News

Case Summaries

ERISA

[03/01] Jones v. Unum Provident Corp.
In an action under ERISA for wrongful denial of benefits, summary judgment for defendant is affirmed where: 1) defendant thoroughly investigated plaintiff's claim, both initially and when plaintiff appealed, and its initial and final decisions were carefully reasoned; and 2) coverage under the policy at issue lapsed more than six weeks prior to plaintiff's return to full-time work, and thus her later disability claim was not covered because of a pre-existing condition clause.

[02/26] Overby v. Nat'l Ass'n of Letter Carriers
In an action seeking a declaration that a purported amendment to a trust plan, which would have rendered plaintiff ineligible to receive benefits under the plan as a surviving spouse, was not properly adopted, judgment for plaintiffs is affirmed where the district court committed no reversible error in either its factual determinations or in its conclusions of law in finding that the trustees of the plan had not submitted the amendment to the fund's actuaries for an evaluation and estimate of its cost, as required by the governing provisions of the plan, and therefore the amendment was not properly adopted.

[02/25] Carpenters Dist. Council v. JNL Const. Co.
In an ERISA action on behalf of certain pension funds against a construction company claiming that defendants failed to contribute union employees' fringe benefits to the funds as required by collective bargaining agreements, summary judgment for plaintiffs is reversed where plaintiffs did not produce sufficient evidence to show the absence of trialworthy issues on the issue of whether defendant corporation was used to perpetrate a fraud.

[02/10] Green v. UPS Health & Welfare Package for Retired Employees
In a class action lawsuit brought by former employees of UPS claiming that defendants raised the amount of health insurance contributions required of union retirees in violation of the retirement plan and, consequently, ERISA, judgment of the district court is affirmed where: 1) district court correctly concluded that UPS violated the Summary Plan Description by collecting additional contributions from local union retirees without collecting from other IBT retirees covered by the plan; and 2) with respect to additional contributions UPS collected from the local union retirees during the term of the 2008 CBA, district court correctly concluded that UPS's determination was within the range of reasonable interpretations, and therefore, not arbitrary and capricious.

[02/05] Battoni v. IBEW Local Union No. 102 Employee Pension Plan
In plaintiffs' ERISA action challenging an amendment to their welfare plan as an unlawful cutback of their accrued benefits under their pension plan, the judgment of the district court in favor of the plaintiffs is affirmed as the amendment violated the ERISA's Anti-Cutback rule, 29 U.S.C. section 1054(g), by constructively amending the pension plan in a manner that decreased an accrued benefit under that plan.

[02/05] Balmert v. Reliance Standard Life Ins., Co.
In plaintiff's ERISA action, a decision upholding the benefits determination of defendant-insurance company denying plaintiff's claim for long-term disability benefits is affirmed as plaintiff received a full and fair review of her claim and defendant's benefits determination was not arbitrary and capricious as it was supported by substantial evidence.

[01/22] Charles Schwab & Co. v. Debickero
In an interpleader action by a bank seeking to determine the ownership of an IRA account held by decedent, summary judgment for the named beneficiaries of the IRA is affirmed where: 1) the surviving spouse protections in ERISA did not apply to the IRA even though some of the funds originated from an ERISA-protected pension plan, and 2) the Internal Revenue Code also did not impose automatic surviving spouse rights on IRAs similar to those protections afforded under ERISA.

[01/19] Richards v. Hewlett-Packard Corp.
In plaintiff's ERISA action, district court's summary judgment ruling upholding the termination of plaintiff's long-term disability benefits by defendant-administrator is affirmed as, the dispute in this case is not whether plaintiff is afflicted with fibromyalgia or chronic fatigue immune dysfunction, but that he has not met his burden of showing that these conditions rendered him unable to perform any job for which he is qualified.

