Objections raised by Standard need to be denied for the principle of justice.

Ms. Kathleen M. Hackett brought suit in this Court against Standard Insurance Company alleging that Standard has wrongfully denied her long term disability benefits claim. Both the parties moved for the summary judgment. And District Court granted summary judgment on August 15, 2007. Court held that although Standard operated under a conflict of interest, it caused a serious breach of fiduciary duty. But Hackett failed to prove any potential finding which shows conflict of interest.

In appeal against the order of the District Court, Eighth circuit Court of appeal reversed and remanded the matter for its reconsideration of the conflict of interest in the light of Glenn V Metropolitan Life Insurance Company.  

In remand, Hackett’s disability attorney served a second set of interrogatories to Standard. Standard raised objections on those interrogatories and pointed out that discovery was already closed and remand was only allowed to consider the administrative records in light of Glenn.

The objections raised by Standard were as under.

Whether the interrogatories put forwarded are Discoverable which are related to the dispute and not asked at trial?

Ms. Kathleen M. Hackett brought suit in this Court against Standard Insurance Company for claiming that Standard has wrongfully denied her claim for long term disability benefits. Both the parties moved for the summary judgment. District Court held that although Standard operated under a conflict of interest, which caused a serious breach of fiduciary duty. According to District Court Standard did not abuse its discretion in denial of Hackett’s claim. Hackett appealed against order of the District Court. The Eighth Circuit Court of Appeals reversed the District Court decision and remanded the matter to District Court for reconsideration in the light of Glenn.   

                                                                                                   

The Court may order discovery of any fact relevant to the dispute. Relevant information need not to be admissible at trial if the discovery appears reasonably calculated to lead to the discovery of admissible evidence.

The appropriate standard of review is a deferential “combination of all factors”

The de novo is a proper standard of review in case in which denial of benefits covered by ERISA. In Glenn V. Metropolitan Life Insurance Company, Supreme Court held that a plan administrator who evaluate and pays claims operate under a conflict of interest. The Court found that such dual role was subject to a conflict of interest and must weight the conflict as a factor in determining an abuse of discretion. The Court did not adopt a rule whereby the reviewing Court must always apply a less deferential standard of review in cases in which conflict of interest existed.  

Conflict of Interest in long term disability claim

Can Court ignore conflict of interest in the long term disability benefits denial decision process?

Kathreen M. Hackett worked for Mileage Plus Inc. (MPI) situated at Rapid City, South Dakota from last 14 years as a Customer Service Supervisor. She was covered by disability insurance offered by Standard. On September 28, 2002, she was disabled due to effects of brain hemorrhage. She underwent emergency surgery by a neurologist, Dr. James Nabwangu. After eleven days she was discharged with instructions to follow up.

On December 3, 2002, she complained that she was getting extremely tired after seven hrs of work. Although, she able to improve her ability to focus. She was able to work on computer.

Hackett’s internist Dr. James Bowman noted that she had slight headache problem in earlier days. But on January 15, 2003, Hackett stated to Dr. Bowman that when she worked on the computer, her problem of headache increased. On March 21, 2003, Dr. Bowman mentioned that she was unable to focus on her job. She still suffers from occasional headaches.

On February 28, 2003 Hackett applied for “own occupation” disability benefits because she was unable to perform her duties as a Customer Service Supervisor.  And same was approved by Standard on May 1, 2003 for the period from December 26, 2002 to January 17, 2003.

Can administrator of the insurance plan abuse its discretion in denying long term disabilities benefits?

Its all depend upon the disability attorneys who interpret the language of the insurance policy. Can plan administrator adhere to his denial decision without any supportive evidence? Can he allow to neglect evidence in support of participant claim? Answer to all this questions you will find in this article.

Mr. Dale W. Gordon brought the lawsuit against Life Insurance Company of North America (LINA) in U.S.District Court, Division Minnesota. Court pronounced final judgment on March 18, 2009.

Let’s see how the Gordon’s disability attorneys found the clues from provision of the policy and how they interpreted the Gordon’s medical reports.

