Disability Insurance Cases Nationwide

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We have written on this subject before and the issue is one we get many questions on. Whether a disability insurance claimant must repay the insurance company for a retroactive social security award depends on the policy at issue and any subsequent agreements between the claimant and insurance company. Unfortunately, most ERISA governed long-term disability policies contain language giving the insurance company the right to recover any award of back benefits made by the Social Security Administration. Insurance companies often take it a step further by requiring claimants to sign “reimbursement agreements” by which the claimant promises to pay back any award of SSDI benefits that would result in an overpayment by the insurance company.
Continue Reading Court Rules Aetna Cannot Collect SSDI Overpayment

In an opinion issued on September 4, 2014 by the United States Court of Appeals for the Sixth Circuit, an Appeals Court upheld a District Court’s opinion that awarded Ms. Ashima James long term disability benefits. Despite Liberty Life’s two independent medical examinations and at least 4 “independent” file reviews, both Courts concluded that James produced a sufficient amount of evidence to qualify for disability benefits under the Policy.
Continue Reading Appeal Court Affirms District Court’s Ruling that Liberty Life Was Wrong in Denying a Disabled Woman’s Long Term Disability Benefits

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.
Continue Reading Plaintiff Awarded Benefits when Sedgwick Abuses its Discretion

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”).
Continue Reading Arkansas court grants Hartford’s motion for summary judgment for claimant’s failure to exhaust administrative remedies

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…

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

When reviewing a claim for disability benefits a plan administrator is not required to do an in-person exam of the claimant. However, in certain circumstances courts have found that an administrator’s failure to do so is arbitrary and capricious.
Continue Reading Reliance Standard abused its discretion when failing to conduct in-person exam for psychiatric disability

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.
Continue Reading Kentucky District Court concludes that Kentucky’s five year statute of limitations applies to ERISA actions

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.Continue Reading Court Upholds Reliance Standard’s Decision to Deny Continued Long Term Disability Benefits to former GAF Materials Corporation Employee

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.
Continue Reading Hartford Approves Disability Benefits At Any Occupation Stage and Then Denies LTD Benefits, But Court Reverses