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Bachrach, Austin and Sweeney Prevail on Behalf of Plan against Doctor’s Disability Claim

February 23, 2021

Joshua Bachrach (Partner-Philadelphia, PA), Heather Austin (Partner-Philadelphia, PA) and Scott Sweeney (Of Counsel-Denver, CO) prevailed in an ERISA disability lawsuit brought by a surgeon in New Mexico against a disability plan insured by the client. The plaintiff stopped working and entered a substance abuse facility, and even after his discharge 30 days later, continued to suffer from anxiety and psychoses. To receive benefits, the plaintiff had to prove that he remained continuously disabled throughout an Elimination Period, but the plan concluded that he was able to return to work earlier. On the merits, the court concluded that  the evidence did not support the doctor’s claim that he was still incapacitated at the end of the Elimination Period. Based on the preponderance of evidence, the court concluded that he was not entitled to disability benefits under the plan and entered judgment for the defendant.

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