The Disability Application

In Cheney v. Standard Insurance Company and Long Term Disability Insurance, the Seventh Circuit Court of Appeals dealt with an issue concerning when the last day was that the plaintiff actually worked in order to determine whether or not she was covered under Standard’s long term disability policy. The question was a complicated one since this plaintiff, an attorney, worked some of the time at home, took long vacations, and also took extended leaves of absence to flirt with a career in politics. The Seventh Circuit remanded to the Illinois district court since “the district court had made no explicit finding about the onset date of Cheney’s long-term disability.” The last day she worked as well as the date upon which she became disabled are crucial questions that must be answered in order to determine if she had coverage under the policy.
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Hogan v. Jacobson et al., is case where, after plaintiff Violet Hogan lost her lawsuit for disability benefits against Life Insurance Company of North America (LINA) in federal court, she filed a lawsuit in state court against two of LINA’s nurses. In her attempt to avoid any reference to her previously unsuccessful lawsuit brought under the Employment Retirement Income Security Act (ERISA), she filed suit in state court and “artfully pleaded” a case for negligence per se against LINA nurses Jo Ellen Jacobson and Kem Alan Lockhart. Hogan claimed the two nurses gave medical advice without being properly licensed in Kentucky. The defendants removed the case to federal court. Hogan objected and moved for the case to be remanded to state court. Her motion was denied, her lawsuit dismissed, and this appeal followed.
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Dowdy v. Metropolitan Life Insurance Company (MetLife) is a sad case for plaintiffs who have a pre-existing condition that contributes to their otherwise qualifying event for collecting insurance benefits. Thomas Dowdy and his wife had purchased an accidental death and dismemberment policy through Mrs. Dowdy’s employment at Bank of the West.
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Clark v. Cuna Mutual Long Term Disability Insurance is a plaintiff friendly case where a Wisconsin federal district court found that CUMA “acted arbitrarily and capriciously in denying Clark benefits.” Clark was employed by CUNA for 21 years as a “Retirement Education Specialist, Virtual” before he became disabled in 2006 after injuring his back while moving a heavy couch. He reinjured his back in 2007 when he tried to save a swimmer from drowning. He was granted short term disability benefits. After being denied long term disability benefits and exhausting his administrative remedies, Clark filed this ERISA lawsuit.
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In Jahn-Derian v. Metropolitan Life Insurance Co., a California Federal Judge disagreed with MetLife’s decision to deny disability benefits due to a lack of objective evidence. First, the court noted that objective evidence is not required since for many medical conditions, such as fibromyalgia, chronic migraines or mental disorders, no objective evidence is medically available. Second, Jahn-Derian provided significant objective evidence to support her claim.

The court did not remand on this issue, but found that, “In sum, the evidence establishes that plaintiff, more likely than not, was disabled within the meaning of the Plan’s terms.” The court ordered MetLife to pay the claimant 24 months of disability based on her inability to perform the tasks of her own occupation. This is a great opinion for disability claimants nationwide.
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