In this video, Attorneys Gregory Dell & Rachel Alters discuss a recent court ruling in which Reliance Standard failed to reasonably evaluate the cognitive aspects of the plaintiff’s requirements to do her job as an attorney. Unfortunately for the policy holder, the court remanded the claim back to Reliance Standard for further evaluation of benefits.
Continue Reading Reliance Standard Denial of Disability Benefits for an Attorney Reversed by Kansas Judge

In Okuno v. Reliance Standard Life Insurance Company, the plaintiff was diagnosed with Crohn’s disease, Sjogren’s syndrome and possibly narcolepsy. Her claim for long-term disability was denied when Reliance determined she could perform the duties of her own occupation. She exhausted her administrative remedies and filed this lawsuit under the provisions of ERISA. In court, she claimed Reliance erred in determining she was not disabled from her own occupation instead of analyzing whether she was disabled from any occupation. The district court disagreed with the plaintiff holding that when Reliance determined she could perform her own occupation it “of course recognized that she could perform a job fitting within the plan definition of ‘any occupation.'”
Continue Reading If Claimant Can Work in Own Occupation She Can Work in Any Occupation

When reviewing a claim for disability benefits a plan administrator is not required to do an in-person exam of the claimant. However, in certain circumstances courts have found that an administrator’s failure to do so is arbitrary and capricious.
Continue Reading Reliance Standard abused its discretion when failing to conduct in-person exam for psychiatric disability

Although this recently decided case was not handled by Attorneys Dell & Schaefer Chartered, it can be used an educational tool for those currently on claim or those thinking of making a claim for disability benefits.

The Factual Background

Sylvia R. suffered from Chronic Fatigue Syndrome. Being employed by GAF Materials Corporation she was apparently covered by a Long Term Disability (LTD) Insurance Policy that would provide her with an income should be unable to perform the duties of her occupation. This Policy was with the Reliance Standard Life Insurance Company.
Continue Reading Court Upholds Reliance Standard’s Decision to Deny Continued Long Term Disability Benefits to former GAF Materials Corporation Employee

The Plaintiff, Joni D., with the help of her Alabama Disability Attorney has filed a lawsuit against Reliance Standard Life Insurance Company and the Group Long Term Disability Policy For Employees Of Madison County Community Hospital for the wrongful termination of long term disability benefits.

In Joni D. Vs. Reliance Standard, Plaintiff is suing the Defendants for the unjust termination of her long term disability benefits under the terms of the long term disability plan.

Plaintiff Needed To Use LTD Plan

Plaintiff worked as a Critical Care Registered Nurse, an occupation that required her to perform and fulfill numerous essential job functions, requirements, and qualifications associated with her occupation, including providing direct and indirect patient care, responding quickly and accurately to changes in condition or response to treatment, and performing general nursing duties. Due to her employment, Plaintiff was eligible and partook in the LTD policy that was underwritten by Reliance Standard.

On or about May 5, 2003, Plaintiff became unable to work due to a culmination of disabling physical health issues. These issues were clearly documented in the Plaintiff’s medical records. Plaintiff became totally disabled on a permanent basis on or about February 25, 2010. This prevented her from any type of gainful employment as was confirmed by the Social Security Administration as of May 4, 2003. But does receiving disability benefits from the Social Security Administration mean the insurance company will also continually provide long term disability benefits? As Joni came to find out, that answer is no.

Filing of Benefits

Plaintiff filed for LTD benefits on or around November 24, 2003. Reliance Standard agreed to pay the LTD benefits effective October 31, 2003. According to the terms of the Plan, the Plaintiff’s condition changed from "disability" to "inability" as of October 31, 2006.

Reliance Standard paid LTD benefits for six years. This included paying the Plaintiff disability benefits under the "any occupation" definition of disability from October 31, 2006 to August 31, 2009.

Reliance Standard Terminated the Benefits Five Times From 2003-2010

On five different occasions, Reliance Standard terminated, denied, or closed the claim between October 31, 2003 and January 7, 2010. This was despite the fact that numerous objective tests showed that the Plaintiff’s back pain and radiculopathy continued to exist. The Plaintiff has also continually submitted additional evidence confirming her pain, including medical records and information from doctor visits.

