May 31, 2018 Practice Points

ERISA Claimants Should Clarify Their Rights to Future Disability Their Rights to Future Disability Benefits

Claimants’ counsel should consider requesting clarification of future benefits, especially in cases involving permanent disability and a plan administrator's egregious conduct

by Benjamin C. Hassebrock

ERISA authorizes an action to “clarify [a claimant’s] right to future benefits under the terms of the plan.” 29 U.S.C. § 1132(a)(1)(B). Courts have not permitted disability claimants to recover the present value of their future benefits under this clause, finding that an “award of future benefits not yet accrued violates ERISA's purely compensatory remedial scheme.” Wade v. Life Ins. Co. of N. Am., 245 F. Supp. 2d 182, 188 (D. Me. 2003). But the recent decision in Gorena v. Aetna Life Ins. Co., No. C17-532 MJP, 2018 WL 2113952, at *1 (W.D. Wash. May 8, 2018) illustrates that claimants may be able to secure meaningful relief with respect to their future benefits.

In Gorena, a Boeing staff analyst sought long-term disability benefits because she could no longer work due to multiple sclerosis and other medical conditions. The plan required the claimant to be unable to perform her “own occupation” for the first 24 months of disability, and “any reasonable occupation” thereafter. Her insurer, Aetna, determined she was not disabled under the “own occupation” standard, and therefore did not evaluate her claim under the “any reasonable occupation” standard.

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