Beth Jordan challenged the decision of a lower court that favored Reliance Standard Life Insurance Company in a case about her long-term disability benefits from August 2, 2016, to September 18, 2017.
The Sixth Circuit Court of Appeals, disagreed with the lower court and sent the case back, telling them to grant Jordan her long-term disability benefits.
This is a great one to listen to as Reliance Standard gets hammered for its improper termination of long-term disability benefits.
Reliance Standard had been paying Jordan long-term disability benefits since July 2009 because she couldn’t work as a nurse anesthetist due to Lyme disease. However, in 2015, they stopped her benefits just before a policy change in how disability was defined. Jordan challenged this decision. When Reliance Standard didn’t respond in time to her appeal, Jordan took the matter to court. The court initially told Jordan she should have completed all the required steps with Reliance Standard before going to court. Reliance Standard then asked Jordan to have an independent medical exam. By February 2018, when this happened, Jordan was already back at work. After the exam, Reliance Standard agreed to pay her benefits only up to August 1, 2016, and refused to pay after that, even though she didn’t start working again until September 2017 and had been treated for breast cancer.
When Jordan took her case to court a second time, the lower court found that Reliance Standard didn’t properly consider Jordan’s and her doctor’s views and the reviews they relied on weren’t good enough. The court sent the case back to Reliance Standard to give better reasons for their decision and to properly consider Jordan’s situation. However, Reliance Standard didn’t change its decision, and this time the lower court agreed with them.
But, when Jordan appealed again, the Sixth Circuit Court found that Reliance Standard’s reasons for denying benefits weren’t backed up by strong medical evidence and they didn’t make their decision fairly. The court said Reliance Standard didn’t pay enough attention to Jordan’s doctor and relied too much on their own doctors, whose opinions weren’t trustworthy. The court also found it wrong that Reliance Standard didn’t share Jordan’s doctor’s letter, which disagreed with their views, with their reviewers. The court didn’t accept Reliance Standard’s use of surveillance from 2015, as the dispute was about a period after August 2016, and they kept paying Jordan even after the surveillance. The court believed Jordan’s doctor proved she deserved the benefits. Instead of sending the case back to Reliance Standard again, the court decided that Jordan should win the case.
Why this case is important to claimants.
Insurance companies often have a “bank” of “experts” who review medical records. These doctors are often not specialists in the claimant’s disease and this comes through loud and clear in this case.
This case demonstrates how important it is to have an experienced long-term disability attorney involved in the case, as the claimant did here.
Ben Glass leads the long term disability department at BenGlassLaw and has been representing claimants in claim denials and lawsuits for over twenty five years.
Listen to Ben Glass Argue Long-Term Disability Cases in Court. Want to hear Ben work before you hire the BenGlassLaw Disability Team? You can listen to Ben Glass at work in long-term disability cases here.