Reliance Standard also improperly handled the Plaintiff’s claims over the years, including a time when it claimed that the Plaintiff returned to work even though she never did. It is alleged that Reliance Standard did this to avoid paying the Plaintiff LTD benefits. Despite Reliance Standard’s own "quality review unit" claiming that Plaintiff met LTD terms of the Plan and could not handle "any occupation," Reliance Standard continually terminated Plaintiff’s benefits until its final termination letter on January 7, 2010.

Plaintiff Files Lawsuit Against Reliance Standard and Group

Plaintiff filed this lawsuit against Reliance Standard because Reliance Standard based its denial on its own "independent" medical examiner’s report and attached physical capacity form, even though the two reports contradicted each other and the Plaintiff’s submitted medical records and reports. The examiner was also provided through MES Solutions, a biased third party company that has regularly had contact with Reliance Standard, indicating a conflict of interest. Plaintiff also claims that Reliance Standard failed to consider all medical records and other information submitted by the Plaintiff.

Plaintiff Seeks The Following From This Lawsuit

Plaintiff wants the following relief from Reliance Standard and Group:

  • A de novo review of the Plaintiff’s claim for long term disability benefits
  • All of the past due long term disability benefits
  • Reinstatement of Plaintiff’s claim to all present and future disability benefits so long as Plaintiff is eligible under the LTD Plan
  • Award of all attorney’s fees and expenses
  • Interest on all past due benefits
  • All other relief that the Court deems to be just and proper 

About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.

Disability Blog & Cases:
Are Independent Medical Evaluation (IME) Providers Really “Independent”?

After being twice denied continued disability benefits, an Addiction Medicine Physician, with the help of his California Disability Attorney, was forced to file a lawsuit against Hartford.


Disability Blog & Cases:
North Carolina Court Determines That Sedgwick Abused Their Discretion And Wrongfully Denied Disability Benefits For BellSouth Employee

A BellSouth Customer Service Assistant, with the help of his North Carolina Disability Attorney, was forced to file a lawsuit against Sedgwick after being denied continued disability benefits.


Disability Blog & Cases:
American Red Cross Worker Sues Reliance Standard Life Insurance Company For Wrongful Termination of Long Term Disability Benefits

In Joanne C. Vs Reliance Standard Life Insurance Company, the Plaintiff seeks the reinstatement of her long term disability benefit payments as defined by the terms of the Plan.


Disability Blog & Cases:
Two Takes on Fibromyalgia

A representative from the American Chronic Pain Association and a Fibromyalgia physician recently appeared on a local news station to discuss Fibromyalgia and methods for treating Fibromyalgia.


Disability Blog & Cases:
Total Knee Replacement, Yet Sedgwick Still Denies AT&T Employee’s Disability Claim

The unreasonable Sedgwick Claims Management disability denial of AT&T employees appears to be a daily occurrence. Recently, it seems as if Sedgwick does not feel the need to comply with ERISA regulations.

In Daniel C. Vs Reliance Standard Life Insurance Company, the Plaintiff has filed a lawsuit with the help of his Ohio Disability Lawyer for the termination of long term disability benefits that were promised under the Plan provided by Plaintiff’s employer, United Dairy Farmers, Inc. (UDF).

History of the Plaintiff

Plaintiff worked at UDF from 1988 to 2006, seven years as a Store Manager, six years as an Area Supervisor, and five years as a Zone Manager for multiple UDF stores. Plaintiff was earning a monthly salary of $5,441.67 when he was unable to continue his work duties due to complications from human immunodeficiency virus disease (HIV).

Plaintiff’s HIV led to his developing Acquired Immune Deficiency Syndrome (AIDS), as well as a related peripheral neuropathy of his lower extremities, which caused pain so severe that it required daily pain treatment with morphine, along with the multiple medications he needed to control his HIV.

Reliance approved Plaintiff’s application for long term disability benefits according to the terms of the Plan in February 2007, with an effective date for benefits of December 18, 2006. In November 2009, Plaintiff was approved for total disability benefits through the Social Security Administration, with an effective date of March 2007. Reliance continued to pay LTD benefits to the Plaintiff through October 24, 2010.

Reliance Cuts Plaintiff Off From Further Long Term Disability Benefits

Via letter dated October 11, 2010, Reliance informed Plaintiff that a review of his medical records determined that he could do work at a sedentary level. Based on this, Reliance terminated future long term disability benefits effective October 24, 2010.

