B & S Welding LLC Work Related Injury Plan v. Juan Pedro Oliva-Barron and Avelina Oliva
The B & S Welding LLC Work Related Injury Plan appealed a trial court's judgment in favor of Juan Pedro Oliva-Barron, who was denied benefits after a work injury. The Plan had accused Oliva of fraud, while Oliva counterclaimed for ERISA benefits. The appellate court affirmed the trial court's finding that Oliva was excused from exhausting administrative remedies due to the Plan's conduct, and that the Plan's termination of benefits was arbitrary and lacked substantial evidence. However, the court reversed the award of medical expenses due to insufficient evidence but upheld the award of indemnity benefits and attorney's fees.