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.
May 17, 2013 —
Have you received a mysterious letter from Aetna with The Rawlings Company LCC emblazoned across the top?
We recently received letters on Aetna letterhead, referencing our clients' claims for disability, which start with: "Aetna Disability administers disability benefits under the group plan sponsored by your employer. We are requesting your cooperation in providing some additional detailed information about your claim, because we believe it...
May 13, 2013 —
A Colorado court recently brought down a very harsh ruling against Northwestern for blatantly abusing its discretion in denying long-term disability benefits to a Colorado Family Law Attorney (Mr. M) who suffered congestive heart failure and underwent aortic valve replacement surgery and thoracic aortic aneurysm repair.
Two interesting issues were addressed by the Court in its ruling. The first is the applicability of a certain Colorado...
April 17, 2013 —
In a recent ruling in the case of Dupell vs. Aetna, which pertained to rights to long term disability benefits under an ERISA governed group disability policy, a West Virginia Federal Judge ruled that the ERISA based disability litigation before the Court should not be dismissed on Motions for Summary Judgment filed by Ms. Dupell or Aetna. Furthermore, the Court ordered that the case should not be remanded back to Aetna for further review, but...
April 15, 2013 —
A New York claimant, Ms. Ingravallo, filed an ERISA lawsuit after Hartford determined that, after paying long term disability benefits for over 3 years due to her diagnosis of Relapsing-Remitting Multiple Sclerosis, she no longer met the Plan's definition of disability and was no longer eligible for continued benefits. Upon review of the administrative record, the New York Court found that Hartford abused its discretion in denying Ms...
April 8, 2013 —
The claimant, Ms. Petrone, worked for a subsidiary of Johnson & Johnson as a Finish Operator for 7 years. She stopped working after she was diagnosed with a L5-S1 disc herniation and underwent back surgery, a lumbar laminectory, which failed and left her with continued post-surgical pain and radiculopathy. Ms. Petrone was approved for short-term disability benefits and then received long-term disability benefits for nearly 2 years before the...
April 1, 2013 —
The claimant, Mr. Judge, had a high school education and worked for 20 years as a baggage handler and ramp agent for a major airline. He applied for disability benefits under the group insurance policy (the Plan) which was provided by his employer and issued by MetLife. MetLife determined that Mr. Judge was not totally and permanently disabled under the terms of the Disability Plan and denied benefits. Mr. Judge exhausted the internal...
March 25, 2013 —
The ERISA Law Governing Disability Insurance Claims Favors Insurance Companies
The law that governs lawsuits brought for denial of short or long-term disability benefits through a claimant's group disability insurance policy with their employer is called ERISA. When a lawsuit is governed by ERISA, the legal process is entirely different than one might imagine because lawyers rarely get to argue their case in front of a judge and you, as a...
March 18, 2013 —
It is vital for claimants to remember that just because disability benefits have been approved and are being paid, this does not mean the insurance company has closed its file and is no longer investigating your claim for disability. You must continue to treat for you illness or injury and your physicians must continue to support your being disabled and not able to work due to your illness or injury. Additionally, medical evidence of the...
March 11, 2013 —
In cases such as Lyme's Disease, and the wider gamut of chronic pain conditions such as Fibromyalgia or RSD and chronic fatigue conditions, the symptoms reported are often subjective in nature. Meaning there is no test to pinpoint the amount of pain a person is experiencing or how fatigued they feel. Despite the fact there is no objective test to measure levels of pain or fatigue, the insurance companies, knowing full well this fact, demand...
March 5, 2013 —
Every day we speak with disability insurance claimants nationwide that are unable to work as a result of chronic headaches and Migraines. Disability carriers often dispute headache and migraine disability claims finding that they are subjective. We recently came across a short documentary film about Migraines and Headaches that we thought was very informative and helpful for people suffering with headaches.
The award winning video document...
February 22, 2013 —
If you are currently receiving Long Term Disability benefits through Cigna Group Insurance, you may be contacted and asked to participate in their Vocational Rehabilitation Assistance Program. Cigna will explain that they may be able to assist you with their Re-Employment Solutions, but will note, however, that your policy contains a Mandatory Rehabilitation Provision which may "require" your participation. This means that your failure to...
February 15, 2013 —
We always welcome people reading our website to share their experiences regarding the handling of their disability insurance claim.
A reader recently posted her thoughts about the Standard Insurance Company application process for disability benefits.
I'm glad I stumbled on this website. I too have been struggling with The Standard Insurance Co. I have been diagnosed with Panic Disorder w/agoraphobia and also PTSD, and I believe major...
February 14, 2013 —
A Mutual of Omaha disability claim was sent back for further evaluation according to a recent decision by a Maryland Federal Judge. The issue dealt with how should Mutual Of Omaha determine the occupation of a disability claimant. Which is a better tool for determining occupation? ONET or DOT?
If O*Net has replaced the DOT, why can an insurance company rely on the DOT?
Unfortunately, there is no simple answer to this question. However, a...
February 11, 2013 —
All disability policies require a long term disability claimant to receive appropriate care and treatment throughout the entire duration of a disability claim. Failure to do so can and will result in termination of disability benefits permanently. A Federal Judge in Florida recently ruled in favor of American International Life, Assurance Company of New York, in an ERISA Disability Lawsuit. Although our firm did not handle this case, this ruling...
