Bloomberg Law
April 25, 2022, 2:00 PM

Case: Health Care & Benefits/Health Benefits (4th Cir.)

The Fourth Circuit affirmed the decision of a federal district court in North Carolina granting summary judgment to the wife of a UPS Inc. employee in her ERISA action challenging the denial of her claim for benefits following spinal surgery. The appeals court agreed with the district court’s conclusion that Central States, Southeast and Southwest Areas Health and Welfare Fund Active Plan abused its discretion by relying on a physician’s review of the surgery without the benefit of relevant medical records when making the determination that surgery for her back and neck pain wasn’t medically necessary.

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