ERISA Disability and Life Insurance Litigation Ben Glass

The claimant was an Enterprise Storage Engineer who encountered severe health challenges due to hydrocephalus, requiring surgery to remove a brain cyst.

Following this, he applied for long-term disability benefits, but his insurance company, Prudential, eventually terminated his claim based on neuropsychological tests suggesting possible malingering. These tests showed failures in nearly all validity measures, with specific tests indicating he might have underperformed deliberately, leading Prudential to question his claim of being unfit for work due to cognitive issues.

Challenging this decision, the claimant appealed, supported by a statement from his therapist. This statement highlighted his exhaustion during testing and his difficulty maintaining the necessary focus and concentration for his job. This appeal was a key effort to contest the insurer's denial, arguing that his medical condition genuinely prevented him from working.

This is the oral argument in the 8th circuit court of appeals.
These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant was a physician, who transitioned from part-time to full-time disability due to her deteriorating health condition. But her application for long-term disability benefits, which is governed under the complex umbrella of ERISA was denied by her Insurance company - UNUM.

At the heart of this dispute lies a contentious debate over the definitions of "full-time employment" versus "active employment." UNUM forwards a compelling argument, positing that the essence of full-time employment transcends the simplicity of a numerical hour threshold. According to them, it should mirror the employer's expectations and the specific demands of the occupation. They critiqued the district court's approach, accusing it of merging the distinct notions of full-time employment status with the active employment criterion, thereby diluting the stringent requirement of being a full-time employee to qualify for eligibility.

This is the oral argument in the 9th circuit court of appeals.
These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant appealed the district court's decision to deny his motion for attorney's fees under ERISA  after Unum Life Insurance Company of America terminated his long-term disability benefits.

The claimant argued he deserved to have his legal fees paid because he somewhat succeeded in his case due to causing a change, a concept known as the "catalyst theory."
However, the court didn't agree with him.

The court looked at several factors to decide whether he should get these fees, including whether Unum (the insurance company) acted badly or in bad faith, whether Unum could afford to pay the fees, if paying the fees would prevent Unum from acting similarly in the future, the importance of the legal issue regarding the law known as ERISA, and how strong each side's case was.

This is the oral argument in the 9th circuit court of appeals.
These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant, a former accountant, was diagnosed with mild cognitive impairment by a board-certified neurologist and determined by a medical doctor specializing in occupational medicine to be unable to work due to his condition. These diagnoses led him to stop working as of October 31, 2015, and he has not resumed working since.

He then found himself at odds with Prudential Insurance Company of America after the company denied his disability claim, asserting he wasn't sufficiently impaired. Undeterred, the claimant mounted a legal challenge to reclaim the $375,000 in benefits he firmly believes were unjustly withheld from him.

Transitioning from this initial confrontation, the claimant's appeal focused on disputing Prudential's rationale for discontinuing his benefits. This challenge was primarily grounded in their evaluation, which questioned the severity of his impairment necessary for policy collection. He countered by asserting his disability was due to cognitive impairments that rendered him unable to work—an assertion Prudential contested, relying on their file review.

This is the oral argument in the 1st circuit court of appeals.
These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant, a former sociology professor at Rollins College, dedicated her career to teaching, advising students, developing courses, grading papers, and contributing to academic research and writing. Unfortunately, her career and daily life were significantly impacted by Chronic Fatigue Syndrome (CFS), fibromyalgia, and a spectrum of associated symptoms, including persistent pain and fatigue.

When the claimant applied for long-term disability benefits due to her debilitating conditions, she encountered a significant challenge. Unum Life Insurance Company of America, her insurer, denied her claim based on a provision in her employer’s plan. This provision limited benefits to a 24-month period for disabilities "due to mental illness and disabilities based primarily on self-reported symptoms." Unum determined that the claimant's conditions—CFS and fibromyalgia, characterized by symptoms such as pain and fatigue—fell under this limitation because they were primarily based on self-reported symptoms.

In response to the denial, the claimant filed an appeal, determined to overturn Unum's decision. She meticulously compiled additional medical information for review, including office notes from a gastrointestinal specialist and updated records from her treating physicians. She also submitted results from the CPET conducted by an exercise physiologist. This test was specifically designed to objectively measure functional capacity and assess the recovery response to physical stressors. The appeal aimed to demonstrate that her disabilities were not solely based on self-reported symptoms and that she had indeed provided objective evidence of her functional limitations.

This is the oral argument in the 1st circuit court of appeals.


These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant was a former social worker at Intermountain Health Care Inc.​ Her medical conditions included Chronic Fatigue Syndrome (CFS), hypersomnia, obstructive sleep apnea, severe depression, and anxiety. Her treatment for these conditions was documented, and during the appeals process, these conditions were considered in the evaluation of her claim for long-term disability benefits.

Hartford Life and Accident Insurance Company denied claimant's claim for long-term disability (LTD) benefits based on their assessment of her condition and the medical evidence provided. Hartford argued that the medical evidence, including APRN Jones's assessment, did not support the claimant's Chronic Fatigue Syndrome (CFS) diagnosis as preventing her from performing a sedentary occupation. Therefore, Hartford decided that based on the medical records reviewed, including those of her treating physicians, and the definitions of disability within the policy, the claimant did not meet the criteria for LTD benefits​.

The claimant appealed the termination decision. In her appeal, she acknowledged receiving treatment for Depressive Disorder, Anxiety Disorder, and Panic Attacks during the period considered under the pre-existing condition limitation. She appealed the initial claim decision specifically regarding her "primary condition" of Chronic Fatigue Syndrome (CFS) and other disability conditions mentioned in the denial letter, specifically hypersomnia and obstructive sleep apnea​.

This is the oral argument in the 10th circuit court of appeals.
These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.