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Cognitive Disorder v. Mental/Nervous limitations: E.D. Va.

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  • Cognitive Disorder v. Mental/Nervous limitations: E.D. Va.

    In a recent case from Virginia, the Plaintiff applied for LTD with the support of his doctor's opinion that he suffered from a variety of cognitive disorders caused by a brain injury. The Defendant temporarily granted LTD while continuing its investigation, but later concluded that the Plaintiff's condition was attributed to a mental disorder, and as such fell under the 24 month mental/nervous limitation. Following the expiration of benefits and internal appeal processes, this action followed. In a relatively straightforward recitation of the relevant abuse of discretion factors, the court held as follows:

    Here, taking into consideration the Booth factors, to the extent they are relevant, the court finds no evidence that Liberty abused its discretion. Liberty's process was reasoned and principled, it had adequate materials that supported its decision, and the determination was not outweighed by any possible motives or conflicts of interest. Liberty's decision making process was reasoned and principled. The claim process spanned roughly five years; involved the request and review of medical records from Plaintiff's treating doctors; sought the review and analysis from four additional doctors; made benefit payments to Plaintiff before the investigation on the claim was complete; and notified and explained to Plaintiff Liberty's determinations.
    Ultimately, the court granted the Defendant's motion for Summary Judgement. The full opinion is attached below.
    Attached Files