Gordon joined Northwest Airlines on 1998 at the age of 49 years.  His main problem started when he felt pain in his left knee in end of 2002. His orthopedist, Dr. Joseph T. Teynor advised to take MRI. In MRI report, it showed a tear in the meniscus and degenerative changes. In next visit Teynor drew fuid off of Gordon’s knee and injected with a corticosteroid. He described Gordon as majorly symptomatic.

Can LINA Argue for Termination of Long Term Disability Benefits after terminating it for Another Reason?

Its all because of disability attorney’s effort, so Douglas Juszynski got the reinstate of his long term disability benefits after LINA denied his claim. Court proceedings can become complicated. Seeking continued long term disability benefits after termination is no exception. A case heard in March 2008 in U.S. District Court for the Northern District of Illinois, Eastern Division, demonstrates this yet again.

When Juszynski’s case came before this Court, his right to compel LINA to reinstate long term disabilities benefits after its termination remain the main issue.. Juszynski filed a motion for summary judgment or in the alternative, an entry of judgment in his favor. On the other hand LINA filed a cross motion for summary judgment or in the alternative, an entry of judgment in its favor. Let’s see how the Court reviewed this case.

Juszynski worked in service of Marconi Medical Services, Inc. as a Senior Service Engineer from February 1969 through July 2001. In July 2001, Juszynski ceased working due to peripheral neuropathy and back, neck and leg pain. He applied for and received long term disability benefits until September 2005. Thereafter LINA terminated his disability benefits.

Juszynski believed that he remained entitled to long term disability benefits, and LINA should not have terminated the payment of his long term disabilities benefits after 24 months. The following evidence supported his claim:

·         A report from his physician Dr. MacEntee showed that he was permanently disabled person.

·         After bypass surgery, his treating physician, Dr, Choudry, submitted a medical report that he is unable to work at that time.

·         The social security Administration had also declared that he was permanently disabled person and entitled to long term disability benefits. Dr. MacEntee sent a follow up evaluation form to LINA stating his view that patient is for disable.

After reviewing his updated medical report LINA approved continuing long term disabilities benefits but once again notified Juszynski in October 2005 that the long term disability company was terminating his benefits because Juszynski had failed to produce evidence of his continued total disability to work. Juszynski appealed twice, but on July 2006, LINA upheld its denial of long term disabilities benefits.

District Court Reviews Long-term Disability Termination De Novo

Juszynski had no choice. In order to have his benefits reinstated, he would have to hire a disability attorney and take his claim before the Court. District Court found that a de novo review would be the proper standard of review using the Supreme Court holding in the case of Perlman v. Swiss Bank.

Juszynski's disability attorney argued that once LINA had approved his claim; it could not terminate benefits, if the medical condition worsens. Juszynski cited a number of cases in which the Courts held that once an insurer approves a claim it cannot terminate the long term disability benefits unless a claimant's condition improves.

The disability attorney claimed that all evidence favored continuation of Juszynski's long term disabilities benefits. LINA’s contention was that based on the medical reports and opinions of Dr. Ivkov, Dr. Choudry, Dr. Patel and Dr. MacEntee, Juszynski's condition was indeed improved.

A certificate from Dr. Ivkov stated that Juszynski was capable of performing the duties of a sedentary occupation. His disability attorney argued that Dr. Ivkov had merely checked a box which indicated his opinion that Juszynski could sit between 2.5 hrs and 5.5 hrs. This did not prove he could work a full day.

 In his reply to LINA’s request for medical information, Dr. Choudry left neither positive nor negative remarks in respect to Juszynski's working capability.

Dr. Patel returned blank physical ability assessment form. An incomplete or blank request form referring to contact physician could not be concluded as affirmative evidence that he has no physical limitation.

LINA contended that none of the three specialists he was seeing held the opinion that Juszynski was totally disabled from any occupation. Only Dr. MacEntee, a general practitioner without any specialization or expertise, held the opinion that Juszynski could not perform the duties of a sedentary occupation.

On the other side, Juszynski's long-term disability attorney argued that, Dr. MacEntee's medical reports had been accepted by LINA initially. This doctor had reported to LINA at least five times.

