The Wagner Law Group Legal Blog

The Ninth Circuit Court of Appeals, in Wallace v. Hartford Life, has upheld a lower court’s determination that a Long-Term Disability (“LTD”) plan’s benefit denial was appropriate despite a clear structural conflict of interest presented in the case by the plan’s...

The IRS, in Notice 2026-6, has issued a one year extension of the transition period provided in Revenue Ruling 2025-4 for states and employers administering paid family and medical leave (“PFML”) programs with respect to medical leave benefits a state pays to an...

The U.S. Court of Appeals for the Eleventh Circuit, in Johnson v Reliance Standard, overruled an insurer’s interpretation of its own preexisting condition exclusion, stating that the interpretation was unreasonable. Facts.  An employee enrolled in long term disability...

In Advisory Opinion 2025-02, the Department of Labor (“DOL”) has determined that the California Association of Professional Firefighters (“CAPF”) Long Term Disability (“LTD”) Plan is not an ERISA-covered employee welfare benefit plan because it is not established and...

The U.S. Court of Appeals for the Seventh Circuit, in Scanlon v. Life Insurance Company of North America, has ruled that a court must fully consider the nature and the duties of a claimant’s job in a Long-Term Disability (“LTD”) benefits dispute. Facts.  An employee...

In Higgins vs. Lincoln Electric Company, Inc., the U.S. Court of Appeals for the Sixth Circuit placed a high burden on a plan participant who claimed that his employer was “estopped” (i.e., prevented) from relying on the terms of an unambiguous plan document that had...

In Witt v. Intel Corp. Long-Term Disability Plan, the United States District Court for the District of Oregon refused to dismiss a long term disability (”LTD”) benefits lawsuit when the plan seemingly made a minor mistake in administering its claims procedure....

In Weyer v. Reliance Standard Life Insurance Company, the U.S. Court of Appeals for the Eighth Circuit has determined that the “but-for” causation standard is appropriate for determining whether mental health limitations contained in a long-term disability (“LTD”)...

In Harmon v Unum Life, the U.S. Court of Appeals for the Sixth Circuit has ruled that an insurer may rely on its own medical advisors in denying long term disability (“LTD”) benefits, as long as the advisors took into account the opinions of the participant’s own...

In Aisenberg v. Reliance Standard Life Ins. Co., the United States District Court for the Eastern District of Virginia has ruled that a long term disability (“LTD”) plan must take into account potential future harm from continued employment when making an LTD benefits...

In Steigleman v. Symetra Life, the U.S. District Court for the District of Arizona has ruled that a small business owner could not sue an insurance company under state law for long term disability (“LTD”) benefits because ERISA preempts the state law. Law. An employee...

The U.S. District Court for the Southern District of Florida has ruled, in Delucca v. The Guardian Life Insurance Company of America, that a long term disability (“LTD”) plan was not bound by prior determinations that a plan participant was totally disabled....

In Laake v. Benefits Committee, Western & Southern Financial Group Co., the U.S. Court of Appeals for the Sixth Circuit determined that the de novo standard of review applies where an employer’s long-term disability (“LTD”) plan ignores plan provisions by allowing...

Ninth Circuit Court of Appeals has ruled, in Steigleman vs. Symetra Life, that neither an employer nor its trade association created an ERISA-covered plan merely because the employer paid for long term disability (“LTD”) coverage or because the association chose the...