In this video Marc Whitehead, a Board Certified Disability Attorney, explains how the Supreme Court case MetLife v. Gleen is so important to disabled claimants. Metropolitan Life v. Glenn is about a Sear employee, Wonda Gleen who suffered from a disabling hear condition in 2000. Glenn applied for Long Term Disability benefits under her Sears employee benefits plan through MetLife. MetLife had both the discretionary authority to determine whether Glenn’s case was valid and acted as payer of benefits. MetLife Initially determined that Glenn couldn’t perform the duties of her own job and she was granted a 24 month disability benefit. MetLife also instructed Glenn to apply for Social Security Disability Benefits. In 2002 Glenn was found, by the Social Security Administration (SSA), to not only be disabled from doing her own job but also from doing any job for which she was reasonably qualified. Glenn was awarded permanent disability payments by the SSA for her disability claim with back due benefits from April of 2000. 3/4th of the Social Security benefits went to MetLife as an offset to their payments rather than to Glenn, the rest went to Attorneys fees. Glenn then applied to MetLife for Long Term Disability benefits and was denied. MetLife justified this by saying her condition had improved to the point that she was no longer totally disabled. Even though the SSA found Glenn to be totally disabled. Glenn challenged the disability claims denial in federal court and MetLife fought back arguing that they were entitled to a discretionary standard of review. Similar to the discretion they’re allowed in determining benefits. The federal district reviewed the administrative record and upheld MetLife’s original denial of benefits. It found that abuse of discretion was the correct standard of review and that MetLife had not abused this discretion. Glenn then appealed to the U.S. Court of Appeals for the Sixth Circuit. The Sixth Circuit reversed MetLife’s decision, concluding that MetLife had a conflict of interest since they decided the claim and paid the claim. Determining conflict of interest was a factor in deciding if MetLife abused it’s power of discretion. Other factors they considered were MetLife’s failure to consider the SSA determination that Glenn was totally disabled. In June of 2008 the Supreme Court ruled against MetLife and in favor of Wonda Glenn, and upheld the Sixth Circuit’s decision. The Court overturning of MetLifes disability claims denial case may improve the standards of review in ERISA disability claims and positively effect the future of ERISA litigation. Conflict of interest will be given proper weight as a factor in determining whether an insurance company abused its discretion. With or with new supreme court decisions an in depth understanding of ERISA law and insurance industry is extremely important when dealing with unfair disability denials.
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