Ninth Circuit: District Court Did Not Clearly Err in Finding that Plaintiff Was Not Disabled During Entire Elimination Period in ERISA LTD Policy

In Atanuspour v. Reliance Standard Life Insurance Company, No. 22-55765, 2023 WL 8663879 (9th Cir. Dec. 15, 2023), a short unpublished memorandum disposition, the Ninth Circuit affirmed the district court’s judgment in favor of Defendant Reliance Standard Life Insurance Company in this action for recovery of long-term disability (“LTD”) benefits under ERISA. In reviewing for clear error, the court determined that the district court did not clearly err in determining that Plaintiff’s disability onset date did not start until towards the end of the LTD policy’s elimination period.

The Reliance Standard LTD policy contained an elimination period which ran from August 8, 2019, through November 6, 2019. Plaintiff had to show total disability during that entire period in order to qualify for disability benefits. The only treating physician for Plaintiff’s lumbar spine condition stated that Plaintiff became temporarily totally disabled “from 10/23/2019.” The records show that Plaintiff’s condition improved during July of 2019 and he did not seek treatment for his lumbar spine condition until October 2, 2019. The court rejected Plaintiff’s argument that the district court legally erred by ruling that later medical evidence could not demonstrate disability during the elimination period. The court read the district court’s decision as finding that the additional records did not establish total disability prior to October 23, 2019. There were no medical opinions contradicting the October 23, 2019 disability onset date. Judgment for Reliance Standard affirmed.

Proving disability during an ERISA policy’s elimination period and beyond can be challenging. If Reliance Standard has denied your long-term disability benefit claim, contact us for assistance.