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Claim for LTD Benefits Denied In Spite of Contrary Representation By HR Representative

A former employee of our client National Distributing Company sued in New Mexico state court alleging that he should have been eligible for Long Term Disability (LTD) benefits under the company’s plan based on erroneous statements from an individual in human resources, even though he was not technically eligible to participate under the terms of the Plan.

We removed the case to federal court and moved to dismiss and for summary judgment. The court agreed that as to the FMLA claim, the plaintiff was not eligible for LTD benefits while on FMLA leave. With respect to our motion for summary judgment, although there was closely related 10th Circuit law under ERISA that permitted an otherwise ineligible employee to participate in a plan due to company misrepresentations, we successfully convinced the court that the plaintiff's circumstances were distinct. The court held that our client did not violate ERISA through its misrepresentations to the plaintiff because other factors should have led the plaintiff back to the plan documents and such documents controlled the outcome of this case.

Otero v. National Distributing Co., 627 F.Supp.2d 1232 (D.N.M. 2009).


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