Employee Benefits

Remand was required for new hearing on claimant’s application for Social Security benefits, where ALJ denied said application, after finding that claimant, although suffering from number of impairments including migraine headaches, was capable of performing her past work. Although ALJ cited to portions of record that supported instant denial, ALJ failed to explain why she did not find persuasive significant portions of record that contained evidence from claimant’s treating physician and others that indicated that claimant’s migraine headaches precluded her from performing her past work for significant periods of time throughout work week.

Dist. Ct. did not err in granting defendant-Pension Bd.’s motion to dismiss instant action alleging that defendant’s failure to reconsider denials of plaintiffs-police officers’ applications for pension credit violated plaintiffs’ due process and equal protection rights, where defendant had granted similar applications for pension credit for other police officers pursuant to Illinois Appellate Court decision that had been rendered after defendant had acted on plaintiffs’ original applications. Under Sola, 794 NE2d 1055, defendant lacked jurisdiction pursuant to Administrative Review Law (ALR) to reconsider its decisions regarding plaintiffs applications for pension credit, where said decisions had been rendered more than 35 days prior to instant reconsideration requests. Ct. further rejected plaintiffs’ claim that ALR’s failure to allow defendant to reconsider decisions beyond applicable 35-day period for doing so constituted due process violation.

Dist. Ct. did not err in granting defendant-insurance company’s motion for summary judgment in ERISA action by plaintiff-beneficiary of life insurance policy alleging that defendant improperly cancelled decedent’s supplemental insurance policy without his consent and had failed to pay plaintiff proceeds of said policy. While plaintiff argued that jury could infer wrongful conduct on defendant’s part since said alleged cancellation took place two months after decedent had been diagnosed with cancer, record showed that supplemental life insurance policy was not in force at time of decedent’s death, and plaintiff failed to present any evidence beyond suspicious timing to indicate that defendant was responsible for cancellation of said policy.

Dist. Ct. did not err in granting defendant-hospital’s motion for summary judgment in plaintiff-health plan’s breach of contract action seeking refund of $1.7 million that plaintiff had paid defendant for medical services provided to child of plaintiff’s beneficiary, where plaintiff determined 11 months after child began medical treatment that child was not covered under plaintiff’s health plan. While plaintiff argued that it was entitled to refund, subject contract did not contain any language calling for refunds, and plaintiff failed to present evidence that defendant had not provided medical services at issue in $1.7 million medical bill. Moreover, Ct. rejected plaintiff’s contention that contract contained implicit term requiring refund and noted that plaintiff could not seek recovery here, where plaintiff was entity that had made relevant mistake by paying medical bills prior to making determination that child was not covered under health plan. Fact that defendant had sporadically provided refunds to plaintiff or other health plans under similar circumstances did not require different result.

Dist. Ct. did not err in granting defendant-County employer’s motion for summary judgment in action alleging that defendant’s failure to provide plaintiff-retiree with cost-free health insurance constituted taking of property without due process, where record showed that at time of plaintiff’s retirement defendant had provided cost-free premiums for said insurance, and plaintiff otherwise had paid no co-payments, co-insurance payments or deductibles in conjunction with her health plan. While plaintiff had vested property interest in participating in defendant’s retiree health plan, plaintiff’s interest was limited to participating in same health plan as active employees, which had co-payments and deductibles. Moreover, at time plaintiff had retired, relevant ordinances required that defendant only provide premium-free health plan for retirees.

Dist. Ct. did not err in dismissing plaintiffs-union and certain union members’ action alleging unlawful interference with union members’ attainment of retirement benefits in violation of section 510 of ERISA, where defendant-employer terminated union members due to lack of contract with third party defendants, and where employer advised plaintiffs that they could apply for their current jobs with third-party defendants at reduced wage and benefit levels. Plaintiffs alleged only unlawful discharge, which presupposes employment relationship with all defendants, and thus plaintiffs had only potential section 510 claim against their employer. Moreover, Dist. Ct. could properly dismiss section 510 claim against employer since complaint merely alleged that employer discharged union members because employer had lost contract with third-parties and not because employer had interfered with union members’ attainment of pension benefits.