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