Federal Court Denies Disability Insurance Claim Based on Conflicting Medical Evidence

The Maryland Federal District Court denied Daniel Ankney's claim for short term disability benefits under ERISA. Ankney claimed he was disabled as a result of spine injuries he suffered in a car accident. He sought disability benefits from MetLife. The Court noted:

• Ankney's own physical therapist noted that Ankney's back condition improved significantly;
• An independent medical consultant concluded that Ankney did not suffer any functional limitations.

Metlife is permitted to credit the opinions of its own medical consultants over the plaintiff's treating physician, the Court noted. The Court's decision is similar to many others in this area.

A key to avoiding this result is to make sure that an individual's record of disability is well-established before submitting his or her claim to the insurance company. It is much more difficult for insurance companys to "re-evaluate" a claim when an individual has a strong well documented medical history supporting his or her disability.