When Your Social Security Award Is Admissible in Long-Term Disability Litigation

Employees in Chicago with claims for long-term disability often ask whether in litigation a court will consider their Social Security disability award. It depends on when you were awarded Social Security relative to your long-term disability claim, and the court’s standard of review. For a discussion of standards of review, see our prior blog post here. Social Security disability usually takes much longer to resolve than ERISA long-term disability claims do before litigation, due to ERISA claims procedure regulations on timing of notification of benefit claims and appeals. See 29 C.F.R. § 2560.503-1. If you are fortunate enough to get awarded Social Security while your long-term disability claim is under review, if you get the decision to the insurer while the claim is under review, it will be part of the administrative record a court will review in the event of litigation. If you are already in litigation, and then get awarded Social Security disability benefits, whether the court will consider the award often depends on whether the standard of review is de novo or the deferential arbitrary and capricious standard of review. A recent case demonstrated how the award was admissible under de novo review.

In Goodman v. First Unum Life Insurance Co., No. 2:21-cv-902, 2023 WL 3224481 (W.D. Wash. May 3, 2023), Goodman suffered from physical, cognitive, and visual impairment symptoms from post-concussion syndrome following a car accident. First Unum approved long-term disability benefits, but terminated benefits after 24 months, contending the disability fell under the mental health limitation. After Goodman unsuccessfully appealed the characterization of the disability, she sued under ERISA § 502(a). While in litigation, Goodman was awarded Social Security disability benefits due to her post-concussion syndrome and sought to have the court consider the award and analysis.

The United States District Court for the Western District of Washington documented the standard of review was de novo, and the award was not issued until after the administrative record was already filed in the litigation. Nevertheless, the court determined the Social Security award was relevant to Unum’s analysis of the cause of disability because it analyzed complex questions of medical experts’ credibility. The court thus admitted the Social Security award, and held the long-term disability insurance policy’s 24-month limitation did not apply to Goodman’s claim.

If you have a claim for long-term disability insurance benefits, contact an experienced ERISA long-term disability lawyer today.