, the court ruled that Hartford had abused its discretion in terminating the WOP benefits, criticizing its failure to conduct a thorough review and consider all relevant evidence. Consequently, the court ordered the reinstatement of Ms. Smith’s WOP benefits.
“Deborah Maher v. Massachusetts General Hospital Long Term Disability Plan”
Deborah Maher, a registered nurse debilitated by chronic abdominal pain, had her long-term disability benefits terminated by Liberty Life Insurance. Despite initial setbacks in appeals and trial, the ERISA Law Center escalated the case to the First Circuit Court of Appeals, which ruled in Maher’s favor. The court found that the surveillance used to terminate her benefits did not prove she was able to work and acknowledged her adequate medical evidence. The case was subsequently remanded and settled, showcasing the ERISA Law Center’s effective legal advocacy.
“Melissa Gardner v. Ameritech Sickness and Accident Disability Plan”
Melissa Gardner, an AT&T Marketing Support Specialist suffering from degenerative disc disease, had her disability claims denied by Sedgwick CMS. The ERISA Law Center took on her case, appealing the denials and filing a lawsuit to argue for a de novo standard of review, as AT&T’s plan hadn’t properly delegated discretion to Sedgwick. The court agreed, allowing an independent review. Subsequent depositions of the evaluating doctors revealed inconsistencies, leading to a favorable settlement for Ms. Gardner.
“Cleveland v. Liberty Life Assurance Company of Boston”
Mr. Cleveland, a former Compuware computer programmer/analyst suffering from severe chronic heart conditions, had his long-term disability (LTD) benefits terminated by Liberty Life Assurance after nine months. After an unsuccessful appeal, the ERISA Law Center took legal action. The district court ruled in Mr. Cleveland’s favor, deeming Liberty’s termination of benefits as arbitrary and capricious due to reliance on biased reviews and ignoring substantial evidence of his disability. The court ordered the reinstatement of his benefits and considered attorney’s fees, leading to a settlement after Liberty appealed. The ERISA Law Center’s advocacy was instrumental in securing this outcome.
“Aileen Murphy v. Deloitte & Touche Group Insurance Plan”
Aileen Murphy, a Tax Firm Director at Deloitte & Touche, had her long-term disability claim denied by MetLife. After an unsuccessful personal appeal, she engaged the ERISA Law Center, which filed a lawsuit and sought to investigate MetLife’s potential conflicts of interest. Initially rejected by the district court, the Tenth Circuit Court of Appeals allowed limited discovery, leading to a case remand and eventual settlement. The ERISA Law Center’s efforts highlighted the critical role of discovery in addressing potential biases in disability claims.
“Beckstrand v. Electronic Arts Group Long Term Disability Insurance Plan”
Mr. Beckstrand, formerly with Electronic Arts, lost his long-term disability benefits in 2004, which he had been receiving since 1998. After a failed appeal, he turned to the ERISA Law Center. Despite an initial district court defeat, an appellate ruling granted a retrial. During the retrial, the ERISA Law Center exposed oversights like disregarded medical opinions and inadequate process notifications, and criticized the reliance on paper reviews. Ultimately, the court ruled in Mr. Beckstrand’s favor, reinstating his benefits retroactively and showcasing the importance of skilled legal advocacy in ERISA cases.