District of Vermont Upholds Denial of Disability Benefits Where Employee Alleged Long COVID But Objective Evidence Did Not Support Disability Before Termination

In Weiss v. Lincoln National Life Insurance Company & Verista, Inc., No. 2:24-CV-00591-CR, 2026 WL 483280 (D. Vt. Feb. 20, 2026), the U.S. District Court for the District of Vermont upheld the denial of both short-term and long-term disability benefits to a former engineer who claimed he became disabled due to “long COVID” immediately before his termination.

The case involved two plans: a self-funded short-term disability (STD) plan administered by the employer, and an insured long-term disability (LTD) policy issued and administered by Lincoln. The plaintiff alleged that symptoms including brain fog, chronic fatigue, photophobia, cognitive decline, and generalized pain rendered him disabled as of February 19, 2022—one day after his employment ended.

Short-Term Disability (De Novo Review)

Because the STD plan did not contain a discretionary clause, the court applied de novo review. The central issue was whether the plaintiff was disabled while still employed.

The record showed:

• The plaintiff worked without restriction through his termination date.
• He used no sick leave and requested no workplace accommodations.
• On February 15, 2022—three days before termination—he reported feeling “overall well.”
• There were no objective findings demonstrating functional impairment as of February 18, 2022.

The court found no persuasive evidence that the plaintiff was unable to perform the material duties of his occupation prior to termination. It therefore concluded he did not meet the plan’s definition of disability while still a participant in the STD plan.

The court also emphasized inconsistencies in the plaintiff’s reporting, the lack of objective confirmation of a COVID infection, normal diagnostic testing, and extensive daily cannabis use that several providers believed could account for many of his symptoms.

Under de novo review, the court independently determined that the plaintiff failed to prove disability before his employment ended and upheld the STD denial.

Long-Term Disability (Arbitrary and Capricious Review)

The LTD policy contained a discretionary clause, so the court applied the arbitrary and capricious standard, while acknowledging Lincoln’s structural conflict of interest.

Lincoln denied the claim on three principal grounds:

1. Insufficient medical evidence of disability prior to termination.
2. Failure to demonstrate continuous disability through the 180-day elimination period.
3. Application of the policy’s pre-existing condition exclusion (based on treatment for anxiety, depression, hysteria/somatic symptom disorder, and ADHD in the three months before coverage began).

The court held Lincoln’s decision was supported by substantial evidence. Independent reviewers concluded:

• There were no objective findings supporting disabling physical limitations as of February 2022.
• Extensive neurological, cardiac, and imaging workups were unremarkable.
• Cognitive testing was normal.
• Psychiatric impairment supporting work restrictions did not appear in the record until October 2022—well after the relevant coverage window.

The court also found it reasonable for Lincoln to rely on evidence of significant cannabis use and somatic symptom disorder when evaluating the claimed functional limitations.

Because Lincoln’s denial was supported by substantial evidence and consistent with the policy terms, the court concluded the decision was not arbitrary and capricious.

Treatment of Social Security Award

Although the plaintiff had been awarded Social Security Disability benefits, the court reiterated that SSA determinations do not control ERISA plan outcomes—particularly where the insurer considered medical assessments not reviewed by the SSA.

Key Takeaways

• A claimant must establish disability while still covered under the plan.
• Courts may closely scrutinize subjective “long COVID” claims where objective findings are minimal.
• Extensive normal testing can significantly undermine disability claims.
• Cannabis use and psychiatric comorbidities may materially affect credibility and causation analysis.
• SSA awards remain nonbinding in ERISA litigation.
• Under arbitrary-and-capricious review, courts will defer to reasonable insurer reliance on independent medical reviews.

The decision reflects a growing trend in ERISA litigation involving post-COVID symptom claims: without objective evidence tying symptoms to functional work limitations during the coverage period, courts are unlikely to disturb plan denials—particularly under deferential review.