Sometimes an ERISA-governed disability benefit claim is denied on a specific issue that precludes the need for a full development of the record on the merits of the claim. E.g., claimant was not eligible for benefits because he was not
Boom: The ERISA Law Blog
Blog Authors
Latest from Boom: The ERISA Law Blog
ERISA (8th Circuit)–Now You Know Why You Should Bring Rule 52 Motions Instead of Rule 56 Summary Judgment Motions
What is the most efficient way to invite the district court to resolve ERISA-benefit claims?
What’s the difference between using Rule 56 motions for summary judgment, versus a Rule 52 Motion for Judgment?
This new case highlights why Rule 52…
ERISA (5th Circuit): Plan Administrators Do Not Waive Exclusions That Develop As A Result Of Court Decisions Affecting The Disability Claim
What happens when an ERISA-governed disability claim is denied solely under the “own occupation” provision, but a reviewing district court concludes the claimant is entitled to “own” occupation benefits?
Does an insurer “waive” an evaluation of the “any occupation” provision…
ERISA – 9th Circuit: Self-Funded ERISA Plans, and Employee-Paid Supplemental Benefits: Can the Abuse of Discretion Standard Apply, Even When State Law Bans It?
You already know that many state laws ban the “abuse of discretion” standard of review in denials of ERISA-governed long term disability benefits.
But self-funded ERISA plans may still apply the discretionary standard of review.
And “incorporating by reference” the…
ERISA: 502(a)(3) Breach of Fiduciary Duty Claim DISMISSED: Repeated Calculation Errors Do NOT Involve “Fiduciary Duties”
We all are seeing more “breach of fiduciary duty claims” asserted in lawsuits seeking ERISA-governed benefits. As you know, ERISA allows participants, beneficiaries, and the Secretary of Labor to obtain relief against ERISA fiduciaries for breaching the fiduciary duties they…
ERISA 6th Circuit: Using the “National Economy Standard” to Defeat Disability Claims
What happens when the claimant is “disabled” from performing her job with her current employer… but can perform that same job with another employer?
This issue highlights the importance of the “national economy” definition of disability as found in most…
ERISA 502(a)(3) Claims: Congress Never Thought the Phrase “Equitable Relief” Included Money Damages
You know that a claimant must exhaust administrative remedies before filing a suit. But is an appeal “optional” when the denial letter says that claimant “may request a second level review”? NO.
And what’s with 502(a)(3) breach of fiduciary claims…
ERISA – 11th Circuit: Awarding Attorney Fees to the Plan When Plaintiff Refuses to Drop Suit After Reinstatement of Benefits
What happens when the ERISA claimant files suit after the disability claim has been denied, and then the ERISA claims administrator reinstates benefits retroactively?
Doesn’t reinstatement “moot” the issues in the lawsuit, or make claims regarding future benefits unripe —…
ERISA: Defeating Credibility Challenges of Medical Reviewers
You know that claims administrators retain experts to review a claimant’s medical and mental health condition to assess whether a claimant is sufficiently impaired to be eligible for disability benefits.
But what happens when the claimant argues that a medical…
ERISA: Arguments to Defeat Breach of Fiduciary Duty Benefit Claims?
You know that claimants seeking ERISA-governed benefits sometimes assert “breach of fiduciary” duty claims under ERISA Section 502(a)(3)(b).
This case highlights some arguments that can be used to defeat breach of fiduciary duty claims. Staropoli v. Metro. Life Ins. Co…