Retirement – ERISA – Long-Term Disability Benefit Denial

Listen to this article

Where a plaintiff has brought suit under the Employee Retirement Income Security Act challenging a defendant administrator’s denial of the plaintiff’s request for long-term disability benefits, the denial was not arbitrary and capricious and should therefore be upheld.

“The defendant has moved for summary judgment in its favor. … I am satisfied that the motion ought to be allowed substantially for the reasons set forth in the defendant’s memorandum. In particular, I conclude: (1) that the plan confers discretion on the administrator to resolve disputed issues with respect to a claim, including, for pertinent example, whether the claimant is totally disabled under the plan’s standard, and that, accordingly, the defendant’s denial should be judged by whether it was ‘arbitrary and capricious’ or not; (2) that on the record considered by the defendant, the denial of benefits was not arbitrary and capricious, and consequently not wrongful under ERISA; and (3) that even if the denial should be reviewed by me de novo, the plaintiff has not offered evidence that would lead me to conclude that she qualified for benefits under the plan and, if I were making the determination anew, I would conclude that she did not qualify and that her claim for benefits ought to be denied.”

Reid v. Teachers Insurance and Annuity Association of America (Lawyers Weekly No. 02-162-98) (3 pages) (O’Toole, J.) (Civil Action No. 96-12462-GAO).