District Court Upholds LINA’s Denial of LTD Benefits Due To Lack of Objective Findings of Mental, Cognitive, or Behavioral ImpairmentNov 14, 2016 | Blog | Share
District court upholds insurer’s denial of LTD benefits agreeing with the insurer’s file reviewer that there are no objective findings from a psychiatric standpoint that indicates the Claimant is mentally, cognitively and/or behaviorally impaired. In Gailey v Life Insurance Company of North America, 2016 WL 6082112 ( M.D. Penn. October 17, 2016), the Claimant was a 48 year old office manager for many years with a history of anxiety and depression. On July 15, 2013 she reported having an emotional breakdown at work and left the office crying, shaking, and suffering a panic attack. She was unable to return to […]
The United States Court of Appeals for the Seventh Circuit issued a decision in Sun Life Assurance Co. of Canada v. U.S. Bank National Association on October 12, 2016 affirming the district court’s judgment. The Court’s decision begins, “A common law principle that so far as we know is in force in every state of the United States forbids a person to own an insurance policy that insures someone else’s life unless the policy owner has an insurable interest in that life. Ohio National Life Assurance Corp. v. Davis, 803 F.3d 904, 907–08 (7th Cir. 2015). So you are allowed […]
Bryant Legal Group’s October 2016 “You Should Know” newsletter was distributed last night. It is available online here. In this issue: “Addiction Explodes with Sales,” “Abuse, Addiction Prevention Checklist,” and “Track Pharma Dollars to Docs.” If you would like to subscribe to our newsletter, you can do that here.
For new and updates relevant to Social Security disability, we recommend visiting attorney Joni Beth Bailey’s blog page. Recent topics include: “Famous Last Words—’I’ve got this! I don’t need an attorney at my Social Security disability hearing!’” and “SSA’s mySocial Security: New Online Security Update” Ms. Bailey is an experienced attorney representing individuals since 1984 and focuses on cases in Southern Illinois (service area map). Her skill is recognized nationally as she is a frequent speaker to other Social Security disability attorneys.
One of the most important tips is simple. Always be honest with your doctors. Your doctor appointments are not the time to put your best foot forward. We frequently hear feedback from clients that they want their doctors to feel positive about their treatment and what they are doing to help them, so they in turn minimize their symptoms. First and most importantly, your doctor needs an accurate report from you of your symptoms and their severity in order to provide the best treatment possible. Secondarily, if you are filing a claim for disability and you always are telling your […]
The Seventh Circuit Court of Appeals affirmed in part and reversed in part the district court’s decision regarding insurer’s duty to defend. Cincinnati Insurance Company brought action seeking declaration that its policy did not apply to the underlying claims against insured, arising out of automobile accident which resulted in death of insured’s wife. The United States District Court for the Central District of Illinois, Richard Mills, J., 2015 WL 4978711, granted in part and denied in part Cincinnati’s motion for summary judgment and granted in part and denied in part insured’s motion for summary judgment. Cincinnati appealed. In August 2010, […]
Zagorski v. Allstate Insurance Company, 2016 IL App (5th) 140056 (May 16, 2016) St. Clair Co. (CATES) Affirmed in part, reversed in part, and vacated in part; remanded with directions. (WELCH and GOLDENHERSH, concurring.) Plaintiffs filed suit against their insurer, Allstate Insurance Company, alleging vexatious breach of contract and common law fraud, under Section 155 of Insurance Code, in handling of their homeowners’ insurance claim. Defendant insurer argued that the trial court abused its discretion in permitting the Plaintiffs to discover the number of times in the last five years that Allstate (a) was cited by the Illinois Department of […]
In the long anticipated ruling in Fontaine v. Metropolitan Life Ins. Co., No. 14-1984, 2015 U.S. App. (7th Cir. Sept. 4, 2015), the Seventh Circuit affirmed that Illinois’s anti-discretionary clause regulation in 50 Ill. Admin. Code §2001.3, that prohibits discretionary clauses in insured employee benefits plans offered or issued in Illinois, was outside the scope of the preemption power of the Employee Retirement Income Security Act of 1974 (ERISA). The decision makes clear that the judicial standard of review for all benefits determinations under ERISA plans offered or issued in Illinois is de novo. This ruling confirms a trend of […]
The American Bar Association’s House of Delegates recently approved Resolution 106B. The Resolution proposes various reforms to the rulemaking provisions of the Administrative Procedure Act (“APA”), many of which embrace principles endorsed in past Administrative Conference of the United States recommendations. This project identifies points of overlap, and offers the Conference’s views on non-overlapping portions of the Resolution. Issuing a Statement on ABA Resolution 106B offers the Conference an opportunity to endorse a series of reforms that would promote transparency and public participation while enhancing the quality of information received by agencies in the notice-and-comment process. Related Links: http://www.americanbar.org/news/reporter_resources/midyear-meeting-2016/house-of-delegates-resolutions/106b.html One suggestion is to hold […]
Stapleton v. Advocate Health Care Network, No. 15-1368 (March 17, 2016) N.D. Ill., E. Div. Affirmed The Court begins the decision, “The Employee Retirement Income Security Act (ERISA) protects employees from unexpected losses in their retirement plans by setting forth specific safe- guards for those employee plans. The Act, however, exempts church plans from those requirements. This case explores the question that has been brewing in the lower federal courts: whether a plan established by a church-affiliated organization, such as a hospital, is also exempt from ERISA’s reach. We conclude that it is not.” The Third Circuit came to the […]