Disability Insurance Cases Nationwide

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In David L. Rothman v. Unum Group, Unum Life Insurance Company of America (Unum), Plaintiff was a Certified Financial Planner who had worked for almost 30 years in a business owned by his father, Rothman Securities, when he developed a drug addiction. He was unable to perform the duties of his regular occupation and received disability benefits from October 12, 2012, until October 2015. On October 1, 2015, Unum terminated Plaintiff’s benefits. Plaintiff’s appeals were denied and he then filed this lawsuit against Unum for breach of contract and bad faith.

Background

In addition to his drug abuse problems, in March 2013, Plaintiff pled guilty to wire fraud and money laundering and was fired by Rothman Securities. In January 2014, he was sentenced to a 4-year prison sentence and in February that same year, his professional license was revoked due to his criminal conviction.
Continue Reading Court Rules in Favor of Unum and Finds Plaintiff Not Factually Disabled

In Lavery v. Restoration Hardware, Inc.,  (D. Mass.), No. 17-10856, March 28, 2018, Plaintiff John Lavery (“Lavery”) filed a claim against Defendant Restoration Hardware, Inc. (“RHI”), based on RHI’s alleged misclassification of Lavery as an independent contractor when Lavery was allegedly in fact in employee under Massachusetts law. Lavery seeks among other damages the value of benefits plan (i.e., a welfare benefits package) that he would have received had he been classified as an employee. RHI moved to dismiss Lavery’s claim for damages with respect to the welfare benefits because RHI contended that claim was preempted by federal law.
Continue Reading Benefits Claim of Employee Who Claimed Prior Misclassification Was Preempted by ERISA

In Mary Beth Tobin v. Hartford Life and Accident Insurance Company, Plaintiff worked in Florida as manager of costuming operations for Disney Worldwide Services. She had been under the care of a physician for fibromyalgia beginning in February 2012. Her last day of work was October 2, 2012. She subsequently moved to Michigan and continued medical treatment with a board-certified family medicine physician.

Plaintiff filed a claim for long-term disability (LTD) benefits, providing Hartford with her medical records, which included the physician’s statement of functionality. Hartford denied her claim and her subsequent administrative appeals, so she filed this ERISA lawsuit in the U.S. District Court for the District Court for the Western District of Michigan.
Continue Reading Michigan Court Reverses Hartford’s Denial of Disability Benefits for Claimant Diagnosed with Fibromyalgia

It seems that claimants are denied long term disability benefits by CIGNA every day. CIGNA’s denials are predictable and tend to follow the same denial techniques from one claim to the next. After a LTD denial claimants are forced to go through the appeals process to get back on claim and with CIGNA it seems almost impossible to convince the appeals department to overturn an initial denial of benefits.

Such was the case with Ms. Sangha as she was left with no other option but to file a lawsuit against CIGNA in a California federal district court.
Continue Reading California Court overturns denial of benefits by CIGNA

If you have Aetna Insurance and hold a Disability Insurance Policy with them, this is a video you need to see. A policy holder with Aetna tried to file a claim after being diagnosed with an aggressive form of cancer and becoming disabled due to treatments.
Continue Reading Aetna Approves then Denies Disability Claim Based on Pre-Existing Conditions Clause

Disability Insurance News:
Appeals Court upholds Virginia court’s ruling that Hartford correctly terminated long term disability benefits to medical transcriptionist who had painful arm.
Appeals Court Upholds Hartford’s Termination of Disability Benefits

Resolved Cases:
Cigna Overturns Denial of LTD Benefits to Maintenance Supervisor previously employed with Checkpoint Systems, Inc., who had a history of 7 spinal surgeries.
Cigna Overturns Denial of LTD Benefits for Maintenance Supervisor Suffering from Serious Back Issues

Resolved Cases:
After initially denying insured’s claim for long term disability benefits, Attorney Stephen Jessup successfully appeals the denial and secures client’s benefits.
Standard Approves Disability Benefits to Attorney with Fibromyalgia

In the case of Michael J. Pacquin v. Prudential Insurance Company of America, Plaintiff Pacquin, a Business Development Director for Transistor Devices, Inc. (TDI), was infected with the West Nile Virus in 2003. As a result, he contracted encephalitis and sustained brain damage. This left him with cognitive difficulties that made it impossible for him to continue his employment.

He was covered under a disability insurance policy which provided him benefits for the first 24 months when he was disabled from working in his regular occupation. After that, in order to qualify for benefits, he had to show that he was disabled from working in any occupation for which he was reasonably qualified.
Continue Reading Court Orders Prudential to Reinstate Long Term Disability Benefits

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

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