News Brief

Bachrach and Austin Win Appeal in ERISA Long Term Disability Case

February 13, 2018

Joshua Bachrach (Partner- Philadelphia) and Heather Austin (Of Counsel – Philadelphia) successfully defended an insurer client in an appeal before the Third Circuit. The District Court for the Middle District of Pennsylvania concluded that the discontinuation of LTD benefits after 24 months was not arbitrary and capricious. On appeal, the Third Circuit rejected the plaintiff’s arguments. The claimant first argued that the plan’s mental/nervous disorders limitation should not apply because her claim did not originally involve such a condition. The court stated that her "static interpretation" of the limitation was inconsistent with the policy language. She then argued that because her condition was a "qualifying disability" under the 24-month limit for musculoskeletal disorders (i.e., benefits that can be claimed beyond 24 months), she was automatically entitled to benefits. The court again disagreed, stating that it only meant that the condition would be treated "the same as any Total Disability." In other words, she still had to prove a disability and she failed to do so. Therefore, the judgment was affirmed.

View more News Briefs