11 results for 'cat:"ERISA" AND cat:"Evidence"'.
J. Marbley grants the insurer's motion for judgment on the administrative record, ruling that while the employee's health has suffered as a result of "long Covid-19," evidence in the record indicates she was able to job on a semi-daily basis and was cleared to return to work by a physician, which is sufficient to support the denial of long-term disability benefits.
Court: USDC Southern District of Ohio, Judge: Marbley, Filed On: March 25, 2024, Case #: 2:22cv3118, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, evidence, Insurance
J. Vatti denies, in part, the financial advisor's objections to the insurer's motion to compel, ruling he must provide requested documents about his clients. The information is not protected by any sort of privilege and is crucial to the insurer's investigation into his application for long-term disability benefits that stems from his alleged inability to manage client funds after a traumatic brain injury.
Court: USDC Connecticut, Judge: Vatti, Filed On: March 15, 2024, Case #: 3:21cv1277, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, evidence, Discovery
J. Morrison denies the ERISA plan administrators' motion for judgment on the administrative record, ruling the employee is entitled to coverage for injuries sustained when he was kicked in the leg by a bull calf. Although there is an exclusion in the policy for injuries sustained while working for another employer, the exclusion did not apply in this case. The employee owns and operates a cattle business; however, the calf that kicked him was being raised for personal consumption - a claim proven by receipts and other testimony - which entitles the employee to medical benefits under the plan.
Court: USDC Southern District of Ohio, Judge: Morrison, Filed On: February 26, 2024, Case #: 2:22cv1789, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, evidence
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J. Simon reverses the insurance company's determination that the insured was not disabled as of March 25, 2020, which the insured claims resulted in the denial of her long-term disability benefits. The insured's test results show that her memory functioning was greatly impaired and the the Social Security Administration found the insured to be disabled, so the insurance company must reinstate the insured's benefits from March 25, 2020 through June 4, 2021, which is the remainder of the 24-month "own occupation" period of her long-term disability plan.
Court: USDC Oregon, Judge: Simon, Filed On: September 20, 2023, Case #: 3:21cv1019, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, evidence, Insurance
J. Evanson grants default judgment in the amount of $193,900 to the joint labor-management funds for their claim that the excavating company did not make the required employee benefit contributions. The joint labor-management funds are entitled to default judgment, because they adequately established that the excavating company is an employer that must pay contributions under the trust agreements, and the amount the joint labor-management funds seek is supported by the trust agreements and other evidence.
Court: USDC Western District of Washington, Judge: Evanson, Filed On: September 14, 2023, Case #: 2:22cv829, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, evidence
J. Lin grants the joint labor-management employee-benefit trusts' request for $190,400 in unpaid contributions for the July 2022 through December 2022 delinquent period, which arises from the trusts' claim that the concrete contractor refused to report for and pay monthly contributions between October 2021 and June 2022. The trusts provide evidence that the concrete contractor owed these contributions, and there is no evidence that the concrete contractor lacked notice of the trusts' intent to sue or that it was otherwise misled about the situation.
Court: USDC Western District of Washington, Judge: Lin, Filed On: July 12, 2023, Case #: 2:22cv1541, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, evidence
J. Chun partially grants default judgment to the labor-management employee-benefit trust funds for their claim that the corporation owes them $100,100 for unreported and unpaid contributions for the audit period between January 2020 and December 2021. The corporation never obtained substitute counsel to defend itself after its counsel withdrew and the trust funds calculated their damages for this period based on the auditor's declaration and the audit report, so they are entitled to damages.
Court: USDC Western District of Washington, Judge: Chun, Filed On: June 14, 2023, Case #: 2:21cv1040, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, evidence, Damages
J. Morrison grants the radiologist's motion for judgment on the administrative record, ruling the insurer's termination of disability benefits was arbitrary and capricious because medical opinions from two doctors expressed serious doubts as to whether he could return to work and adequately perform his job. Although there was improvement in the radiologist's vision after several surgeries and he expressed he was satisfied with his vision, this opinion is not conclusive evidence his vision had improved to the point where he would be able to interpret medical images and accurately diagnose diseases for his patients; therefore, his total disability benefits will be reinstated.
Court: USDC Southern District of Ohio, Judge: Morrison, Filed On: June 12, 2023, Case #: 2:22cv112, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, evidence, Insurance
J. Siler finds the lower court properly considered both objective and subjective evidence regarding the employee's disability when it determined she was qualified for long-term disability benefits. The circuit has found on several occasions that subjective evidence, including this employee's complaints of pain, can be considered alongside expert testimony to determine an employee's eligibility for benefits. Meanwhile, the employee's own testimony, alongside that of her treating physicians, was sufficient to establish her eligibility for long-term disability benefits because her ability to stand only for one hour of an eight-hour work day rendered her unable to perform sedentary work. Affirmed.
Court: 6th Circuit, Judge: Siler, Filed On: May 19, 2023, Case #: 21-4178, Categories: Employment, erisa, evidence