We monitor the actions of every disability insurance company nationwide. We constantly report on the latest disability insurance lawsuits, claim handling trends and answer frequently asked questions in order to help disability insurance claimants secure their benefits. Feel free to either leave a comment on any of our articles or privately contact us should you have any questions.
April 13, 2016 —
In Zuke v. American Airlines, Inc., plaintiff had received 13 years of long term disability benefits when MetLife, the plan administrator, terminated them. When Zuke's administrative appeal was denied, she filed an ERISA lawsuit. When the Ohio district court agreed with MetLife, she appealed. On appeal, the Sixth Circuit held that MetLife's termination of benefits was arbitrary and capricious since it was based on reviewing doctors' opinions...
March 29, 2016 —
In McMillan v. AT&T Umbrella Benefit Plan No. 1, the plaintiff, who had worked for AT&T for nearly six years as a Senior IT Client Consultant, filed a claim for short term disability benefits based on multiple medical conditions, including his coronary disease, hypertension, diabetes and sleep apnea. The plan administrator for AT&T is Sedgwick Claims Managements Services, Inc. (Sedgwick).
Although his job duties required detailed cognitive...
March 24, 2016 —
In Sim v. Reliance Standard Insurance Co., et al, the Sixth Circuit court in Ohio granted plaintiff's motion for discovery in his quest to show that Reliance did not give his claim for disability benefits a full and fair review due to its conflict of interest between being the plan administrator and the payor of benefits. In granting plaintiff's motion, the court relied on other Sixth Circuit cases and noted that, "The court need not decide...
March 22, 2016 —
In Mackey v. Liberty Life Assurance Company of Boston, an Arkansas federal court ruled that Liberty abused its discretion when it denied benefits to Mackey on the grounds that there were three vocational alternatives for her without actually considering her abilities to perform the job duties of the alternate occupations. The court did not accept Liberty's conclusion and remanded with instructions that, "A benefit plan administrator must also...
March 17, 2016 —
Every week we speak to individuals nationwide seeking assistance with Liberty Life Insurance short and long term disability claims. In this video, disability insurance lawyers Gregory Dell and Stephen Jessup discuss their experience in handling Liberty Mutual claims at all stages.
March 15, 2016 —
In Anderson v. Sappi Fine Paper of North America, plaintiff worked for Sappi for 30 years as a carton line operator during which time she suffered continuously from chronic pain due to her club feet. Her job required her to stand for several hours a day. After she fractured her foot while on vacation, she quit work and filed a claim for disability asserting that due to her long-term feet and knee problems, she could no longer stand long enough...
March 9, 2016 —
The court discounted the video surveillance, finding "The video surveillance footage was of marginal, if any, relevance." The court continued, "The surveillance video of Ms. Young does not depict activity inconsistent with her reported limitations. The video does not demonstrate Ms. Young has the ability to work full-time in her regular occupation." The court ordered that the plaintiff was entitled to long term disability benefits due to her...
March 3, 2016 —
In Allen v. Unum Life Insurance Company of America, after her long term disability benefits were denied, plaintiff, a pharmacy technician who suffered a serious back injury in a car accident, filed a federal lawsuit under ERISA. She included a claim for defamation based on two letters sent by the Plan administrator. One letter was to her treating physician asking for more information about her medical condition. The other letter was to her...
February 23, 2016 —
In Tracia v. Liberty Life Assurance Co., of Boston, despite an extended discussion of the history of the plaintiff's disability, his various medical conditions, reports of treating physicians and analysis of independent reviewers, the court divided the case into two main issues:
#1- Liberty erred by failing to advise the plaintiff of the type of objective evidence it required in order to consider his claim, and in not giving him an...
February 17, 2016 —
Herbert v. PNC Financial Services Group, Inc. and Affiliates Long-Term Disability Plan involves a plaintiff who applied for long-term disability benefits based on her chronic vertigo (dizziness) and nausea. She was treated by five different physicians who all noted she had these chronic conditions, but not one medical professional placed upon her any restrictions relevant to her employment.
Despite the plaintiff's argument that she should not...
February 15, 2016 —
MetLife is one of the top five largest group and private disability insurance companies nationwide. As of January 2016 it appears that Met Life is now interested in considering the buyout of a claimant's group long term disability policy. Met Life has always done buyouts of individual disability insurance policies. For the past ten years Met Life was not interested in buying out the disability policy of a claimant that has been on claim without...
February 11, 2016 —
Principal Financial is one of the more interesting disability insurance companies to deal with. They sell both individual disability and ERISA group disability policies. Our disability insurance lawyers have helped hundreds of Principal Financial policy holders at all stages of their short or long term disability claims. In this video, nationwide disability insurance lawyers Stephen Jessup and Gregory Dell discuss their experience handling...
February 10, 2016 —
In this video we discuss the recent trends they have observed with regard to Unum Insurance Company's denial of long term disability benefits. We offer some tips that can either help you to avoid a claim denial or possibly improve your chances to stay on claim. Contact any of our disability insurance lawyers for a free consultation to discuss your disability claim.
February 4, 2016 —
Unum reached a new low today which displays absolute disregard for the rights of a UNUM insured. Our law firm advised Unum in a January 16, 2016 letter that we would be sending a videographer to record the Orthopedic Compulsory (Independent!) Medical Examination requested by UNUM. On January 18, 2016 Unum sent us a letter stating that they scheduled a videographer and that UNUM would pay for the videographer. Unum also advised that we would...
February 2, 2016 —
In the case of Solnin v. Sun Life and Health Insurance Company, et al., the plaintiff, an assistant bank manager, injured her back at work and was initially granted short term disability benefits under her employee benefit plan. The case has an extensive procedural history of Sun Life terminating benefits, adminstrative appeals and at least one previous court case.
