Free Consultation 877.583.2524
We do not handle social security disability claims
logo celebrating

Nationwide Leaders in Disability Insurance Law

shook hands

FEDERAL COURT FINDS CUNA MUTUAL ABUSED ITS DISCRETION ON LONG TERM DISABILITY CLAIM HANDLING

Wednesday, March 16th, 2016

A Federal Judge in Wisconsin has determined that CUNA Mutual acted arbitrarily and capriciously in denying a claim for long term disability insurance benefits to a claimant suffering from orthopedic problems, including lumbar radiculopathy, degenerative disc disease, and chronic pain. The claimant worked for CUNA Mutual and was seeking benefits under its own Long Term Disability insurance plan.

The Court determined that CUNA Mutual abused its discretion in its handling of the claim, by engaging in conduct which was considered to be arbitrary and capricious. This included the selective review of various medical records, as well as relying upon medical reports that failed to provide any reasoned explanation for not agreeing with the medical support provided by the treating medical providers, and by creating a “moving target” for what documentation would suffice to support the claim and then changing the requirements.

The claimant also argued, unsuccessfully, that it was improper to rely upon the same medical provider’s review for both levels of appeal. The Court did not have an issue with this conduct, but did take issue with the substance of the medical review. While the Court noted that CUNA Mutual was not required to adopt the opinions of the claimant’s doctors, the Court also noted that it was improper to fail to explain why it rejected outright the support offered by the claimant’s doctors. The Court noted that “bare conclusions are not a rationale” in finding problematic the medical review relied upon by CUNA Mutual.

The Court therefore remanded the action for a further, more appropriate review, and permitted Plaintiff to move for his attorneys’ fees and costs.

Clark v. CUNA Mutual

Categories

Archives

Ready To Talk?

Fill out the form to request a FREE legal consultation

Sorry, we do not handle SSDI/Social Security claims.

Frankel & Newfield does not currently handle any Social Security Disability Insurance claims.

CLOSE

*Required fields are marked

I have read the disclaimer.

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

CLOSE

This is about a Social Security Disability claim.

Ipad image

Download Our Free eBook

FILING A DISABILITY INSURANCE CLAIM

Secrets the Disability Insurance Companies Don't Want You to know! Download Now

HELPING THE DISABLED NATIONWIDE

No matter where you are nationwide, we are here to help.

We have the resources and support to take on the largest insurance companies.

Contact us today for our nationwide service.

CHAT
NOW