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Stone v. Bayer Corp. Long Term Disability Plan

2010 U.S. Dist. LEXIS 3440, 61838 (USDC Or. 2010), affirmed by the Ninth Circuit on appeal by the long term disability Plan, 2011 U.S. App. LEXIS 15105 (9th Cir. 2011)

pilsStone became disabled from a combination of conditions, including traumatic brain injury, mold-caused illnesses, allergic reactions, pulmonary compromise and cancers, while employed as a customer service representative by Bayer. When Bayer finally denied her application for disability benefits on the basis that she was disabled from work stress — a condition excluded from coverage by the Plan — she sued Bayer in United States District Court of Oregon. The Court reversed Bayer’s denials and ordered Bayer to pay her back benefits, noting that Stone’s disability was not the result of work stress, and also that the Plan had failed to identify the exclusion for work stress in the administrative process of considering the claim.

After a relatively short time, Bayer denied Stone’s claim again, claiming that she was no longer disabled, taking the position that she was never disabled and was entitled to benefits only because the Court had entered a judgment in her favor.

Thus Stone was forced to sue Bayer again, in the federal court in Portland. After receiving evidence and argument, the Court again ruled that Stone was entitled to long term disability benefits and entered a judgment in her favor.

Bayer appealed the case to the Ninth Circuit Court of Appeals, which is headquartered in San Francisco. After briefing, but before oral argument to the Ninth Circuit, the Court upheld the judgment in favor of Stone.

ERISA
The Employee Retirement Income Security Act, is a federal law passed by congress in 1974, ostensibly to safeguard and provide fair and regular procedures for the administration of employee welfare benefit plans subject to ERISA.