December 2009

Our client was a litigator with his own successful practice. Early in 2009 he began to experience increasing pain in his upper back and neck. Thinking it was just a result of stress, he continued to try to work through the pain.
Continue Reading Berkshire Approves Total Disability Benefits For Litigation Attorney Following Multi-Level Fusion Of Cervical Spine And Surgery To Remove A Cancerous Tumor

Our client was a former officer in the United States Marine Corp with combat service in both Iraq and Afghanistan, who upon retiring from the USMC began working as a medical device sales representative in an operating room setting.
Continue Reading Reed Group Overturns Its Decision To Terminate Short Term Disability Benefits To Retired Marine Corp. Officer Suffering From Post Traumatic Stress Disorder

Once again the Ninth Circuit U.S. Court of Appeals has upheld a state’s rights to protect employees that have long-term disability insurance policies issued by their employers. In an opinion filed on October 27, 2009, three circuit judges on the ninth circuit reached a unanimous decision that a state’s practice of disapproving insurance policies that…

On November 4, 2009, a ruling was handed down in the Sixth Circuit Court of Appeals that will surely have insurance companies looking at how they define “pre-existing condition”. Ruth Mitzel is certainly happy that the court affirmed the lower court’s decision that Anthem Life Insurance Company, her employer and insurer, had wrongfully denied her long-term life insurance benefits.
Continue Reading Court Rules That An Undiagnosed Pre-Existing Condition Will Not Result In Denial Of Long-Term Disability Benefits

After receiving disability benefits for more than 10 years, the Reliance Standard denied disability benefits. After a 4 year legal battle, the Arizona district court determined that Melisa Gemmel was disabled by fibromyalgia. Melissa Gemmel was employed at Systemhouse, Inc. and covered under her employer’s long-term disability plan, issued by Reliance Standard (NYSE:DFG).
Continue Reading Arizona Court Reverses Reliance Standard And Awards Disability Benefits to Woman Suffering From Fibromyalgia

It is vital that you hire the right long-term disability firm to represent you. Debra Swanson had to learn this the hard way, as a recent ruling in the Fifth Circuit court of Appeals in the Southern District of Texas demonstrates. How did Swanson’s attorney fail her? Her counsel failed to file a proper appeal.
Continue Reading Texas Court Rules That Hartford Wins Long-term Disability Case, Claimant Failed To Exhaust Administrative Remedies

Aside from the fact that many disability insurance companies already have a conflict of interest for being both the administrator of benefits and the entity that decides whether or not an employee qualifies for disability insurance, there are some cases in which it appears that insurance companies simply decide they don’t want to pay disability benefits.
Continue Reading Texas Court Reverses Hartford’s Unreasonable Denial Of Disability Benefits To A Hospital Employee

Alvin Hintz was an employee of CCL Custom Manufacturing, Inc. as Director of Information Systems for more than a decade. The company was purchased prior to Hintz’s termination, by KIK Custom Products, Inc. On August 8, 2005, Hintz was terminated along with eight other employees. In the separation agreement, there was a ‘general release of claims’ that Hintz signed. The long term disability plan was administrated by Prudential.
Continue Reading After Denial Of Long-Term Disability Benefits, Director Disabled By Heart Disease Takes Prudential To Illinois Court

Donna Blake was an employee of Express Scripts, covered under both a long term disability plan and a short term disability plan, when she applied and was denied for short term disability coverage. After internal appeals, Mrs. Blake brought her claim to the United States District Court, Missouri Eastern Division. Upon the settlement of Mrs. Blake’s claim for short term disability, she claimed that she would be prevented from filing for long term benefits, because the denial of her short term disability claim, “prevented her from applying for LTD benefits from the LTD Plan, as she was required to satisfy the applicable period of STD before becoming eligible for LTD benefits.”…
Continue Reading MetLife’s Motion To Dismiss Long-Term Disability Claim For Failure to Exhaust Administrative Remedies Is Denied By Missouri Court

When you apply for a disability policy, it is very important to answer all questions as truthfully as you can. The courts generally will not render a summary judgment in favor of the disability insurance company if the company can’t prove that you answered a question with the intent to defraud.
Continue Reading After Claimant Paid Premiums For 15 Years, Northwestern Mutual Rescinds Disability Policy