Insurance – ERISA — disability benefits

Listen to this article

United States Court of Appeals For the Seventh Circuit

Civil

Insurance – ERISA — disability benefits

Where an employee was found by SSA to be unable to perform his current job, but not unemployable, his disability insurer arbitrarily denied his disability benefits.

“At the time that Cigna initially approved disability benefits for Raybourne, he was in the first twenty-four months of his disability, a period when the Plan paid benefits to claimants who could not perform their current job. At that time, Cigna and the SSA both found that Raybourne was not capable of returning immediately to his former work. Although that finding was sufficient to qualify for benefits under the Plan, it was not sufficient to qualify for Social Security disability payments. There was thus no inconsistency between the conclusions of the SSA and Cigna during the first twenty-four months of Raybourne’s disability.”

Affirmed.

11-1295 & 11-1427 Raybourne v. Cigna Life Insurance Co. of New York

Appeals from the United States District Court for the Northern District of Illinois, Gettleman, J., Rovner, J.