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Claim Decision Reversed; Not The Result Of Deliberative, Principled Reasoning Process

Tuesday, September 15th, 2009

A Court in Michigan has reversed the denial of a disability claim under ERISA, where the administrator failed to engage in a full and fair review, largely because it based its decision upon the conclusory evaluations of its hired doctors. These hired doctors simply rejected the opinions of the treating physicians, and the administrator simply adopted those conclusions, despite extensive evidence in the record supporting impairment.

The Court reconciled the Supreme Court’s holding in Black and Decker v. Nord, and found that the administrator simply failed to fully address any contrary evidence without meaningful explanation. The selective review of records furthered the Court’s concerns about the lack of a full and fair review. Unfortunately, the Court remanded the claim to the administrator for further consideration.

Dockery v. USG Corp. Retirement Plan (E.D. Mich. 2009)

Justin C Frankel

Written By:

Justin C. Frankel - Disability Insurance Attorney

Justin Frankel is a founding partner of the disability insurance law firm Frankel & Newfield and is a highly skilled litigator and advocate. He has published numerous articles on the challenges facing clients with private or individual disability insurance policies and those who own group or ERISA disability insurance policies.

Learn more about Justin | See Justin’s Publications

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