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This week’s notable decision is Dorris v. Unum Life Ins. Co. of Am., No. 19-1701, __F.3d__, 2020 WL 524726 (7th Cir. Feb. 3, 2020), in which the Seventh Circuit stridently announced, “[a]t least in this circuit, ERISA de novo review requires no review at all, but an independent decision.” It then made clear the plaintiff bears the burden of proving she is entitled to benefits, not that the plan administrator erred. 

For Stephanie Dorris, the former president of Beans Plus, Inc., this failure to recognize her burden was determinative. Her disability provider, Unum, had paid benefits for over 12 years – the last ten of which were under the “any occupation” standard. Unum then terminated Dorris’ benefits claiming she was able to return to work at her own occupation. Dorris fought hard to prove that Unum’s explanation for its decision was wrong. She convinced the district court that it was, largely because the occupation demanded long hours and constant mental acuity – job duties that aggravated her Lyme disease symptoms.
Continue Reading In Seventh Circuit, de novo ERISA Cases Are Reviewed Just Like a Breach of Contract Case

This week’s notable decision is Kaviani, D.M.D. v. Reliance Standard Life Insurance Company, No. 19-11798, __F.App’x__, 2020 WL 506551 (11th Cir. Jan. 31, 2020), where the Eleventh Circuit characterized Reliance Standard’s long-term disability (“LTD”) determination as ignoring “uncontradicted record evidence of disability.”  Though this is an unpublished decision, it provides a good road map of arguments for disability claimants who suffer from progressive conditions causing pain and who have attempted to continue working despite the pain.  The decision also arguably reflects a softened arbitrary and capricious standard in the Eleventh Circuit.
Continue Reading Eleventh Circuit Affirms Judgment against Reliance Standard in Favor of Dentist in Long-Term Disability Dispute

As a daughter of a disabled veteran, I’m unhappy to report this week’s notable decision, Martinez v. Sun Life Assurance Co. of Canada, No. 18-2127, __F.3d__, 2020 WL 415145 (1st Cir. Jan. 27, 2020). The First Circuit affirmed the district court’s determination that Sun Life properly interpreted the language of a disability plan, which it funded, to permit the offset of service-connected disability compensation (“Veterans’ Benefits”) against employer-sponsored long-term disability (“LTD”) benefits.  In so doing, the Court determined that Veterans’ Benefits are unambiguously “Other Income Benefits” covered by the Plan’s offset provision and that the offset is not a violation of the Uniformed Services Employment and Reemployment Rights Act (“USERRA”).  
Continue Reading First Circuit Gives Sun Life Green Light to Offset Veterans’ Benefits against Long Term Disability Benefits