Read More

Government Benefits

[03/08] Wildman v. Astrue
In a petition for review of the denial of social security disability benefits, the petition is denied where: 1) the Administrative Law Judge (ALJ) did not err in discounting a physician's opinion because it was conclusory and failed to account for petitioner's unjustified noncompliance; 2) the ALJ did not err when he discounted petitioner's testimony regarding her limitations due to her noncompliance; and 3) the ALJ properly considered and weighed the available medical evidence and petitioner's testimony.

[03/05] Rhine v. Stevedoring Servs. of Am.
In a petition for review of a decision of the Benefits Review Board under 33 U.S.C. section 921(c) of the Longshore and Harbor Workers' Compensation Act, the petition is denied where: 1) a reasonable mind could have concluded that the Pacific Maritime Association Average adequately represented petitioner's annual earning capacity; and 2) the availability of alternative employment was determined by reference to two criteria: the claimant's physical abilities and the economic availability of particular jobs in the market.

[03/03] California Pharm. Ass'n v. Maxwell-Jolly
In an action to enjoin the California Department of Health Care Services Director from implementing state legislation reducing payments to certain medical service providers, a preliminary injunction in favor of plaintiffs is affirmed where the state failed to study the impact of a 5% percent rate reduction on the statutory factors of efficiency, economy, quality, and access to care prior to implementing the rate reductions.

[03/03] Dominguez v. Schwarzenegger
In an action to enjoin California legislation that reduces the state contribution to wages paid to In-Home Supportive Services (IHSS) providers as preempted by Section 30(A) of the Medicaid Act, a grant of the injunction is affirmed where: 1) both the legislature and the Department of Social Services recognized that reimbursement rates ? that is, providers' wages and benefits ? were directly correlated to ensuring that services were consistent with efficiency, economy, and quality of care, and sufficient to ensure access to services under the IHSS program; 2) the state should have studied the impact of its decreased contribution to providers' wages and benefits prior to passing Cal. Welf. & Inst. Code section 12306.1(d)(6), and the State was not ipso facto immunized from challenges to its actions because it had no system in place to make such an assessment; and 3) the district court did not abuse its discretion in concluding that plaintiffs established irreparable harm absent injunctive relief, as its finding regarding provider harm was not clearly erroneous.

[03/02] St. John's Well Child & Family Ctr. v. Schwarzenegger
In a petition for writ of mandate by a nonprofit network of five community health centers and six school-based clinics in medically underserved areas of the state, claiming that Governor Schwarzenegger's use of his line-item veto authority exceeded constitutional limits because individual budget cuts he further reduced were not items of appropriation that could be individually vetoed or reduced, the petition is denied as the particular Assembly Bill 4X 1 budget reductions at issue were "items of appropriation" within the meaning of article IV, section 10(e) of the state constitution and the governor's line-item vetoes reducing them, while approving other portions of the Bill, were constitutionally authorized.

[02/25] Denton v. Astrue
An ALJ's denial of claimant's application for disability benefits claiming that she could not work because of certain physical and mental illnesses is affirmed where: 1) the ALJ did fully consider the impact of claimant's depression and related symptoms; and 2) the ALJ's finding of no disability was supported by substantial evidence.

[02/25] US v. Phillips
Conviction of defendant for Medicare fraud is affirmed where: 1) defendant can show no plain error in denying her motion to exclude redacted recording nor can she show admission of a recording likely changed the trial's outcome; 2) there was no error when admitting a redacted recording in failing to consider redacted exculpatory statements because defendant had the burden of pointing them out and she failed to do so; and 3) defendant waived her remaining arguments.

[02/23] Wright-Hines v. Comm'r of Soc. Sec.
Denial of plaintiff's claims for supplemental security income and disability insurance benefits is affirmed where: 1) the ALJ noted that a written report from the vocational expert (VE) was consistent with his conclusion that plaintiff was capable of performing past relevant work as a cashier; 2) ALJ never posed a hypothetical question to the VE; 3) ALJ's determination that plaintiff had past relevant work as a cashier was supported by substantial evidence; and 4) plaintiff's argument that the district court erred in denying her motion for default judgment under Fed. Civ. Rule 55 is without merit.

Read More