Gregory Dell

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In Thomas v. Prudential Insurance Co. of America, et al., plaintiff Thomas learned the hard way the importance of filing an ERISA lawsuit within the time frames established by the employer-sponsored disability benefits plan. Without even referencing the medical condition upon which Thomas based her claim for long-term disability benefits, a federal district court in Louisiana dismissed her lawsuit due to her failure to file it on time.
Continue Reading ERISA Disability Benefit Lawsuit Against Prudential Dismissed for Failure to File Timely

Federal law governing ERISA disability lawsuits requires claimants to submit an administrative appeal of the denial of benefits before they can file a lawsuit in the federal district court. In the recent case of Lewis-Burroughs v. The Prudential Insurance of America, et al., the plaintiff filed an administrative appeal and, according to Prudential’s own rules, consistent with federal law, the insurer had a maximum of 90 days to render its decision.
Continue Reading After submission of an ERISA disability appeal, when can I file an ERISA disability lawsuit?

This recent California Federal ERISA long term disability case is another example of an unreasonable denial by the Standard Insurance Company. While this lawsuit was not handled by our disability insurance lawyers, we felt that disability insurance claimants could learn a lot from the findings of this disability lawsuit.
Continue Reading The Standard Denies LTD Benefits to California Woman with Addison’s Disease

In a case not handled by Attorneys Dell & Schaefer, but which can be utilized to our clients’ advantage in the future, a Long Term Disability (LTD) Claimant has earned a partial victory against Standard Insurance Company.
Continue Reading California Federal Court Finds that Standard Insurance Company’s Review of LTD Claim was Insufficient; Remands Claim Back to the Plan Administrator

Can a Functional Capacity Evaluation be Useful to determine if a Claimant with Fibromyalgia is disabled?

It is very common for an insurance company to deny disability benefits to individuals suffering from Fibromyalgia. This happens more often than not due to the inability to provide the insurance company with objective proof of the disability, as none exists. There are no known objective tests for fibromyalgia at this point in time.
Continue Reading Unum abused its discretion by disregarding results of a functional capacity evaluation (FCE) of a disabled registered nurse

In this recent case out of the Eastern District of Pennsylvania the court found that Unum had abused its discretion when it failed to consider whether the claimant could do the material and substantial duties of her regular occupation. The case answers a question posed by many claimants: Is the insurance company obligated to consider my job duties when evaluating my claim?
Continue Reading Unum was wrong for not considering the claimant’s job duties during its claim review

In a recent ruling from the United States District Court District of Nevada, a Judge ruled that CIGNA/LINA was wrong in denying continued Long Term Disability Benefits to Kimberly Brown.
Continue Reading Court Rules that CIGNA/LINA Wrongfully Terminated Disability Benefits of Person with Cognitive Limitations caused by a Brain Tumor

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