Joshua Bachrach (Partner-Philadelphia, PA) and Angela Heim (Of Counsel-Philadelphia, PA) secured full dismissal of the claims against Wilson Elser’s client in a lawsuit seeking long term disability benefits and attorney’s fees under an ERISA-governed plan filed in the District of Maine. The plaintiff submitted a claim for benefits after she fell down a flight of stairs in her home. The fall resulted in a fractured spine of the neck and injuries to her shoulder and back. She later returned to work part-time and then full-time for two days before being terminated. The disability claim was approved only through the date she returned to full-time work. She then filed the lawsuit seeking additional disability benefits.
 
On referral, the Magistrate Judge filed a Report and Recommendation in favor of the defendant. The plaintiff filed timely Objections to the Recommendation which were considered but rejected by the District Judge. First, the court rejected the plaintiff’s argument that our client failed to adequately consider her mental health condition as a basis for the claim because this was not identified in her application and she did not identify any treatment for it. The court also agreed with the defendant that the neck pain for which plaintiff underwent surgery after the claim was denied was not a continuation of her earlier neck pain. The court cited to a medical record which stated that her more recent pain began one month earlier, placing the onset of her more recent pain after the claim denial. Finally, the court concluded that the plan/client properly reviewed the duties of the plaintiff’s regular occupation and concluded that she could perform all of them – as she did prior to being terminated. As a result, judgment was entered for defendant.