Disability Insurance Claims Law Blog

Disability Insurance Claims Law Blog

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Plaintiff Awarded Benefits when Sedgwick Abuses its Discretion

Posted in Disability Insurance Cases Nationwide, Sedgwick Claims

Sedgwick Claims Management is notorious for abusing its discretion when determining whether a claimant qualifies for disability benefits. The most common ways in which Sedgwick abuses its discretion includes, the failure to consider treating doctors’ opinions, failure to consider a favorable determination by the Social Security Administration, failure to speak to treating doctors regarding the claimants’ disabling conditions, failure to have the claimant examined and relying solely on paper reviews of paid doctors. A court in the Northern District of California addressed some of these very issues resulting in a very favorable outcome for the Plaintiff.
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Arkansas court grants Hartford’s motion for summary judgment for claimant’s failure to exhaust administrative remedies

Posted in Disability Insurance Cases Nationwide, Hartford

This is yet another case shedding light on the importance of timely exhausting administrative remedies before filing an ERISA lawsuit. In this recent case, which was decided by a U.S. District Court in Arkansas, Mr. Deaton, a former Walmart Stores employee, was on claim for disability with Walmart’s disability insurer, Hartford Life and Accident Insurance Company (“Hartford”).
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How Do I Get Attorney Fees Awarded In An ERISA Disability Benefit Appeal or Denial?

Posted in Disability Insurance Cases Nationwide

Long term disability lawyers Gregory Dell and Rachel Alters recently released an educational video which discusses the issues surrounding an award of attorney fees in ERISA disability claim. In this video, they discuss the standards that must be satisfied to win attorney fees and the difficulties that can arise in a court awarding ERISA attorney fees.

Greg and Rachel have litigated the issue of attorney fees extensively and this video was designed to discuss the most common issues. If you have been denied disability insurance benefits and have been forced to file a lawsuit, then you may be able to recover attorney fees. Contact any of our disability insurance lawyers to learn more about how Attorneys Dell & Schaefer may be able to assist you.

Federal Appeals Court Rules that Sun Life Can Offset VA Benefits Even Though Such Benefits Are Not Listed in the Policy

Posted in Disability Insurance Cases Nationwide, Sun Life

In an unpublished opinion issued on July 7, 2014 from the United States Court of Appeals for the Tenth Circuit, a Federal Court ruled somewhat surprisingly and approved Sun Life’s decision to “offset” VA Benefits from a disabled Veteran’s monthly disability benefits. While this case is not “binding precedent,” it can serve as a warning for those that are receiving VA Benefits, or any other income benefits, that are not listed in their Long Term Disability (LTD) ERISA Policy.
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Plan administrator gets the benefit of the doubt in another ERISA lawsuit

Posted in Uncategorized

Claimants often ask why ERISA lawsuits are so difficult. Among other reasons, the biggest obstacle for claimants in ERISA lawsuits is often the standard of review employed by the court reviewing the claim denial.

The core of every ERISA lawsuit involving the recovery of disability benefits essentially comes down to whether the court will give the claims administrator the benefit of the doubt. In most cases, where the plan gives the administrator discretionary decision making authority, the court reviews the claim denial merely for an abuse of discretion. In other words, the administrator gets the benefit of the doubt.
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Kentucky District Court concludes that Kentucky’s five year statute of limitations applies to ERISA actions

Posted in Disability Insurance Cases Nationwide, LINA

In Hester v. Life Insurance Company of North America, a recent case out of the Eastern District of Kentucky, the widow of a deceased employee of CSX attempted to bring an ERISA action, alleging that LINA wrongfully denied her claim for death benefits nearly eleven years earlier. Finding plaintiff’s civil action to be untimely, the Kentucky court entered judgment in favor of LINA.
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Court Upholds Reliance Standard’s Decision to Deny Continued Long Term Disability Benefits to former GAF Materials Corporation Employee

Posted in Disability Insurance Cases Nationwide, Reliance Standard

Although this recently decided case was not handled by Attorneys Dell & Schaefer Chartered, it can be used an educational tool for those currently on claim or those thinking of making a claim for disability benefits.

The Factual Background

Sylvia R. suffered from Chronic Fatigue Syndrome. Being employed by GAF Materials Corporation she was apparently covered by a Long Term Disability (LTD) Insurance Policy that would provide her with an income should be unable to perform the duties of her occupation. This Policy was with the Reliance Standard Life Insurance Company.
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Hartford Approves Disability Benefits At Any Occupation Stage and Then Denies LTD Benefits, But Court Reverses

Posted in Hartford

A California federal Judge recently reversed Hartford’s denial of long term disability benefits to a former manager that was initially approved from 2008 until July 2011. Hartford once again relied on their use of video surveillance and an IME report to wrongfully deny LTD benefits. Thankfully the claimant in this case took Hartford to court and won. While our disability attorneys have handled hundreds of cases against Hartford, this case was not handled by our law firm. The Judge’s opinion in this case was outstanding as it addresses all of the wrongdoing done by Hartford.
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