Disability Attorney Argues that Disability Plan Ignored Social Security Disability Decision

When it terminated Juszynski’s benefits, LINA failed to take in to account the determination of the Social Security Administrator. LINA was aware of this determination. In fact it reduced LINA’s payout of long term disability benefits to $1174 per month. In Anderson v. Operative Plasterers & Cement Masons international Ass'n Local No. 12 Pension & Welfare Plans, the Court held that that the findings of the Social Security Administration are key evidence with respect to an ERISA claim. LINA never addressed why it need not consider this decision during the whole administrative appeals process.,

LINA Points to Alcoholism Limitation in Long-term Disability Benefit Plan

LINA went on to argue that the alcoholism limitation in the plan made Juszynski ineligible for benefits after he completed 24 months of long term disabilities benefits. In reply Juszynski's disability benefit attorney argued that while there was evidence which indicated that the condition of Juszynski suffered could have been due to alcoholism, LINA had never once given this as a reason for terminating his client's benefits.

The disability attorney argued that the Court must find that LINA had waived its right to raise this objection before his client had not been given the opportunity to address this issue before the commencement of suit. LINA had waived its right to raise this issue after the fact because it had not been an issue before.

Juszynski's attorney argued that LINA’s attempt to invoke the alcoholism limitation of the policy was not allowed by ERISA. In addition to this issue, LINA had already generally failed to give proper notice to Juszynski with specific reasons for terminating his benefits and had failed to give him reasonable opportunity refute the decision by giving specifics as to what information the disability plan needed from him.

After considering the facts and the evidences produced by the parties and hearing both the sides, the Court entered judgment in favor of Juszynski. LINA was ordered to reinstate Juszynski's long term disabilities benefits of $ 1174 per month retroactive to October 1, 2005. And to compensate Juszynski for any unpaid benefits.

Judgments like these are not only helpful to individuals Juszynski but also to others who are disabled and have their claims denied or terminated by disability benefit plans. Juszynski was in strong position through out the whole matter.

It also helps that Juszynski's case was well represented by his disability attorney. With the help of an expert disability plan attorney, with an eagle eye for evaluating the facts, and an understanding and deep knowledge of the subject matter, Juszynski's rights to long-term disability benefits were re-established. 

LPO as career option for Lawers and Law Graduates.

Legal Process Outsourcing involves in-house legal departments, corporations, law firms or organizations outsourcing legal work from areas where it is costly to perform, such as the United States or Europe to areas where it can be performed at a significantly decreased cost, primarily India.

LPO for Law graduates:

Starting a career as a lawyer in court is really difficult for a junior, one need to practice under a senior lawyer for years and it is really difficult to establish one’s own practice.

India

Earlier, in India after graduation, one had to do 2 years of LLB degree and 1 year of practice under a lawyer to work as a lawyer, later the 3 year course was introduced with the court visits in the final year. In 1985, five year LLB course was introduced. Many students in India applied for LLB 5 years course just because they did not get the medical and engineering seats.

In India one has to complete 12 (10+2) years of education to apply for 5years of LLB, and one has to complete 3 years of graduation course after 10+2 to apply for 3 years of LLB course. Students applying for 3 years of LLB in India have come down of recent.

There are about 700 Bar Council approved law colleges in India and about 80,000 law graduates passes out every year.

There are only few national law schools in India, one has to write Common Law Entrance Test (CLAT) to be eligible to get into these premier law schools. The salaries of students passing out from these schools have crossed more than 12 lacs per annum.

Only few graduates make hard effort and join a corporate law firm. Many of the law school students passed out of national law schools get into corporate law firms and in-house legal departments of companies.

In India, after 5 years of the law graduation, many of the graduates enrol themselves in the state bar council and start practice under a senior lawyer or a law firm having 2- 20 lawyers.

United States (USA)

In USA, after 12 years of education ( i.e. after secondary education), one has to complete 4 years of bachelor degree and score at or above the seventieth percentile in the Law School Admission Test (LSAT) to apply for Juris Doctor (J.D.). There are 200 American Bar Association accredited law schools (188 with full accreditation and 12 with provisional accreditation) in the country.

In USA, J.D is a 3- 4 years course which make them to earn a degree in Law.

Once the J.D. is completed, candidates require to appear for the bar exams of particular state to practice in such state. In USA, it is a difficult task to get into the top Law firms in the country.

