Life Insurance Company of North America (LINA)

The plaintiff, Heath Evans, was employed by Schlumberger Technology Corporation. Evans worked as a wireline operator, a role the Department of Labor classified as requiring very heavy physical labor. Evans suffered a workplace injury to his back in November 2013, leading to significant back pain and functional limitations. He underwent two surgeries, one in 2014 …

Evans v. LINA – LINA Denies Disability Benefits To Wireline Operator With Severe Back PainRead More

In this case, the Court found that the Plaintiff’s complaints of pain were credible there was no reason to question the Plaintiff’s credibility. As such, the Defendants’ motion for decision was denied and Plaintiff’s motions was granted.

Brown v. LINA – Can A Peer Review Doctor Outweigh My Doctor’s Opinion?Read More

Ms. Harrison was a claimant who worked as a customer service representative for a cash advance lender. Her duties included selling financial products to customers, providing customer service, handling money, and overseeing financial transactions. She also suffered from depression and anxiety during her time at this place of employment. Ms. Harrison had suffered for many years from depression and …

Harrison v. LINA – Claim Denied Based On Pre-Existing Condition ExclusionRead More

In this case, the medical reports in the administrative record were not sufficient to show by a preponderance of the evidence that Shaw was unable to perform the material duties of her regular occupation. The only reports that supported her claim were conclusory, and provide insufficient information concerning Shaw’s functional capacity.

Shaw v. LINA – Plaintiff Refused To Follow Recommended Treatment PlanRead More

Defendant informed Plaintiff that her claim for LTD benefits was denied because the medical information provided did not support restrictions and limitations and did not demonstrate a functional loss. The plaintiff argued that she was not required to submit objective medical evidence to prove her disability.

Graham v. LINA – Court Rules LINA Must Review Claim Under “Medium-Occupation” StandardRead More

The Court held that Life Insurance considered all relevant information, including Abbey’s treatment notes, treatment notes from Plaintiff’s treaters at Philhaven, and the notes from the board-certified psychiatrist based on his peer review of Plaintiff’s medical records. The Court concluded that in light of the foregoing thorough review and subsequent basis for its denial, Life Insurance’s decision to deny long-term disability benefits to Plaintiff was not without reason and did not meet the required arbitrary and capricious standard. The Court further held that Life Insurance did not engage in any action violating Section 503 of ERISA and that Plaintiff did not have a separate, private cause of action for attorney’s fees and litigation costs.

Gailey v. LINA – Court Upholds Long-Term Disability Claim DenialRead More

In this case, the court ruled that the conclusion by the peer review consultant was without reason when the evidence of record was examined. Thus, defendant acted arbitrarily and capriciously when relying on the peer review report to deny benefits.

Esbensen v. LINA – Defendant Acted Arbitrarily And CapriciouslyRead More

Here, Chernequa Dawson (“Dawson”) worked as a Care Transition Coordination (“CTC”) Nurse Care Manager and was employed by Cigna Corporation (“Cigna”). Through her employment with Cigna, she was covered under both a short-term and long-term disability plan. For these plans, Cigna pays the short-term disability plan benefits, while Life Insurance Company of North America (“LINA”) pays for long-term …

Dawson v. LINA – Court Rules Plaintiff Didn’t Provide Enough Objective EvidenceRead More

Because the record establishes that LINA acted arbitrarily and capriciously in denying Calhoun long-term disability benefits, the Sixth Circuit REVERSED the district court’s judgment and REMANDED this case to the district court.

Calhoun v. LINA – LINA Acted Arbitrarily And Capriciously In Denying ClaimRead More