Eleventh Circuit Reinstates Disability Benefits Even Though The Insured Returned To Work During Case
In 1996, the Eleventh Circuit ordered BellSouth to begin paying an insured’s benefits. It did so even though she had returned to work after her claim was initially denied.
BellSouth Employee Becomes Disabled
Carol Godfrey had worked for BellSouth for 27 years rising through the ranks. However, in 1990 she became very ill and was diagnosed with fibromyalgia, lumbar disc syndrome, rotator cuff disease, severe sciatic pain, and many other conditions.
She was forced to begin taking very potent drugs to deal with the pain. She could no longer work. So, she applied benefits under BellSouth’s disability insurance plan. BellSouth denied the claim. It denied the appeal. BellSouth then informed her that she would have to return to work or be fired.
Having no other choice, with a dependent son, she returned to work with her condition and under the influence of potent drugs. However, even though she tried, she could not regularly attend work. Because of her sickness, her attendance was the worst in the unit. BellSouth disciplined her for her absences.
Court Holds BellSouth Administered Ms. Godfrey’s Claim Under a Conflict of Interest
Normally, under a federal law called ERISA, insurance providers are given discretion in their decisions. This means that even if a court believe they made the wrong decision they can only rule against them if they acted arbitrary and capricious.
Here, the court held BellSouth was not entitled to discretion because it acted under a conflict of interest because BellSouth was administrator of this plan and stood to gain financially if it denied Ms. Godfrey her benefits.
Court Holds Ms. Godfrey Disabled Even Though She Returned to Work
The court determined, although Ms. Godfrey had returned to work, she was disabled under the terms of the disability plan. It also determined that BellSouth threatened to fire her in order to prevent her from becoming eligible for disability benefits.
Disability Insurance Companies Have Lawyers. Shouldn’t You?
At Dabdoub Law Firm we specialize in disability cases. Because of our focus on this one area of the law we have dealt with both situations in Ms. Godfrey’s case. We have stripped insurance providers of their discretion in court countless times. We have also successfully litigated and won cases where our clients remained working or returned to work even though they were disabled.
We have also:
- Fought all major disability insurance companies and know their tactics;
- A track record of success;
- Won major disability lawsuits that created good law; and
- Recovered millions of dollars in disability benefits.
All of our lawyers commit every day of their legal career to helping people get disability benefits from insurance companies.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help. We help clients nationwide.
Call to get experienced disability lawyers on your side when:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.