Dutkewych v. Standard Ins. Co., No. 14-1450 (1st Cir. 2015)
Annotate this CasePlaintiff was a participant in a disability plan (Plan), which was insured and administered by Defendant under ERISA. The Plan limited long-term disability (LTD) benefits to twenty-four months for a disability caused or contributed to by mental disorders, substance abuse, or other limited conditions. Defendant terminated Plaintiff’s benefits after twenty-four months after applying this limited conditions provision. After his unsuccessful administrative appeal, Plaintiff filed suit against Defendant for unpaid benefits. Specifically, Plaintiff argued that he had been diagnosed with chronic Lyme disease, a physical illness allegedly not limited under the terms of the Plan. The district court granted summary judgment in favor of Defendant. The First Circuit affirmed, holding that even if Plaintiff was disabled as a result of chronic Lyme disease, the mental disorder limitation nonetheless applied because Plaintiff's mental disorders contributed to his disability as of June 1, 2011.
The court issued a subsequent related opinion or order on April 3, 2015.
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