Insurance companies generally have the law on their side when it comes to termination for benefits in disability cases governed by a federal statute known as ERISA. Despite this, disability insurance company Liberty recently lost a case before an Illinois court. In Aberg v. Liberty Life Assurance Company of Boston the court not only disagreed with Liberty’s termination for benefits, but it also found that the decision was unreasonable.
Aberg mainly suffered from severe, chronic back pain resulting from two separate horseback riding accidents. Liberty approved Aberg’s short term and long term disability claims and began paying benefits. Just one month after approving long term disability benefits, Liberty hired its own doctor to review Aberg’s claim again and write an opinion on disability.
Looking at the same medical records used to approve disability benefits only a few weeks prior, Liberty’s doctor found that while Aberg had some limitations due to her back pain, she was not disabled from working. Liberty used its doctor’s opinion to terminate benefits for chronic pain.
The Illinois court found that Liberty’s doctor ignored parts of the medical record that supported its original decision that Aberg was totally disabled. All of Aberg’s doctors had agreed she was disabled. In fact, they had told Liberty many times in writing that Aberg was “totally incapacitated” and had “no ability” to return to work due to “marked pain”. The court also found that the medical records Liberty based its termination on did not reasonably support an opinion that Aberg could return to full-time work. Liberty also failed to offer any reasoned explanation for refusing to consider Aberg’s doctors’ opinions and for changing its prior decision to award her disability benefits. Liberty was ordered by the court to pay Aberg past disability benefits due, plus interest, as well as her attorney’s fees and costs.
ERISA is a complicated area of the law, where insurance companies have the deck stacked in their favor. For this reason, it is important to hire a seasoned long term disability attorney to handle your ERISA disability claim.
