The United States Supreme Court in the case Black & Decker Disability Plan v. Nord
made clear that plan administrators did not have to give added weight to the opinion of a treating
doctor even though the doctor had been regularly treating a patient over a number of years. The
court also cautioned, however, that a plan administrator could not arbitrarily refuse to credit a
claimant’s reliable evidence, including the opinion of a treating physician.
In a recent case in Indiana, Maiden v. Aetna, the court found Aetna’s refusal to pay benefits
arbitrary capricious. Aetna had inexplicably disregarded the opinions of treating physicians and
ignored evidence supporting disability while cherry picking the evidence it needed to support a
denial. It did so with two (2) consultants that it regularly used. While the arbitrary and
capricious standard can be challenging, it can be satisfied when there is no principled reason or
basis to ignore the opinions of treating physicians.
Need legal assistance? Call a ERISA lawyer of Tuscaloosa today for a consultation!