Justia Lawyer Rating
American Association for Justice
Indiana Trial Lawyers Association
IFCD
indybar
Super Lawyers
Badge

Long term disability benefits wrongfully denied

Hartford Life's decision to terminate Gessling's disability benefits was arbitrary and capricious. In many ERISA cases where plans have acted improperly to deny benefits, a remand for further consideration is the appropriate remedy, but where the plaintiff was actually receiving disability benefits that were improperly terminated, as they were here, the Seventh Circuit directs that the more appropriate remedy is reinstatement of benefits that were being paid before the improper denial. See Hackett, 315 F.3d at 775-76 (reversing grant of summary judgment for plan and ordering reinstatement of benefits that were improperly terminated); see also Halpin v. W. W. Grainger, 962 F.2d 685, 967 (7th Cir. 1992) (affirming reinstatement of benefits that were improperly terminated). "The distinction focuses on what is required in each case to fully remedy the defective procedures given the status quo prior to the denial or termination. Hackett, 315 F.3d at 776. And here, as in Hackett, "the status quo prior to the defective procedure was the continuation of benefits. Remedying the defective procedures requires a reinstatement of benefits." Id., accord, Schneider v. Sentry Group Long Term Disability Plan, 422 F.3d 621, 630 (7th Cir. 2005) (finding that where benefits had been terminated by improper procedures, the "appropriate remedy is an order vacating the termination of her benefits" and directing the plan to "reinstate retroactively the benefits").

Accordingly, Gessling is entitled to retroactive payment of his benefits, with interest, for the remainder of the "own occupation" period, and the court remands the matter to the plan and its administrator to determine whether Gessling was disabled from working in "any occupation" within the meaning of the policy after the "own occupation" period expired. No later than March 30th (14 days), the parties shall submit either one joint or two separate calculations of the principal and interest due as of March 31, 2010. The court will then enter final judgment accordingly.

Read the original case document

Indiana Long Term Disability Lawyer Blog - Long term disability denial
Client Reviews
★★★★★
I can't thank you enough at The O'Ryan Law Firm for all you have done for me! I had questions and was really in a bind when I first started out but you took over and won my case! All of your valuable time and efforts were so appreciated! May God truly bless you and your business! Thanks for all of the encouragement and also doing your job in the most timely fashion! Truly the BEST LAW FIRM ANYWHERE!!! Denise
★★★★★
Thanks again for all your help with my eye sight case. Please feel free to use me as a reference for any of your potential clients who want to know if you are qualified or experienced in vision impairment cases like mine. I do read for a living and I really appreciate everything you did to help me recover the money my insurance company did not want to pay. You are definitely familiar with my vision impairment and how it disabled me for many months. Thanks again. You did a GREAT JOB. Best Regards, Mike D
★★★★★
I am so incredibly thankful for your hard work and expertise on my case. This means so much to me, I started crying when I read your email. The settlement guarantees that I will be able to stay in my home with my son and not have to worry about moving back in with my parents in Illinois. This illness has, over the last several years, taken away nearly everything that was important to me, and my son was about all I had left. Knowing that I can stay in my home and continue to be a part of his daily life leaves me speechless with gratitude for you and your firm. Matthew K