In a recent Long-Term Disability case brought to Minnesota District Court by Blake Bauer, Principal Attorney with Fields Law, the court decided in favor of the plaintiff and awarded our client backpay and on-going Long Term Disability benefits. Reliance Standard then filed an appeal, and the case was heard by the 8th U.S. Circuit Court of Appeals.
At issue was the denial of benefits based on the 24-month mental health limitation in the policy. Typically, if a claimant suffers from mental health issues, the benefits are only paid for 24 months. However, our client also suffered from physical disabilities due to a Lyme Disease diagnosis several years earlier.
Bauer argued that under the “but-for” standard, her benefits would be approved. The court agreed that if her “physical disability was independently sufficient to render [her] totally disabled, [her] eligibility for benefits would not terminate after twenty-four months because [she] also suffered from a mental condition.”
A History of Denials and Appeals
Ms. Weyer, a client of Fields Law who suffered from Lyme Disease, Chronic Fatigue Syndrome, Colitis, anxiety and depression, was not a stranger to the insurance company denying her benefits. Fields Law had previously appealed and won benefits for her twice after the insurance company had sent letters stating they did not find she met the policy’s definition of Total Disability.
When they denied her claim a third time, the appeals were unsuccessful and ultimately went to lawsuit where our attorneys won. However, the insurance company appealed the decision, and we ultimately won with the precedent setting appellate court decision.
Ironically, while the insurance paid for the period they owed following the appellate court decision, they denied her claim again shortly after, stating that the records submitted while the case was being appealed failed to show she now meets the “definition of disability” and she is capable of sedentary work such as Social Group Worker, Psychiatric Social Worker, Caseworker-Family, Eligibility Worker, or Residence Supervisor.
Protecting Your Long Term Disability Benefits
While the binding precedent was set as the “but-for” standard in Minnesota and five other states in the district, it has already been adopted by various circuits, including the Second, Fourth, Seventh, Ninth, and Eleventh Circuits.
To prove disability discrimination using the new precedent, an employee must show that their disability was the reason why they were terminated or demoted, and if they did not have the disability, there would not have been an adverse action.
To support your case, it is important to follow these guidelines:
- Ask your physician to provide work restrictions based on physical vs. mental conditions.
- Gather medical evidence that show how your physical conditions restrict your ability to perform work tasks.
- Keep a symptom diary of how your physical conditions alone are disabling.
- Work with an attorney to ensure your records are complete and deadlines are not missed.
If you are concerned that your benefits may be denied due to mental health limitations in your policy, schedule a free consultation with our Long Term Disability lawyers.
