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.
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...
November 6, 2015 —
In a recent claim denial our disability law firm is handling for a physician suffering with cervical myeolopathy, Lincoln Financial stated, "A condition warranting surgery does not necessarily equal a condition qualifying an insured for Total Disability." In this claim Lincoln's own IME doctor was surprised that the claimant did not have neck surgery. Regardless of the fact that the IME doctor felt the claimant was surgical candidate, he still...
October 29, 2015 —
Mr. V had previously worked as a project manager for the YMCA until severe and chronic lower back and radiculopathic pain caused by sciatica, lumbar radiculitis, degenerative disk disease and osteoarthritis forced him to cease working and file a long-term disability claim under his employer's long-term disability insurance plan funded and administered by CIGNA.
According to the National Institute of Neurological Disorders and Stroke, 80%...
October 1, 2015 —
After Frederick Ervin drowned in the spring of 2014, his widow, filed a claim to collect death benefits under his accidental death insurance policy carried by his employer. Her claim was denied as was her administrative appeal. She then filed this ERISA lawsuit. In Ervin v. Nat'l Union Fire Ins. Co. of Pittsburgh, PA, a federal court in Maryland agreed with National that the widow was ineligible to collect benefits based on the specific language...
September 10, 2015 —
Unum is obviously scraping the bottom of the barrel and making attempts to reduce the number of claimants that are currently receiving long term disability benefits. We recently reviewed a Unum denial letter for a woman that has been deemed disabled by Unum since September 18, 1998. This woman was approved for social security disability benefits in 2000 and she has been receiving $488 a month from Unum. She is currently 53 years old. Her...
September 4, 2015 —
In Stockman v. GE Life, Disability and Medical Plan et al., the plaintiff severely injured his foot and totally lost the function of it for 12 months. He then applied for benefits under the GE Life policy claiming he suffered a "total and permanent" loss of the use of his foot. MetLife, Plan Administrator for GE, denied his claim on the grounds that the loss was not total and permanent. Both the Ohio district court and appellate courts disagreed...
August 28, 2015 —
A Pennsylvania federal court ruled in favor of a claimant who continued to suffer severe debilitating neck, shoulder and upper arm pain following a cervical fusion surgical procedure. The pain sent her into depression and she became dependent on pain killers requiring her to spend time in a drug rehabilitation program. The Life Insurance Company of North America (LINA) denied her application for long term disability benefits finding that her...
August 27, 2015 —
In this video nationwide disability insurance lawyers Gregory Dell and Cesar Gavidia discuss the latest trends they are seeing in Metlife's handling of both ERISA and private disability insurance claims.
August 21, 2015 —
Watch Gregory Dell and Stephen Jessup discuss Cigna's latest strategy for handling disability benefit claims. This video has some tips which may help you to secure disability benefits. Any of our lawyers are available for a free initial phone consultation to discuss your claim.
July 28, 2015 —
The deal combines the second - and fourth - biggest insurers in the U.S., measured by members, and would have estimated revenue of about $115 billion and serve more than 53 million people with medical coverage.
Anthems announcement to buy Cigna comes on the heels of two other health care industry mergers: Humana and Aetna Inc. agreed to buy Humana Inc. for $35 billion earlier this month, a day after Centene Corp. struck a $6.3 billion deal...
July 9, 2015 —
Watch our latest video discussing the recent increase in disability IME exams which we have noticed. In this video disability insurance lawyers Gregory Dell and Stephen Jessup discuss multiple ways that you can be prepared for a disability IME Exam.
July 3, 2015 —
In this video nationwide disability insurance attorney Stephen Jessup discusses a recent Sun Life long term disability claim in which the court finds that Sun Life failed to conduct a proper evaluation. The claimant that filed for long term disability benefits had a mental nervous disorder.
June 26, 2015 —
Gregory Dell and Cesar Gavidia just released this video discussing the recent claim handling activities of Unum insurance company. This video is not only helpful to learn about Unum insurance claims, but it is also helpful for claimants that have a disability benefit claim with any other disability insurance company. Let us know your thoughts about the video and any comments you may have about your experience with Unum.