Plaintiff appealed this decision and presented additional records and comment from his primary care physician, a board certified family practice physician and specialist in the treatment of HIV and AIDS. The doctor concluded that the Plaintiff could work no longer than four hours per day. Additionally, his pain from peripheral neuropathy was only moderately controlled by the multiple narcotic medications he took, but these medications also caused added fatigue and concentration problems.

Reliance hired an occupational medicine specialist to perform a file review and independent medical examination of Plaintiff in July 2011. The Reliance IME physician concluded there was not sufficient information in the clinical record to support the plaintiff’s doctor’s peripheral neuropathy diagnosis or to confirm that the Plaintiff was actually taking the prescribed medications that caused his reported side effects. The IME physician stated that the Plaintiff was capable of light demand level, full-time work "if motivated."

As a result, of this review and examination, Reliance rejected Plaintiff’s appeal on August 11, 2011. Due to the exhaustion of all administrative remedies, Plaintiff has filed this lawsuit against Reliance.

Basis of Lawsuit Against Reliance

Plaintiff claims that Reliance unfairly, wrongfully and arbitrarily denied Plaintiff’s claim for long term disability benefits despite the Plaintiff’s submission of medical evidence from his primary care physician, a qualified specialist in his illness, that established that the Plaintiff remains unable to perform the duties of any full-time occupation.

Plaintiff Seeks Following Relief From Reliance

Plaintiff wants the Court to provide the following relief from Reliance:

  • All long term disability payments as defined by the terms of the Plan that have not been paid, along with accrued interest
  • Consequential damages and costs associated with this lawsuit
  • All reasonable attorney’s fees associated with this lawsuit
  • All other relief that the Court finds proper and appropriate

About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.

Disability Blog & Cases:
Texas claimant takes Reliastar to task for denied disability benefits

Suffering from multiple medical conditions and unable to function in a daily job, a health care professional and her Texas disability lawyer filed a lawsuit against Reliastar Life Insurance Company to force the insurer to pay disability benefits as contracted in an employee welfare benefit plan.


Disability Blog & Cases:
Wells Fargo disability claimants in Alabama and Florida file lawsuits against Liberty Life Assurance Company of Boston for unpaid long term disability benefits

Wells Fargo disability claimants in Alabama and Florida file lawsuits against Liberty Life Assurance Company of Boston for unpaid long term disability benefits

Recently, two Wells Fargo employees were forced to file Federal Lawsuist against Liberty Life after being denied disability benefits. Utilizing the services of an Alabama Disability Attorney and a Florida Disability Lawyer, the two lawsuits are currently pending. Let’s take a closer look at both cases:


Disability Blog & Cases:
Tempur employee suffering from chronic fatigue syndrome sues Union Central Life for denial of disability benefits

A federal lawsuit was recently filed in the U.S. District Court in Pennsylvania against the Union Central Life Insurance Company (Union) by a Pennsylvania disability attorney. The Plaintiff, Janet G., worked as a Direct Sales Supervisor for Tempur World, Inc. (Tempur). Due to her employment at Tempur, Janet was provided long-term disability insurance with Union Central.

Two different ERISA lawsuits were recently filed by disability attorneys in California and Florida against Reliance Standard Insurance Company for the wrongful denial of disability benefits.

The First Case

In the first case, the plaintiff, through a California disability attorney filed a lawsuit in the District Court for Eastern California. The plaintiff was employed by Nu Skin Enterprises. While working for Nu Skin Enterprises, the plaintiff participated in Nu Skin’s Long-Term Disability Package to its employees. Reliance was the plan administrator for the disability insurance plan.

The plaintiff applied for Long Term Disability through Reliance on June 1, 2007 due to falling ill and experiencing severe pain in both his hips and knees that kept him from being present at work and being unable to perform the duties of his position for three continuous years. Reliance stated its approval of Plaintiff’s claim for benefits on December 14, 2007. Plaintiff applied for Social Security benefits as required by the Plan and his disability began on June 1, 2007. Plaintiff received a back award of $21,769.68 from the Social Security Administration and made a payment in this same amount to Reliance to meet the terms of the Plan. Plaintiff still receives Social Security Disability Benefits.

On September 29, 2009, Reliance informed Plaintiff that further long-term disability benefits would be denied based on the condition that the Plaintiff was suffering from a mental or nervous disorder. Reliance informed Plaintiff that because he was not in a Hospital or Institution, he could not receive further payments beyond August 30, 2009, 24 months after the first benefits were paid out.

