Disability Benefit Claims Law Blog : Disability Benefits Lawyer & Attorney : Dell & Schaefer : Disability Insurance Claims Law Blog

The case we are going to look at here highlights the importance of involving a disability insurance attorney in your disability insurance policy purchasing decision. The language in disability insurance policies is complex and can often be turned against you when you most need the benefits. It is never safe to trust the assurances of the disability insurance company that a policy meets your requirements. The following case clearly demonstrates this reality.

→ Continue reading Was Boston Mutual's decision to terminate long-term disability insurance correct? (Part I)

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On September 2, 2009, District Judge William E. Smith of the Rhode Island U.S. District Court filed a Memorandum and Order, delaying his final judgment on the case of D & H Therapy Associates v. Boston Mutual Life Insurance Co. until all of the matters which were not under the jurisdiction of the Employee Retirement Income Security Act (ERISA) could be resolved (you may find the arguments presented to Judge Smith of interest; we discussed them in an earlier article titled Was Boston Mutual's Decision to Terminate Long-Term Disability Insurance Correct?). On March 8, 2010, both sides asked Judge Smith to reconsider his earlier order.

→ Continue reading Boston Mutual can not recover $163,000 overpayment to long-term disability claimant (Part II)

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On May 24, 2010, the United States Supreme Court rendered an opinion in the case of Hardt V. Reliance Standard, which is a major victory for disability insurance claimants that have a long-term disability policy governed by ERISA. Reliance Standard, a disability insurance carrier attempted to argue that a disability claimant was not entitled to attorney fees because she was not a "prevailing party" after her case was remanded back to Reliance. For a background summary of this case see Can I recover attorney fees if my long-term disability claim is governed by ERISA?

→ Continue reading ERISA disability claimants can receive attorney fees with "some degree of success"

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A case heard recently before the U.S. District Court in the District of Massachusetts highlights the fact that a long-term disability plan administrator can choose to deny a claim even though the person making the claim may not be able to find employment. The plan administrator does not claim to offer unemployment benefits, so if the long-term disability plan finds that the claimant can work, the plan may refuse to extend benefits.

This is what happened to Andrew Gross, an employee of Federal Express Corporation (FedEx) until he suffered a heart attack in October 2003. He had been a full-time checker/sorter since 1989. In order to fulfill the duties of his job, he had to be able to lift up to 75 lbs. When his doctor checked him out of the hospital, it was with clear instructions to lift no more than 25 lbs. His doctor also ordered a leave from work.

→ Continue reading FedEx employee disability plan wrongfully denies LTD benefits without proving job exists for man to fill

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Our law firm was recently contacted by a woman that has been denied long-term disability benefits by Hartford. The claim is currently pending, but I asked if I could share her story so that others could learn about the real actions taken by disability companies such as Hartford. I strongly advise all disability claimants to never submit for a field interview without the presence of an attorney.

→ Continue reading Hartford pays disability benefits for 12 years and then uses video surveillance to deny benefits

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Imagine a disability claimant has their long-term disability claim denied, files an appeal which is denied, then files a lawsuit to recover disability insurance benefits. After 2 years since the first denial and hundreds of hours of litigation, the court says the disability carrier needs to reconsider their claim denial. The disability carriers argues that the court sending the claim back for another review is not a victory by the claimant and the claimant's attorney is not entitled to collect attorney fees.

This is the exact argument that Reliance Standard has made in a further effort to make it more difficult for claimants with ERISA governed long-term disability policies to collect benefits. Most disability case victories result in the court remanding the case back to the company for an additional review. If a court's remand of the case back to the disability company is not considered to be a victory, then there will be very few cases in which the disability carriers will be responsible for attorney fees.

→ Continue reading Are attorney fees payable in long term disability insurance cases governed by ERISA?

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The Standard Insurance Company sells multiple different long-term disability policies to dentist and other medical professionals. The difference in each policy is usually the definition of disability. In my opinion, the following definition of Own Occupation Disability sold by Standard is called an Own Occupation definition, but it is not a true Own Occupation policy. The following definition of Own Occupation is misleading and essentially requires the policy holder to be unable to work in any occupation.

Our law firm has represented numerous claimants that have purchased a long-term disability policy from Standard with the following definition of Own Occupation:

→ Continue reading Dentist and doctors: beware of the Standard Insurance Company Group's long-term disability policy

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Once again, long-term disability insurance provider Metropolitan Life Insurance Company (MetLife) has been ordered by the court to reverse a long-term disability denial because the Court found the grounds for denying the benefits were arbitrary and capricious. This is a far too common occurrence, and one that disability insurance attorneys see frequently. In MetLife denies long-term disability benefits to a consultant after approving them, we looked at background behind John Lanier's claim.

Now, we are going to look at how Lanier's disability insurance attorney represented him before Judge David M. Lawson of the U.S. District Court, Eastern District of Michigan, Southern division.

→ Continue reading MetLife ordered to reverse denial of long-term disability insurance benefits

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In the case we are going to look at, a disability insurance attorney found himself representing a client who believed that Metropolitan Life Insurance Company (MetLife) had wrongfully denied the extension of his long-term disability benefits.  This is a far too common occurrence, and one that disability insurance attorneys see frequently. As we look at this case, you will see that without the representation of a disability attorney, John Lanier would not have received his rightful benefits.

→ Continue reading MetLife denies long-term disability benefits to a consultant after approving them

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This is a case in which Unum's decisions to deny benefits was consistent with the policy language. Employer-provided group disability insurance plans are different from individual plans. An employer-provided disability plan depends upon the employer/employee relationship. If something happens to interrupt this employer/employee connection it can have consequences, as Carol Jones discovered.

→ Continue reading Unum denies disability benefits to a Minnesota legal secretary with pre-existing condition

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