The overwhelming majority of ERISA governed, employer provided disability insurance policies contain a 24 month limitation on benefits due to disabilities caused by a Mental Health condition. Although the language and extent of the limitations can vary depending on the insurance carrier there will almost always be some limitation written in your policy. Despite efforts by insureds and lawyers to challenge these limitations under the American with Disabilities Acts, Courts throughout the country have deemed them enforceable. However, a recent federal court opinion in Montana may have opened the door as to how to effectively challenge these limitations.
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A federal court in Pennsylvania recently gave the plaintiff somewhat of a victory by reversing a decision of Liberty Mutual Life Assurance Co. of Boston. According to the court ruling, Liberty acted arbitrarily and capriciously in denying the claimant’s application for long term disability benefits. Liberty used the wrong definition for the plaintiff’s “own job.”

Unfortunately, this is somewhat of a common tactic used by disability insurers to deny claimant’s benefits. It is a manipulative technique that claimants do not always notice. Without an attorney to help, claimants may not realize the wrong definition is being used. They go forward with their administrative appeals and even litigation while overlooking this important part of their claim.
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In a recent ruling from the United States District Court District for the Western District of Michigan, a Judge ruled that Liberty Life Assurance Company of Boston was wrong in denying continued Long Term Disability Benefits to Michelle R. Rouleau.

Facts of the Case

Ms. Michelle R. Rouleau previously worked as a registered nurse for Sparrow Hospital in Michigan. She was forced to stop working in June of 2012 due to intractable back pain. Prior to her claim, Ms. Rouleau had a long history of treatment which included times of relief and times of experiencing more pain. After years of treatment including epidural injections and bilateral facet block, a lumbar fusion surgery was finally performed in June of 2012. Following the surgery, Ms. Rouleau had planned to return to work within 10 weeks. After initially feeling relief in the first few weeks after surgery, by August of 2012 Ms. Rouleau’s pain level had increased and long term disability benefits were applied for and approved in September of 2012.
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The Plaintiff has filed this lawsuit against Liberty Life Assurance Company of Boston (Liberty) in Massachusetts Federal Court for the improper denial of short-term and long-term disability benefits.

These benefits were to be provided under the terms of a Plan that the Plaintiff was eligible for due to her employment with Beth Israel Deaconess Medical Center.

In Cindy M. vs. Liberty Life Assurance Company of Boston, Plaintiff is seeking $33,600 in unpaid disability payments, along with accrued interest and future disability payments as she is entitled to receive under the terms of the Plan.
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Like countless other lawsuits against Liberty Life, Five Plaintiffs have recently sued Liberty Life Assurance Company Of Boston (Liberty) for the wrongful termination of the long-term disability benefits. In all five cases that were filed by the Plaintiffs, Liberty is accused of denying long-term disability benefits in violation of the terms and conditions laid out in the Plaintiffs’ respective Policies.
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