Attorneys Gregory Dell and Cesar Gavidia discuss problems encountered in litigation on behalf of a client who had a stroke. He returned to work, but three years later filed a claim for long-term disability benefits with Aetna Disability Insurance. Aetna agreed with his treating neuropsychologist that he could not work in his own occupation due to his symptoms indicating cognitive, visual, auditory, spatial, and perception issues and awarded him benefits.
Continue Reading Disability Attorneys Discuss Aetna’s Denial of LTD Benefits to Software Engineer Who Suffered a Stroke Followed by Cognitive Losses

In this video, attorneys Gregory Dell and Stephen Jessup discuss the importance of medical documentation by a treating physician. They need to include what impact that condition has on the claimant’s ability to do his or her job. Mr. Jessup won a recent case against Lincoln Financial Group when, on a second administrative appeal, he was able to present convincing evidence that the claimant, who suffered from multiple sclerosis (MS), could not do her job.
Continue Reading Treating Physicians Need to Document in Their Medical Records How a Medical Condition Restricts a Person’s Ability to Do Their Job

This video shows disability attorneys Gregory Dell and Stephen Jessup discussing a win against Hartford’s denial of disability insurance benefits to a Human Resources director who was suffering from Rheumatoid Arthritis (RA). In addition to the usual symptoms associated with arthritis of joint pain and swelling, his impaired cognitive functioning was of more concern to him. His initial claim for benefits was approved when Hartford agreed he was disabled from working in his own sedentary occupation.
Continue Reading Disability Attorneys Discuss the Transition From Inability to Work in “Own Occupation” to “Any Occupation”

Resolved Cases:
Principal terminates surgeon’s residual disability claim after following claimant with surveillance and determining his activity level indicated he could operate on a full-time basis.
Principal Reinstates Benefits of Orthopedic Surgeon Unable to Work Full-Time After Attorney Rachel Alters submits Appeal


Resolved Cases:
Retail clerk suffering from arthritis, chronic knee pain, chronic back pain, depression, anxiety, and bipolar disorder who was denied long term disability benefits after Cigna performed a questionable in house review is back on claim after Dell & Schaefer Appeal.
After Appeal Filed by Attorney Alexander Palamara, Cigna Overturns its Previous Denial of Long Term Disability Benefits for Retail Clerk Suffering from Bipolar Disorder and Chronic Pain


FAQ:
We have recently reviewed Lincoln denial letters in which Lincoln only appears to rely on MDGuidelines to determine an insured’s medical restrictions and limitations.
Is Lincoln Relying on MDGuidelines to Review Disability Appeals?

In this video, disability attorneys Gregory Dell and Victor Peña talk about a case won by Mr. Peña in a second appeal for a man who suffered with back and knee injuries as well as carpel tunnel syndrome. The man claimed he was unable to work in his own occupation which was classified by a vocational assessment as a light-duty occupation.
Continue Reading Dell & Schaefer Disability Attorneys Discuss Winning LTD Benefits on Second Appeal to MetLife and the Importance of Medical Documentation

Disability attorneys Gregory Dell and Rachel Alters discuss a case out of the Western District of Washington in which the district court found that Hartford acted arbitrarily and capriciously when it terminated the benefits of a woman suffering from fibromyalgia. The woman had been receiving benefits for nearly two years after Hartford had agreed she was disabled from working in her own sedentary occupation.
Continue Reading Disability Lawyers Discuss Court Ruling Reversing Hartford’s Termination of Benefits to Claimant Suffering from Fibromyalgia

In this video, disability insurance lawyers Gregory Dell and Cesar Gavidia consider the effect on Amazon workers’ disability claims now that Hartford has bought the Aetna Disability Insurance Company. They conclude that changes will be unlikely since both companies now engage in extensive and exhaustive claims review, using every possible avenue they can to avoid paying long-term disability claims.
Continue Reading Disability Attorneys Discuss Hartford’s Purchase of Aetna and How It May Affect Amazon Workers

In this video, Attorneys Gregory Dell and Victor Peña discuss general trends with Disability Insurance companies. They note that no matter how large an insurance company is, nor how long it has been in business, all disability insurers seem to have the goal of denying as many claims as possible. The insurance companies are in the business of making money, and the more people they have on claim, the less profit there is to the business.

There are more than 40 long term disability (LTD) insurance companies, and they all seem to have different behaviors, which often change as a company undergoes new management, hires new workers, and develops new strategies. At Dell & Schaefer, we have learned how to work with each one of them and know how they each deal with a claim.
Continue Reading Disability Lawyers Discuss How the Largest Insurance Companies View a Claim for Disability Benefits

Resolved Cases:
Insurance Sales Agent gets LTD Claim approved a second time after Attorney Alexander Palamara files second appeal to Prudential.
LTD Claim Approved for a Second Time for an Insurance Sales Agent after Prudential Denies Claim Based on Self-Reported Physical Capabilities


Disability Insurance News:
Washington District Court overturns denial of benefits to former Boeing Employee.
Court Finds Aetna Had No Credible Argument Whatsoever To Support Its Decision To Deny Benefits To Claimant With MS

A recent decision from the United States District Court for the Middle District of Tennessee established strong arguments in support of total disability for an OB/GYN suffering from an injury to her right index finger. In Nylander v. Unum Life Insurance Company of America (Unum) the Court was tasked with ruling on a Motion for Summary Judgement filed by Unum in which Unum was asking the Court to dismiss Dr. Nylander’s claim for total disability benefits. For reasons discussed below the Court denied Unum’s motion and in doing so allowed Dr. Nylander’s claim for total disability to proceed through to trial.

There are certain legal factors that must be determined by a Judge when entering a ruling on a Motion for Summary Judgment, the most important being a determination as to the existence of a material issue of fact for a decision maker (Jury) to consider. This article will focus on the factors that the Court deemed were sufficient to establish a material issue of fact in Dr. Nylander’s claim for total disability benefits that resulted in the case not being dismissed. It should also be noted that Dr. Nylander’s disability insurance policy was an Individual Disability Income/Insurance (IDI) policy and not an employer provided group disability policy governed by ERISA. As such Dr. Nylander has a great deal more rights as it relates to trial- including a jury trial, live testimony, the ability to take depositions, etc.
Continue Reading Court Finds Evidence of Total Disability for OB/GYN With Finger Injury