In this action, in its attempt to discredit the plaintiff and prove she was...
January 28, 2016 —
The plaintiff in Neno v. Aetna Life Insurance Company, employed as a Senior Forensic Professional by a computer corporation, received short term disability benefits under his employer's welfare benefit plan due to his debilitating neck and hip pain. After 24 months, those benefits were exhausted and his application for long term disability benefits was denied.
According to Aetna's policy, in order to obtain long term disability benefits, Neno...
January 26, 2016 —
In Charles v. UPS National Long Term Disability Plan et al., the plaintiff, Marvin Charles, was being treated for a reoccurrence of a seizure disorder, a condition that had been dormant for about 30 years. In 2008, he had a grand mal seizure and consulted with his physician who prescribed Lacmital, a medication used for the control of seizures. He was granted 24 months of short term disability when Aetna agreed he was unable to perform the...
January 21, 2016 —
In Hopper v. Aetna Life Insurance Company, a machinist with 11 separate medical diagnoses was initially granted short term disability benefits. When those benefits were exhausted, Aetna granted him 24 months of long term disability benefits when Aetna determined he was disabled from performing the duties of his own occupation. Due to his respiratory problems and skin rashes and visual problems, it was not difficult for Aetna to determine that he...
January 19, 2016 —
In Valentine v. Aetna Life Insurance Company, the plaintiff applied for disability benefits claiming her disability began in December 2011, when she was diagnosed with trigeminal neuralgia which caused her severe facial pain. She also claimed that her pain medications had side effects that made it impossible for her to concentrate and perform her job duties. Her claim was accompanied by medical records from her treating physician, Dr. Sirois, a...
January 14, 2016 —
Be Sure To Maintain a Copy of Your Original Disability Policy
It is extremely important to make sure you maintain a copy of your disability policy once it is initially provided by your insurance company. If your policy is lost, it is possible that your insurance company may be able to provide you with a copy, but they are not obligated to do so, nor are they obligated to maintain one. In order to make sure that your insurance company abides by...
January 12, 2016 —
In McIlhaney v. Anthem Life Insurance Company Long Term Disability Plan, a California Federal District Court held that Anthem was "unreasonable" in its denial of long term disability benefits to its claimant when the medical records supported her claim for benefits and Anthem made a mistake in its reading of plaintiff's Activities of Daily Living (ADL) report which contributed to its denial decision.
This case was not handled by our law...
January 5, 2016 —
Mr. G had previously worked as a foreman for a large fertilizer company. One day at work Mr. G suffered a fall into a bin of fertilizer. Although Mr. G suffered some injuries, he soon began developing serious neurological symptoms which included parkinsonian type symptoms, seizure episodes and muscle spasms. Initially, he believed his symptoms were related to his fall into the bin of fertilizer, however, they persisted and worsened. His symptoms...
December 29, 2015 —
This ERISA case was not handled by our office, but we feel it can be instructive to others who may be in a similar situation as this claimant.
In MacDonald v. Anthem Life Insurance Company, the plaintiff, who suffered from chronic regional pain syndrome (CRPS), alleged Anthem was arbitrary and capricious in terminating her long term disability benefits on the grounds that she could work at "any gainful occupation" without conducting a new...
December 16, 2015 —
The Michigan Federal Court agreed that the plaintiff had physical limitations, but none of the activities from which she was restricted were required by her sedentary occupation Plaintiff's initial claim for long term disability benefits was denied by Anthem. The denial was upheld following three administrative appeals. After reviewing her medical records, all three separate independent reviewers agreed that although the plaintiff's physical...
December 10, 2015 —
District Court Proceedings
In Decovich v. Anthem, a Nevada District Court granted Anthem's motion for summary judgment finding Anthem's denial of plaintiff's application for long term disability benefits was reasonable. According to the court, the "administrative record is voluminous, well-known to the parties, and its contents are not disputed." Accordingly, the court opinion provides only a brief synopsis of what happened in the...
December 8, 2015 —
The current case of Robertson v. Standard Life Insurance Company concerns the proper calculation of prejudgment interest based on the court's previous ruling that Standard had abused its discretion in terminating plaintiff's long term disability benefits. The original order was based on Standard’s denial of benefits under the "own occupation" definition of disability under its policy. To date, Standard has made no decision on whether the...
December 3, 2015 —
Although this Virginia Federal ERISA long term disability case was not handled by our disability insurance lawyers, it is an example of how Anthem denies disability benefits by asserting claimants are not disabled from performing their job duties without ever determining or analyzing what those job duties are.
In the case of Wyant v. Anthem Life Insurance Company, Anthem denied long term disability benefits to Wyant deciding...
November 20, 2015 —
The Indiana federal district court case of Kennedy v. Lilly Extended Benefit Plan is a refreshing example of how perseverance in asserting a claim for long term disability benefits after they have been terminated can pay off. The plaintiff suffered from the pain and stress of fibromyalgia as well as other medical problems which turned out not to be relevant to the court's order that Anthem reinstate her benefits. The court ruled that remanding...
November 17, 2015 —
Attorneys Dell & Schaefer has transformed their office space into an art gallery. Attorneys Dell & Schaefer is partnering with local arts organizations and inviting members of the community to enjoy and appreciate art. Plans are to rotate the art quarterly to allow for a procession of artists to share their work through the space. The art serves to convert office space into a creative work space and invites members of the community to enjoy and...
November 12, 2015 —
The Federal District Court in Vermont noted that there was no question that the plaintiff suffered from "degenerative disc disease resulting in significant pain." Since the denial of long term disability benefits under the "any occupation" definition of disability was based only on a subjective conclusion without any discussion of the physical requirements of "any occupation," the case was remanded to ING / ReliaStar for...