We are finishing up our discussion of an 8th Circuit case that highlights the complexities of insurance companies' benefits decisions. Each decision is based on the opinions of a number of professionals, including the treating physician(s). The plan in this case defined two long-term disability benefit periods: In the first 24 months, the claimant cannot perform his own job; after that, he cannot perform any job.
The insurance company denied benefits after the first 24 months. The claimant's treating physician had said he was unable to work at any job, but the insurance company's reviewing physician thought otherwise. The reviewing doctor's opinion, however, was based in part on a misreading of the record. The claimant appealed.





