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Donahue & Horrow LLP Prevails in Federal ERISA Disability Case Published by the Court, Strengthening Protections for Long-Haul COVID Claimants

Business Wire

EL SEGUNDO, Calif.--(BUSINESS WIRE)--
Donahue & Horrow LLP has secured another published federal court victory. In this matter, we represented Austin Baltes, a Google Senior Software Engineer whose long-term disability benefits were wrongfully denied by Metropolitan Life Insurance Company (MetLife). The United States District Court for the Central District of California ruled that Mr. Baltes was “Totally Disabled” under the terms of Google’s ERISA-governed long-term disability plan, granting his Rule 52 motion and denying MetLife’s competing motion.

This decision is published, meaning it will guide courts, insurers, and disability claimants throughout the country. The opinion addresses several key issues that repeatedly appear in ERISA disability cases involving long-haul COVID and other post-viral or subjective conditions. Once again, Donahue & Horrow LLP continues to be a leader in fighting for disability benefits under ERISA.

This published decision addresses several recurring issues in ERISA disability claims, including how insurers must weigh treating-physician evidence, the limitations of file-only medical reviews, the proper evaluation of symptoms that do not always produce objective biomarkers, and the requirement that disability be assessed in relation to a claimant’s actual occupational duties.

This published ruling builds on a growing body of long-haul COVID disability litigation handled by the firm. In a separate case, Donahue & Horrow LLP reinstated long-term disability benefits and attorneys’ fees for a client facing similar post-viral limitations.

Mr. Baltes contracted COVID-19 twice and continued to experience significant long-haul symptoms, including cognitive impairment, fatigue, and difficulty sustaining concentration, all of which interfered with the occupational demands of his Senior Software Engineer position. Although his treating physicians consistently documented these limitations and provided substantial supporting evidence, MetLife denied his long-term disability claim based on paper-only medical reviews that did not account for the full medical record or the specific cognitive requirements of his occupation.

In its published decision, the Court found Mr. Baltes’ symptoms credible and consistent with long-haul COVID, concluding that the insurer’s review fell short of ERISA’s requirements. The Court determined that MetLife did not properly engage with the treating physicians’ findings, failed to evaluate the actual duties of his role at Google, and relied on isolated personal activities that had no bearing on whether he could sustain full-time work. The ruling reinforces that disability assessments must be grounded in the claimant’s real job responsibilities and the totality of the medical evidence, particularly in cases involving post-viral or fatigue-based conditions.

“This published opinion provides important guidance for disability claimants nationwide,” said Michael Horrow, founding partner of Donahue & Horrow LLP. “It confirms that insurers cannot rely on incomplete file reviews, disregard treating-physician findings, or minimize conditions simply because they do not produce traditional biomarkers. Most importantly, it reinforces that ERISA requires insurers to evaluate a claimant’s actual job duties and the full scope of medical evidence before denying benefits.”

Donahue & Horrow LLP continues to represent individuals whose long-term disability, life insurance, accidental death, or long-term care claims have been denied or delayed by private insurers.

About Donahue & Horrow LLP

Donahue & Horrow LLP is a California-based law firm with decades of experience representing policyholders in ERISA disability denials, long-term disability denials, insurance bad-faith cases, and medical malpractice claims, specializing in birth and brain injury. The firm has recovered more than $300 million for clients and is recognized for its detailed understanding of insurance law and relentless advocacy for individuals and families.