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Fourth Circuit ERISA Ruling Shows Plan Discretion Is Not Limitless
DeBofsky Sherman Casciari Reynolds P.C.
May 12, 2022 "A doctor's opinion relied on by the plan that was not based on a full review of the relevant evidence was viewed by the court as neither principled nor reasoned.... [T]he plan's imposition of an absolute requirement that all conservative treatments must be exhausted before approving surgery was also considered an abuse of discretion.... Finally, ... [an] abuse of discretion may exist when the benefit determination is inconsistent with the purpose of the plan." [Garner v. Cent. States, SE & SW Areas Health & Welfare Fund Active Plan, No. 21-1602 (4th Cir. Apr. 20, 2022)] MORE >> |
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