United Kingdom (UK)

In UK, after 13 years of education, ( i.e. after GCSE and A-level), one applies for LLB or diploma in Law and then takes a one year Legal Practice Course (LPC) to become a solicitor or Bar Vocation Course to become Barrister. LPC is usually followed by two years' apprenticeship, known as a training contract. Bar Vocational Course (BVC), followed by 1 year training in set of barristers' chambers, known as pupilage.

There are also other graduates, who after their graduation apply for Common Professional Examination (CPE) (also known as law conversion course or the Graduate Diploma in Law (GDL).

Foreign lawyers become solicitors in UK and the numbers of solicitors are on growth.

It is difficult to have a training contract in UK. It is also difficult to join top law firms in UK.

Since the LPO industry is on growth, LPO industry is the best option for Law graduates of India, USA and UK as it gives more stability and career growth.

There are many LPO’s in India offering Indian fresh law graduates the post of legal assistant, legal associate and legal executive or associate attorney at the entry level.

Law graduates from USA and UK can join the LPO industry and assist the LPO team. They can also take role in the marketing and business development of the LPO, they can also act as the coordinator between the LPO and the clients.

LPO for Lawyers:

Law education is not perfect unless you start practice in court for some years. All the law graduates are not lawyers, but all the lawyers are law graduates. Lawyer profession is also called as the noble profession. Lawyers are considered as the officers of the court in India.

Some people describe the law profession as “work- no money, work- money, and no work- money”. It is evident that where you will start to practice with no money for few years and start to earn money as you continue practice and at the later stage, you will be having no work, only money - your juniors will carry out every work.

Lawyers represent the plaintiff and defendants in the case and take a lead role in drafting of contracts, registration of properties, companies etc…

Lawyers’ roles vary depending upon the area of law they practice and the firm where they practice.

There are about 1 million lawyers in India, more than 1 million in USA and about 80,000 solicitors in UK.

If you are not having a good practice as a lawyer/ attorney/ solicitor or interested into a LPO, LPO is the better option for the Lawyers. LPO sector today needs the service of Lawyers having good drafting skills, it would be easier for lawyers draft complaints, motions and to research on the legal issues faster then the fresh law graduates. Lawyers also can take up the review of work done by the junior level LPO employees in the LPO sector.

As the US and UK lawyers are concerned, they can have partnership with the LPO vendors and share the profit. They can also take part in review and supervision of LPO work.

Designation:

LPO industry today offers many designations depending on the nature of work involved. E.g. Legal executive, legal assistant, associate attorney and legal associate at the entry level. Senior legal executive, Senior legal associate, assistant team Lead, and team lead after 2 years of experience. And Assistant manager, Manager, Assistant project manager, project manager, Vice president etc... after 3-7 years of LPO experience.

Salary:

The salary for entry level varies from Rs.8, 000 to Rs. 20,000 depending on the firm and reputation it has got.

Team lead would be getting salary of Rs. 20,000 to Rs. 50,000, and the Assistant project manager salary would be Rs. 40,000 to Rs. 60,000.

As the lawyers of UK and USA are concerned, the salary depends on the current salary offered for lawyers in US and UK.

Microsoft to outsource general legal work to India

Software giant Microsoft will begin outsourcing general legal work to India after signing a deal with legal process outsourcing (LPO) company CPA Global. The news comes as CPA outlined plans to expand its Indian workforce from 600 to 1,000 by the end of 2011, and hinted at opening another outsourcing centre.
CPA said that it will be taking on ‘multi-jurisdictional legal research’ for Microsoft, but could not give further details, citing client confidentiality. Microsoft has outsourced intellectual property (IP) work to CPA since 2005, although no lawyers work on the IP team.
In June last year, Rio Tinto announced an outsourcing deal with CPA which the mining giant forecast would cut 20% from its annual legal spend. CPA lawyers review and draft contracts, undertake legal research and review documents on behalf of Rio Tinto. Leah Cooper, former managing attorney at Rio Tinto, joined CPA Global’s executive team this week. She will lead the strategy and development of CPA Global’s legal services outsourcing business.
CPA spokesman Venu Nair said that the south Indian cities of Bangalore, Hyderabad and Chennai are being considered as locations for a new CPA office.