February 8, 2013 —
An Indiana Federal Judge recently ruled partially in favor of a claimant who was denied Long Term Disability (LTD) benefits by Sun Life. In the December 2012 ruling in the ERISA Disability Lawsuit, the Court found that Sun Life needed to review and properly address the medical opinion of one of the claimant's treating physicians. This physician's review and opinion were in stark contrast to the final opinion and decision of Sun Life. As such...
February 4, 2013 —
A recent decision by a Federal Judge in a California ERISA Disability Lawsuit serves as a reminder to all individuals receiving disability benefits: If your disability policy allows for the insurance company to "offset" other income benefits and to collect for overpayments, you must always remember that eventually you may owe that money to the insurance company should they request it soon thereafter or at a later date.
In a case against...
January 25, 2013 —
Everyone has heard the expression "You get what you pay for." Disability insurance policies are contracts and the better the policy language for a disabled claimant; then the more expensive it is going to be to buy. Some employers that buy short term or long term disability insurance policies of their employees may look to spend as little as possible. Unfortunately, employees may be stuck with a disability policy that does not provide the...
January 22, 2013 —
The case of Helfman v GE Group Life Assurance Company, et al (to include Sun Life Assurance Company of Canada) has an interesting factual history that played out over 6 years. However, it was a recent Order entered by a Michigan federal judge against Sun Life Insurance Company regarding the right to pre-judgment interest on unpaid benefits that is a victory for disability claimants nationwide.
The Sun Life disability denial and eventual award...
January 11, 2013 —
A recent ruling was issued on an ERISA Disability Lawsuit that had been filed in Missouri against Hartford Life and Accident Insurance Company. While our firm did not handle this case, this case and its ruling is so important because it shows the importance of finding competent representation who have significant experience handling ERISA Disability Appeals and Lawsuits. This disability claimant's case was dismissed because their attorney did...
January 9, 2013 —
Too many disability companies try to wrongfully use the 24 month mental nervous disorder limitation to deny long term disability insurance claims. How can Cigna pay disability benefits for 5 years and then claim a person should be limited to only 24 months of disability payments? In an ERISA Disability Lawsuit, a United States District Court in Oregon recently ruled that the Life Insurance Company of North America's (LINA/CIGNA) decision to deny...
January 2, 2013 —
Congratulations to the state of California disability division for making the state disability insurance application process easier for its residents. California residents eligible for state disability can finally apply online. "The online application process for California disability benefits should make the application process easier and more efficient for disabled individuals", stated Cesar Gavidia, a California disability insurance attorney...
December 25, 2012 —
A recent ruling by the United States District Court for the District of Nevada in an ERISA Disability lawsuit allows a claimant a chance for justice after the Federal Court denied multiple motions to dismiss a case that was filed by both Liberty Life Assurance Company and HSBC. Liberty Life and HSBS apparently believed that a disability claimant should not be allowed to file a lawsuit against them after they deny a claim for Disability Benefits...
December 21, 2012 —
Today we received a great comment on our website from a person that has been receiving benefits for almost 3 years due to a mental health condition. He wanted to know if he should be concerned about the disability carrier denying his benefits since he has now transitioned into the any occupation phase. Click here to read his post and Attorney Gregory Dell's response.
December 19, 2012 —
What is Cigna disability company trying to hide from its own insured? Why would Cigna refuse to release all video surveillance and fail to release information about its relationship with a hired physical therapist? It's unfortunately either an intentional act or the product of unqualified Cigna employees that are being asked to make the claim decisions on short term and long term disability claims.
It is not uncommon for a disability...
December 14, 2012 —
American Conference Institute recently published an article authored by Gregory Dell discussing Reliance Standard Insurance Company's use of the the 24 month mental nervous limitation.
Click here to read the article.
December 11, 2012 —
The Employee Retirement Income Security Act of 1974, better known as ERISA, the federal law which governs most employer provided insurance benefit plans (ie. group disability, health, life, etc.), is not known for its favorable treatment of claimants seeking recourse and recovery of monetary damages through the federal courts. However, there can be penalties for an insurance company's or plan administrator's wrongful actions which violate...
November 29, 2012 —
One of the most difficult things in any ERISA governed long term disability claim is dealing with a discretionary clause. A discretionary clause is language found in most ERISA disability policies which gives a plan administrator the ability to choose who will make decisions to approve or deny claims. If a disability policy has a discretionary clause then usually a court must apply an abuse of discretion standard when a case is litigated. The...
November 12, 2012 —
From our law firm's experience it seems that Walgreens will look for any excuse to deny short term or long term disability benefits to a plan participant. In a recent disability lawsuit filed in Michigan, Walgreens tried their best to use a legal technicality to dismiss the lawsuit of a former employee. Fortunately, the court did not buy Walgreen's unreasonable argument.
Matthew, a Walgreens Store Manager was forced off work on December 29...
November 2, 2012 —
Prudential Disability Insurance Company has their national headquarters in New Jersey. There are thousands of disabled individuals that are receiving short term or long term disability benefits from Prudential every month. Unfortunately, many of these claimants have suffered significant losses as result of Hurricane Sandy. Many of these claimants will be unable to treat with their doctors for several weeks or months as a result of damage to...
October 1, 2012 —
Here is an other example of case against Hartford Insurance Company which shows that you can never let your guard down when it comes to protecting your payment of long term disability benefits. Prior to going on disability, Michael O. was a heavy equipment operator in Virginia. In 2004 he was involved in an automobile accident, which resulted in having to undergo neck surgery. Despite the seriousness of his injury he was able to return to work...