Hogan v. Jacobson et al., is case where, after plaintiff Violet Hogan lost her lawsuit for disability benefits against Life Insurance Company of North America (LINA) in federal court, she filed a lawsuit in state court against two of LINA’s nurses. In her attempt to avoid any reference to her previously unsuccessful lawsuit brought under the Employment Retirement Income Security Act (ERISA), she filed suit in state court and “artfully pleaded” a case for negligence per se against LINA nurses Jo Ellen Jacobson and Kem Alan Lockhart. Hogan claimed the two nurses gave medical advice without being properly licensed in Kentucky. The defendants removed the case to federal court. Hogan objected and moved for the case to be remanded to state court. Her motion was denied, her lawsuit dismissed, and this appeal followed.

Hogan tried to avoid in her pleadings any mention of her previous LINA case, Hogan I. The federal court caught on to the connection: LINA’s Plan Administrator had relied on the advice of the two nurses in making the decision to deny Hogan disability benefits. The court noted, “Her careful pleading does not change the fact that this relationship arises solely from an ERISA benefits plan.” The federal appellate court upheld the district court’s denial of Hogan’s request to remand the case to state court and dismissal of the action “Because Hogan’s artfully pleaded state-law claims are, at the bottom, claims for the wrongful denial of benefits under an ERISA plan that arise solely from the relationship created by that ERISA plan, we AFFIRM the denial of Hogan’s motion to remand.”

Hogan’s Claim Against the Nurses Was Preempted by ERISA and the Proper Defendant Was the Plan Administrator

Hogan’s only connection to the defendants was their role in recommending Hogan’s claim for disability benefits be denied in Hogan I. So, no matter what label she put on her claim, it was “in essence,” a claim for “an ERISA plan benefit.” The court held “that Hogan’s claim is a claim for ERISA benefits because the negligent it alleges, though carefully veiled, is the negligent processing and denial of her claim for ERISA benefits, which, Hogan’s protestations aside, arose solely from the ERISA plan.” As such, is was preempted by ERISA and “the proper defendant in an ERISA action concerning benefits is the plan administrator.”

The Decision in the ERISA Lawsuit is Res Judicata against Hogan’s Current Claim

This claim meets all four prongs of res judicata which prevents the relitigation of issues that have already been decided. Since the nurses were in privity with LINA in the prior action, and a final decision had already been entered in the previous case, further litigation was barred.

The Defendants Are Not Entitled to Sanctions Because Hogan’s Claim Was Not Frivolous

The defendants requested sanctions, arguing that Hogan’s claim was frivolous because of her careful attempts to avoid any reference to or discussion of Hogan I, and the fact that her counsel had tried this same type of pleading in other cases and lost. The court disagreed, holding that this was the first case that had made it to the appellate level, and that the court would not penalize Hogan’s counsel who “appears to have come up with a novel legal theory.”

This case was not handled by our office, but we think it can be instructive to those considering filing a state lawsuit after they have lost their ERISA lawsuit for disability benefits. If you have questions about this or a similar matter, or about any aspect of your disability claim, feel free to contact one of our attorneys for a free consultation.