The court order remanding Michael Woolsey’s claim to Aetna included a determination that Aetna’s administrative process was “significantly deficient,” and it gave Woolsey “a renewed opportunity to secure benefits,” the US Court of Appeals for the Ninth Circuit said. This qualifies as “some success on the merits” and makes Woolsey eligible for an award of attorneys’ fees under the Employee Retirement Income Security Act, the court said.
The appeals court cautioned that its ruling doesn’t mean that any remand order, “without more,” is sufficient for an award of attorneys’ fees under ERISA. But this one is, because the district court completed a substantive review of Woolsey’s claims and concluded that Aetna failed to fulfill its duties under the statute, the court said.
Woolsey, a financial adviser for UBS, sought disability benefits in 2016 on account of debilitating migraine headaches and related depression.
The opinion was issued by Judges Michael Daly Hawkins, Richard A. Paez, and Paul J. Watford.
Kantor & Kantor LLP and Scott E. Davis PC represent Woolsey. Ogletree, Deakins, Nash, Smoak & Stewart PC represents Aetna.
The case is Woolsey v. Aetna Life Ins. Co., 9th Cir., No. 20-16885, unpublished 5/20/22.