The plaintiff appealed the denial and was issued a final denial by Reliance on October 26, 2010. In the lawsuit, the Plaintiff alleged that Reliance breached the terms of the Plan, which has caused the Plaintiff to suffer currently and to continue suffering in the future.

The Second Case

The second lawsuit was filed at the Middle District Court for the District of Florida by a Florida disability attorney. The plaintiff in this case was an employee for Southern Freight. He was provided with a LTD coverage plan that was fully insured by Reliance. Plaintiff received short-term benefits that ran from January 26, 2010 to April 27, 2010. However, despite continuing to fulfill the definition of "disabled" as defined by the Plan and being backed by the written testimony of his physicians, Reliance denied LTD benefits on July 21, 2010.

Relief Sought in the Lawsuits

In the aforementioned cases, the relief sought by the plaintiffs from Reliance in their lawsuits comprises of:

  • A declaration that the plaintiffs are entitled to LTD benefits under their respective plans
  • Benefits that are due and have not been paid, as well as interest
  • An award of attorney’s fees and costs
  • Any other relief that the court deems just and appropriate

About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.

June 22, 2011 – A recent opinion from the Ninth Circuit United States Court of Appeals has helped clarify the rules as to who you can sue in actions for benefits under a long term disability policy See Cyr v. Reliance Standard & Channel Technologies, 2011 WL 2464440, June 22, 2011. The Court concluded that under appropriate circumstances, an entity other than the plan itself or the plan administrator may be sued under 29 U.S.C. § 1132(a)(1)(B).

Laura Cyr was employed by Channel Technologies, Inc. ("CTI") as a vice president. CTI provided its employees with long term disability benefits under a program insured by defendant Reliance Standard Life Insurance Company ("Reliance"). CTI was the plan administrator, and Reliance effectively controlled the decision whether to honor or deny a claim for benefits. In October 2000, Cyr filed a claim for long term disability benefits based on a back condition. Reliance approved the benefits and based her monthly payment on her salary of $85,000/year.

Ms. Cyr later filed suit against her employer, CTI, alleging gender discrimination. A settlement agreement was eventually reached which awarded Cyr a retroactive salary of $155,000/year. When Cyr asked Reliance to increase her monthly benefit amount in accord with her adjustment in salary, Reliance declined. Cyr was forced to file suit to pursue her claim for the increased benefits.

Cyr filed suit against Reliance, the CTI Group Long Term Disability Benefit Program (the ‘Plan’), and CTI as the plan administrator for the Plan. Reliance moved for summary judgment, arguing that only the plan or plan administrator could be held liable under the statute. Initially, the district court agreed with Reliance, but later the court changed its mind and ruled in favor of Cyr. Cyr was awarded fees, costs and interest on the money owed. In light of this ruling, Reliance appealed.

The issue for the Appellate Court was whether Reliance was a proper defendant in a suit for benefits under 29 U.S.C. § 1132(a)(1)(B) even though it was neither a plan or plan administrator. The Court first noted that neither 29 U.S.C. § 1132(a)(1)(B) nor 29 U.S.C. § 1132 stated any limits about who could be sued. Additionally, the Appellate Court looked to a United States Supreme Court ruling for guidance. In Harris Trust & Savings Bank v. Salomon Smith Barney, Inc., 530 U.S. 238 (2000), the Supreme Court addressed a similar question of who can be sued under a similar statute, 29 U.S.C. § 1132(a)(3). In that case, the Supreme Court noted that 29 U.S.C. § 1132(a)(3) makes no mention at all of which parties may be proper defendants. The Court then ruled that there was no limit in 29 U.S.C. § 1132(a)(3) as to who could be sued.

Similarly, in the case at hand, the Appellate Court felt that because 29 U.S.C. § 1132(a)(1)(B) contained no limitation as to who could be sued, the Court could not read a limitation into the statute. The Court concluded that parties other than plans can be sued for money damages as long as that party’s individual liability is established. The Court looked to related section 29 U.S.C. § 1132(d)(2) which provides that ‘any money judgment under this subsection against an employee benefit plan shall be enforceable only against the plan as an entity and shall not be enforceable against any other person unless liability against such person is established in his individual capacity under this subsection.’

In the case at hand, the Court determined that Reliance, as plan insurer who is responsible for paying legitimate benefits claims, is a logical and proper defendant for Cyr to recover benefits due, along with the plan and the plan administrator. The Court denied Reliance’s appeal.

About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.