Nugent v. Aetna Life Ins. Co., C.A. No. 13-30795 (5th Cir. Jan 3, 2014)
This is a case for long-term disability benefits. Court reiterated its earlier position that where there is an existing SSA determination finding that a claimant is disabled, the plan administrator must address the SSA's decision in its determination; failure to do so renders a determination procedurally unreasonable. evidence, structural conflicts of interest, and whether the SSA has awarded benefits. Schexnayder v. Hartford Life & Accident Ins. Co., 600 F.3d 465, 471 (5th Cir. 2010).
Here the court determine that Aetna had addressed the Social Security Administrator's finding that Ms. Nugent was disabled and that Aetna chose not to follow the SSA finding because Aetna had more recent medical information than the SSA had in its file.