The Schipper Law Group, PLC Regains Long-Term Disability Benefits for Client Terminated from ERISA Plan
On May 23, 2023, The Schipper Law Group, PLC convinced Judge Denise Page Hood that its client was unlawfully terminated from her employer’s long-term disability benefits plan with The Lincoln National Life Insurance Company. (See Full Opinion)
After being paid benefits for two years, our client, who suffers from severe narcolepsy, among other conditions, was terminated from the policy on the premise that she was able to achieve the major job duties under the “any occupation” clause of her employer’s long-term disability policy.
The Schipper Law Group provided an extensive administrative appeal, but Lincoln continued to deny liability. The Schipper Law Group filed suit in the Federal Court of Eastern District of Michigan. The parties were unable to come to a settlement and finally moved for cross-motions for judgment.
Upon considering each party’s argument, Judge Page Hood awarded judgment in favor of our client and reinstated her disability benefits. The court was persuaded by the conclusions of our client’s treating physicians, the Administrative Law Judge who awarded her Social Security Disability benefits, and the testimony of our client (who formerly practiced as a nurse practitioner) and her family members that she would be unable to perform any occupation in the economy given her severe impairments. In particular, the fact that our client must nap for two hours in the middle of the workday in order to control her narcolepsy was proof to the court that “she is inhibited from performing the Main Duties for any occupation, as one fundamental condition for performing an occupation is being awake.” The court also found “it notable that the reports and opinions of physicians Defendant identifies lack any in-depth analysis regarding Plaintiff’s narcolepsy; in fact, most fail to even acknowledge or discuss Plaintiff’s narcolepsy.” For these reasons, the court was satisfied that our client is totally disabled under the terms of her policy and that she was therefore entitled to judgment in her favor. Our client’s benefits were reinstated retroactive to the termination date and into the foreseeable future, which the court noted is unlikely to change as there is no known cure for narcolepsy.
If you have been terminated from a long-term disability policy, please do not hesitate to contact The Schipper Law Group or call us at (248) 729-2414. We have helped many clients regain their benefits after being unlawfully terminated from coverage.