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August 29, 2008
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Recent Cases and Decisions

ERISA & Insurance Cases

All litigation firms win and lose cases.  With this section, Foster Law Firm does not lament its losses or trumpet its victories.  Instead, we wish to share recent ERISA and insurance cases we have handled which we believe to be of interest or legal significance.

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On February 20, 2008, the United States Supreme Court issued its unanimous decision in LaRue v. DeWolff, Boberg & Associates, - U.S. -, 128 S. Ct. 1020, 169 L.Ed.2d 847 (2008).  With LaRue, the court considered an extremely important question regarding remedies available under ERISA, 29 U.S.C. § 1132(a)(2). The court held, for the first time, that individual plan participants in ERISA governed 401(k) plans can sue to recover losses to their individual accounts caused by a breach of fiduciary duty.  As The New York Times points out, the case affects up to 70 million American workers.  James LaRue, the prevailing party, has been represented by Foster Law Firm Attorney Rob Hoskins from the outset of his case. Mr. Hoskins appeared before the Supreme Court along with his co-counsel, Peter Stris of the Whittier Law School in California, who presented oral argument on behalf of Mr. LaRue. The United States also argued on LaRue's behalf. To view a news article on the case, click here.   Click here to link to the SCOTUS Wiki entry for LaRue which contains the actual court filings on the case and commentary.  Click here to view the Supreme Court's opinion.

In Evans v. Eaton Corporation Long Term Disability Plan, 514 F.3d 315 (4th Cir. 2008), the firm's attorney, Rob Hoskins, represented the Plaintiff. Evans involved an ERISA governed long term disability plan. In Evans, like the Donovan case below, the ERISA plan from which Evans sought benefits was funded by her former employer, Eaton Corporation, and administered by Broadspire Services, Inc. The plan had denied Evans' claim for benefits. After exhausting administrative remedies, Evans filed suit. The District Court Judge held that the evidence in support of Evans' disability was much more compelling than the evidence cited by the plan in support of its denial. The District Court reversed the claim denial and entered judgment for Evans. The plan appealed to the United States Court of Appeals for the Fourth Circuit in Richmond, Virginia. The Fourth Circuit reversed. The Fourth Circuit essentially held that Evans had presented some very compelling evidence and even stated that if the court were considering Evans' claim under a less burdensome standard of review that Evans would prevail. However, the court reversed the District Court and ruled in favor of the plan. The court used the case to underscore one of the most unfair and significant aspects of ERISA (at least from a claimant's standpoint) which is the "abuse of discretion" standard of review. The court stressed that under ERISA, in appropriate circumstances, a reviewing court must apply the "abuse of discretion" standard of review which the court emphasized is, by its nature, very deferential to the plan's decision. The court held that in reviewing a claim under an abuse of discretion standard the court should not exercise judicial abstinence, but should certainly use a "healthy dose of judicial restraint". In essence, the Evans case, which is a published decision, stands for the proposition that if a person's disability claim hinges on a "close call" then the plan will win under the abuse of discretion standard. The Evans decision is binding precedent in the Fourth Circuit. Click here to view the decision. Click here to view a news article.

On January 23, 2008, in Wilson v. Phoenix Specialty Manufacturing Co., Inc., 513 F.3d 378 (4th Cir. 2008) the United States Court of Appeals for the Fourth Circuit affirmed a district court verdict in the amount of $197,783.00 for Plaintiff Jimmy Wilson on his claim brought under the Americans With Disabilities Act. Mr. Wilson was represented by a team of attorneys including Foster Law Firm attorney Robert E. Hoskins, former Foster Law Firm attorney, Candy Kern-Fuller (now a partner in her own firm, Powdersville Law Group), and Victoria Eslinger of Nexsen Pruet. The Wilson case involved peripheral ERISA issues, but was decided based upon a primary issue under the Americans With Disabilities Act. The Wilson decision is a published decision meaning that it is binding precedent in the states which comprise the Fourth Circuit (South Carolina, North Carolina, Virginia, Maryland, and West Virginia). Click here to view the decision.

In Donovan v. Eaton Corporation Long Term Disability Plan, 462 F.3d 321 (4th Cir. 2006), the firm's attorney, Rob Hoskins, represented the Plaintiff Deborah Donovan. Donovan involved an ERISA governed long term disability claim. In Donovan, the ERISA plan from which Donovan sought benefits was funded by her former employer, Eaton Corporation, and administered by Broadspire Services, Inc. (See Evans above) Broadspire and Eaton had denied Donovan's claim by procuring numerous in-house medical opinions from Broadspire affiliated physicians and an opinion from a service known as Medical Review Institute of America. Despite the fact that the plan and its administrator had procured numerous opinions that Ms. Donovan was not disabled, those opinions were all lacking in some regard. The District Court ruled with Donovan and reversed the plan's claim decision holding that the opinions the plan relied upon were all either lacking in some respect or simply unreasonable. The District Court held that if the administrator had considered all of the relevant portions of the record including the objective medical evidence and the opinion of Donovan's treating physician that it surely would have concluded that Donovan was disabled. After losing the case at the District Court level, the plan appealed the decision to the United States Court of Appeals for the Fourth Circuit. After hearing the case, the Fourth Circuit affirmed the District Court's decision in ruling with Donovan. The Fourth Circuit held that the plan only denied the claim because it disregarded important medical evidence in the record and failed to consider the whole of the contents of the record. The Donovan decision is published meaning that it is binding precedent in the Fourth Circuit. Click here to view the decision. Click here to view a news article.

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Past case results do not predict outcomes in future cases. Each case is determined on its own merits. We at Foster Law Firm LLP use our experience and best efforts to try to put our client's case in the best possible position to increase the chances of a successful outcome. Some cases, however, present difficult factual and/or legal circumstances which will affect the outcome of the case.

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