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Court Finds Decision Arbitrary And Capricious

Wednesday, December 23rd, 2009

Despite acknowledging that the abuse of discretion standard of review is quite deferential to plan administrators, a court has determined that Harvard’s termination of benefits was an abuse of discretion. The Court found the administrator improperly rejected the panoply of supporting physicians, and that the only medical opinions that were unfavorable to the claimant were those procured by the administrator. The Court also was troubled by the failure to consider both Social Security and Workers’ Compensation awards.

In language that can be offered to other Courts throughout the country, the Judge stated that while “plaintiffs seldom if ever prevail when the standard [abuse of discretion] is applied. But seldom if ever cannot mean never at all, or the promise made to claimants that federal courts will review their benefits decisions for abuses of discretion would be a cruel and illusory exercise.” McGahey v. Harvard University

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