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Vermont Federal Court Makes ING / Reliastar Reevaluate its Denial of LTD Benefit Under Any Occupation Definition

Attorney Gregory DellAuthor: Attorney Gregory Dell

The Federal District Court in Vermont noted that there was no question that the plaintiff suffered from “degenerative disc disease resulting in significant pain.” Since the denial of long term disability benefits under the “any occupation” definition of disability was based only on a subjective conclusion without any discussion of the physical requirements of “any occupation,” the case was remanded to ING / ReliaStar for reevaluation.

Although the law firm of Dell & Schaefer Chartered did not represent the plaintiff in this matter, we felt that it was important to bring this case to the attention of those who may be insured by ReliaStar as an example of the hurdles they may need to jump over in order to collect their long term disability benefits.

The case of Mead v. ReliaStar Life Insurance Company demonstrates the commitment of ING / ReliaStar to deny its claimant long term disability benefits and the tenacity of the claimant, Susan Mead, in continuing to fight for them. The case has been in the court system for more than 10 years making life even more difficult for this claimant who, according to the district court there is no doubt that she “suffers from degenerative disc disease resulting in significant pain, and that her pain limits her ability to sit for extended periods of time. Various medical treatments, including epidurals and nerve blocks, have provided only limited relief.”

Mead’s quest began in 2003 when she first applied for long term disability benefits due to degenerative disc disease and fibromyalgia. It took two trips to the Vermont district court before the court ruled in 2010 that she was entitled to long term disability benefits based on the disability definition of being unable to work in her “own occupation.”

After exhausting those benefits, Mead applied for long term disability benefits under the provision of the policy that provided benefits if she could not work at “any occupation.” ING / ReliaStar denied this application and, once again, she found herself wending her way through ERISA administrative appeals and having her claim denied. Mead then filed her third ERISA lawsuit in the Vermont federal district court.

In evaluating her claim, the court specifically noted that, according to the plan, “Mead must show by a preponderance of evidence that she was ‘unable to work at any occupation [she had] or could reasonably become qualified to do by education, training or experience.'” According to the court, in denying her claim, ReliaStar had abused its discretion by:

  • Failing to give credence to her own complaints of pain.
  • Relying on only one reviewer who had not examined Mead, and who relied only on the opinions of non-treating physicians who concluded she was not disabled. There was no reference to the opinions of those who supported her claim. Particularly missing was any reference to a doctor whom the district court relied on in its previous decision awarding benefits under the “own occupation” disability provision.
  • Failing to provide any discussion of the “physical requirements of any occupation.”
  • Ignoring the district court’s previous opinion upholding her claim for disability under the definition of not being able to work in her “own occupation.”

In its remand order, the Federal court stated that the denial of benefits “determination is highly conclusory, and despite an expansive record, citing only one, non-examining reviewer by name. No obvious credence is given to Mead’s subjective statements of pain, to contrary medical reviews, or to this Court’s previous findings with regard to Mead’s limitations. Because the latest determination is cursory at best, this matter must once again be remanded for a more thorough analysis.”

Despite more than 10 year of battling ING both in and out of the courts, it appears her battle will continue as she once again waits for ING to determine if they think she is disabled. The amount of time involved in litigating this case is not the norm and it is sad that ING continues to deny benefits to Ms. Mead.

If you have questions regarding your claim for disability benefits or need help pursuing your claim, contact Disability Attorneys Dell & Schaefer for a free consultation.



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