When a former DuPont employee challenged the termination of her long-term disability (LTD) benefits, she argued both that the review process violated ERISA’s procedural protections and that the administrator acted unreasonably in cutting off benefits despite years of approval and a favorable Social Security ruling. But in McDonald v. E.I. Dupont De Nemours and Company Total and Permanent Disability Plan, No. CV 23-1141-RGA, 2025 WL 2733637 (D. Del. Sept. 25, 2025), the court sided with the Plan and its administrator, The Hartford, granting summary judgment in their favor.
Judge Richard Andrews’ opinion illustrates the uphill battle ERISA claimants face under the “arbitrary and capricious” standard of review. The court rejected the plaintiff’s procedural arguments under ERISA § 503 and concluded that substantial evidence supported The Hartford’s decision, even in the face of contrary opinions from her treating physician and a prior Social Security Disability Insurance (SSDI) award.
Procedural Challenge Rejected
McDonald first argued that IMEDECS, the independent reviewer handling her final-level appeal, violated ERISA’s procedural protections by relying on “new evidence” without giving her the chance to respond. ERISA § 503, along with 29 C.F.R. § 2560.503-1(h)(4)(i)–(ii), requires that claimants be provided access to new or additional evidence considered in connection with an adverse determination.
The court was unpersuaded. Judge Andrews noted that McDonald failed to identify any actual “new” evidence relied upon by IMEDECS. Instead, the record showed that IMEDECS conducted a paper review of the same materials already in the administrative record. As the court explained, McDonald herself described IMEDECS as having relied “solely on a paper review” rather than generating new evidence.
Substantial Evidence Supported the Termination
The heart of the...
