In the September 21, 2018 issue of the Los Angeles Daily Journal, the Daily Journal published a list of its top “Verdicts & Settlements,” which included the McKennon Law Group’s case of Brian Wright v. AON Hewitt Absence Management LLC, et al. The judgment in Mr. Wright’s favor was rated as the third highest award of damages for a plaintiff for the period of time covered. The McKennon Law Group PC represented Mr. Wright in a dispute over the payment of short-term and long-term disability benefits. We won this ERISA case at trial and our client was awarded all of his disability insurance benefits, attorney’s fees, costs and interest. The list includes a summary of the case and the relevant portion is reprinted below.
Verdicts & Settlements
RESULT DATE: Apr. 30, 2018
Brian Wright v. AON Hewitt Absence Management LLC; The Boeing Company; Aetna Life Insurance Company, and Does 1 to 10, inclusive (2:17-cv-01856 AG (JPRx))
CD CA
18-JV 129799
TOPIC: Employment Law
SUB TOPIC: ERISA
FURTHER DESCRIPTION: Denial of Long Term Disability Benefits
Bench Decision
JUDGE:
Andrew J. Guilford
ATTORNEYS:
Plaintiff:
Scott E. Calvert (McKennon Law Group PC)
Robert J. McKennon (McKennon Law Group PC)
Defendant:
Shannon L. Ernster (Gordon & Rees LLP)
Ronald K. Alberts (Gordon & Rees LLP)
FACTS: Brian Wright was an engineer at The Boeing Co. and a participant in both the short-term disability and long-term disability insurance plans offered by his employer. The short-term disability plan was self-funded and administered by AON Hewitt Absence Management LLC, while Aetna Life Insurance Co. was both the claims administrator and funding source of the long-term disability plan. Both disability plans provided benefits to claimants who, because of a sickness or illness, are unable to perform the material and substantial duties of their occupation.
Wright filed a claim for short-term disability benefits with AON Hewitt, and shortly thereafter a long-term disability claim with Aetna. AON Hewitt approved Wright’s short-term disability claim for a short period of time, before denying his short-term disability claim prior to expiration of the maximum benefit period. Aetna also denied Wright’s claim for long-term disability benefits.
Wright administratively appealed both claim decisions, as required by the terms of the plans and ERISA, but both denial decisions were upheld by Aetna and AON Hewitt. Wright then filed his lawsuit against Aetna, Boeing and AON Hewitt under ERISA requesting the federal district court to overturn the short-term disability and long-term disability denials.
PLAINTIFF’S CONTENTIONS: Wright was forced to stop working due to degenerative disc disease, stenosis, spondyloarthritis and related chronic back pain, which were diagnosed by numerous treating physicians and confirmed through MRI reports and physical examinations. Wright contended that his medical records fully supported his diagnoses, complaints of pain and reported restrictions and limitations, and also contended that the denial decision by Aetna of his long-term disability claim was erroneous and should be overturned using a de novo review standard.
Wright argued that Aetna’s claim decision failed to properly consider his reports of pain and the medical evidence supporting his claim, improperly relied on cursory and biased physician consultants, improperly required that he satisfy a more restrictive definition of disability than was contained in the long-term disability plan, failed to offer substantial evidence of improvement after his receipt of short-term disability benefits and failed to engage in a meaningful dialogue as required by ERISA.
DEFENDANT’S CONTENTIONS: Aetna claimed that Wright’s medical records showed neither a dramatic change nor significant deterioration of his condition over time, and that there was no medical basis for any restrictions and limitations in Wright’s activities. Aetna property relied upon the opinions of an in-house nurse and in-house physician, as well as an outside physician hired to review Wright’s records, all of whom determined that Wright’s medical records did not support restrictions and limitations that would preclude him from working in his occupation.
OTHER INFORMATION: Additionally, the parties reached a settlement in which Aetna agreed to pay Wright’s attorney fees and costs.
LENGTH: half day
DAMAGES: Wright sought all benefits due and owing under the long-term disability plan together with pre-judgment and post-judgment interest, costs, and his attorney fees.
RESULT: The court found for Wright, concluding that he established eligibility for benefits under the long-term disability plan. The court rejected the argument that Wright’s previous ability to work despite his pain was evidence that he was not entitled to benefits. The court awarded Wright benefits for the entirety of the “own occupation” definition of disability, and remanded the claim to Aetna for consideration under the “any occupation” period of disability.
On remand, Aetna approved Wright’s claim under the long-term disability plan’s “any occupation” period of disability.
FILING DATE: Mar. 8, 2017