June 2, 2015 —
Between 836,000 and 2.5 million people suffer from what is now known as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The actual number is likely higher since many physicians misunderstand the disease and, as a result, some people suffer from the syndrome for years without being properly diagnosed.
Since only about half of medical school textbooks include information about ME/CFS, and only about one-third of medical schools...
May 22, 2015 —
The U.S. Court of Appeals for the Fourth Circuit recently agreed with a federal district court in South Carolina that the Federal Express Corporation (FedEx) was blatantly wrong when it denied long-term total disability benefits to its employee who was injured on the job. The claimant, Richard Bilheimer, had been employed by FedEx for eight years when he was involved in his second on the job car wreck. He was left with major injuries and...
April 21, 2015 —
You MUST file TWO appeals with Lincoln prior to filing suit!
Most long term disability insurance companies only require one mandatory appeal prior to initiating a lawsuit in federal court. Some insurers allow a voluntary appeal after the first appeal is denied, but do not require a second appeal prior to filing suit. However, Lincoln National Life Insurance Company requires TWO MANDATORY appeals before a suit may be filed in federal court...
April 14, 2015 —
A Georgia Federal Court recently concluded that Aetna abused its discretion in denying long term disability benefits to an Aetna employee who suffered from chronic pain due to Lupus, Fibromyalgia, Asthma, Hypocalcemia and Mild Degenerative Joint Changes. Aetna unreasonably denied benefits by relying on flawed peer review reports of the plaintiff’s medical records. The court found the reports “ignore and mischaracterize the evidence” and...
April 7, 2015 —
If you are insured under or receiving disability benefits from an employer provided Group Disability Insurance Policy governed by ERISA your benefit is or will be subject to reduction for sources of "Other Income" benefits you receive while on claim. Of these sources of Other Income Benefits, Social Security Disability (SSDI) benefits are the most common. These provisions are legal and enforceable, but what happens when Reliance Standard, for...
April 2, 2015 —
Click here for the case: Gaines vs Aetna . PDF
March 13, 2015 —
A Massachusetts Federal Court recently held that MetLife wrongfully denied long term disability benefits and abused its discretion by failing to address contrary evidence and placing undue weight on certain evidence. The court remanded the case back to MetLife with specific instructions to re-evaluate the claim. This case was not handled by Attorneys Dell & Schaefer but it is a good victory for disability claimants suffering with...
March 11, 2015 —
In a case not handled by Attorneys Dell & Schaefer, a Prudential Claimant has lost her right to sue after being denied disability benefits. In a recent decision by a Circuit Court Judge in the United States District Court for the Western District of North Carolina, a disabled woman's lawsuit against Prudential was dismissed because she unfortunately waited too long to file a lawsuit.
The claimant was previously employed by Thermo Fisher...
March 6, 2015 —
Employee Terminated Despite Suffering From Disability Which Impacted His Work Performance
Kevin worked for Ametek, Inc. from 2008 until July 2012, holding various positions over the course of that time. Beginning in 2009 he began suffering a number of serious health problems which forced him to take medical leave until early 2010, at which time he returned to work. Kevin worked, despite his serious health problems stemming from a spontaneous...
February 19, 2015 —
We get many calls involving claims denied based upon exclusions for losses or disabilities resulting from certain excluded conditions. Common excluded losses are those resulting from pre-existing conditions, suicide or attempted suicide, acts of war, or criminal acts.
In a recent case out of Kansas, a federal court was faced with determining whether there was a sufficient causal nexus to deny a claim based upon a criminal-act exclusion. The...
January 29, 2015 —
In a recent long term disability case out of the Puerto Rico United States Federal District Court, a long term disability claimant's ERISA lawsuit was dismissed when the court ruled that MetLife's three year period to file a lawsuit following a claim denial is enforceable. In the case of Santana-Diaz v. Metropolitan Life Insurance Company, which was not handled by our law firm, the claimant argued that the disability denial letter did not warn...