A federal court in Kansas held that UNUM was arbitrary and capricious to deny benefits based on a policy exclusion that the claimant’s (“Kathy”) fibromyalgia was a self-reported condition. Last week the court agreed to vacate the record of its decision against UNUM that it had improperly discontinued Kathy’s long-term disability benefits in violation of the Employee Retirement Income Security Act (ERISA). The record of the decision was vacated because UNUM made it a condition of settling with Kathy in lieu of continuing its appeal.
Even though the decision that UNUM acted arbitrarily in this ERISA case was based, as it must be, on specific evidence in the record, mere factual differences do not necessarily mean that the decision will not be useful to someone in the future. “Because UNUM presumably has many disability policies outstanding with precisely the same provision concerning self-reported limitations, it may be important to UNUM that others not become aware of how that limitation has been construed in this case”, the court reasoned.
Despite public policy reasons against erasing the record of UNUM’s ERISA violation, the court reluctantly concluded that this case involved exceptional circumstances. Equitable principles justified vacatur after considering the length of time that Kathy had been attempting to collect her disability benefits, her age, her medical condition, and the additional delay that a continued appeal would cause. In a parting shot, the court stated that, [w]hether the vacatur gives UNUM what it really desires-to have the court’s opinion disappear entirely-remains to be seen, depending upon whether, or to what extent the opinion is removed from the Westlaw database.”
The good news is that the court removed only the record of the decision which did not interfere with Kathy keeping her settlement.
Alan Olson writes this web-log to provide helpful information regarding long-term disability cases. He practices long-term disability law throughout the United States from his offices in New Berlin, Wisconsin. Attorney Olson may be contacted at [email protected] with questions about the information posted here or for advice on specific disability benefit claims.
