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ERISA — 8th Circuit: When Malingering Justifies Disability Claim Denial

By Mike Reilly on March 25, 2019
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When does evidence of malingering justify denial of a long term disability claim?  It depends. A physician’s subjective opinion regarding malingering may have less weight than objective neuropsychological testing.

Key Take Away:  When the claimant’s neuropsychological testing is rendered invalid due to “failed validity tests,” that may be enough to deny the claim. It is important that the record contain evidence how the tests were conducted, and how the tests objectively measured validity.

Here’s the case of Johnston v. Prudential Ins. Co., 916 F. 3d 712 (8th Cir. February 25, 2019). 

FACTS: Johnston, a computer engineer, sought ERISA-governed long term disability benefits for cognitive impairment after brain surgery. Johnston underwent neuropsychological tests, rendered invalid because he “failed almost all of the validity tests.” Failed validity tests indicate one may be “actively attempting to perform poorly.” After Prudential denied disability, Johnston appealed. Prudential sought a second neuropsychological examination, and Johnston’s testing failed the validity tests again.

The District Court, applying discretionary review, affirmed Prudential’s denial of the disability and Johnston appealed. 

ISSUE: Whether repeat, invalid neuropsychological tests justified claim denial?

 EIGHTH CIRCUIT HELD: YES. 

  1. Prudential’s benefit denial was upheld because there was evidence Johnston was “deliberately exaggerating his symptoms, making it impossible to determine whether he had cognitive deficiencies that rendered him disabled.”  Op. at 5.
  2. With neuropsychological tests there are “multiple established ways to test validity of a neuropsychological examination.  The record showed how the tests were administered, and how these tests objectively measure validity.”  Op. at 6.
Photo of Mike Reilly Mike Reilly

Mike Reilly is a nationally recognized labor, employment and employee benefits attorney, named one of the “Top 100 Most Powerful Employment Attorneys in the Nation” for the past five consecutive years by Human Resource Executive®. He has decades of experience providing strategic employment…

Mike Reilly is a nationally recognized labor, employment and employee benefits attorney, named one of the “Top 100 Most Powerful Employment Attorneys in the Nation” for the past five consecutive years by Human Resource Executive®. He has decades of experience providing strategic employment advice, and has represented clients in more than 75 jury trials, arbitrations, bench trials and claims before the EEOC and Washington State Human Rights Commission.

Small and large employers retain Mike for his strategic advice and decades of experience in employment issues and litigation, business decisions and litigation avoidance. Mike provides advice in claims involving discrimination, retaliation, wrongful discharge, disability accommodation, ERISA and non-ERISA employee benefit claims, and wage/hour claims. He served as lead counsel in an employee raiding/trade secret case as reported in the Wall Street Journal, and defends employers in class action claims.

Mike’s remarks on employment issues have been quoted in Newsweek, Corporate Legal Times, Seattle Times, Employee Relations Law Journal, Puget Sound Business Journal, CFO.com, and other professional journals and management publications. Chambers USA’s Guide to America’s Leading Lawyers for Businessrates Mike in the top ranking (band one) for his work in labor and employment law, and has described him as “one of Seattle’s top-rate attorneys” who is “truly phenomenal [with] superb legal instincts” and “an amazingly assertive litigator.” His clients include Nordstrom, Seattle Seahawks, Home Depot, KeyBank, Starbucks, Fred Hutchinson Cancer Research Center, Red Robin and Seattle Chamber of Commerce, among others.

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  • Posted in:
    Employment & Labor
  • Blog:
    Boom: The ERISA Law Blog
  • Organization:
    Lane Powell PC
  • Article: View Original Source

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