MetLife Hammered in Disability Case After Ignoring Treating Physician Opinion

A Pennsylvania federal judge hammered Met life for its disability insurance determination.  The Court held that where the insured's treating physicians' disability opinion is unequivocal and based on a long-term physician-patient relationship, reliance on a non-examining physician's opinion premised on a records review alone is suspect and suggest that the insurer is looking for a reason to deny benefits.

Here is the court was highly critical of Met life and its doctor for failing to give a rationale for its conclusion that the claimant was able to work at a sedentary job and the court pointed out that MetLife's doctor ignored a functional capacity evaluation that supported the claim.  The court also was critical of the fact that the reviewing doctors disregarded the plaintiff's job requirements, and only knew that the job was "sedentary."

This case was Kauffman versus MetLife and it was decided on September 24, 2009.

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