Disability Blog & Cases:
The evolution of denying fibromyalgia and chronic fatigue syndrome claims in group long term disability policies

As a disability claimant it is important to be aware of any limited benefit periods which may unfairly limit your benefits to two years. Once considered “fringe” conditions not commonly understood by many- especially Group Long Term Disability insurance companies, Fibromyalgia and Chronic Fatigue Syndrome (CFS) have become more prevalent, spurning widespread acknowledgment and recognition of these debilitating conditions. The medical communities acceptance of Fibromyalgia and CFS as disabling conditions have resulted in Long Term Disability insurance companies looking for ways to combat paying claims for these conditions.

Disability Blog & Cases:
Reliance Standard terminates long-term disability benefits after receiving the results of an IME and FCE

A recent federal court opinion upheld Reliance Standard’s decision to terminate a claimant’s long-term disability benefits. The Court stated that the existence of both an Independent Medical Examination (“IME”) and a Functional Capacity Examination (“FCE”) was evidence of a thorough investigation. The Court concluded that the results of those exams and the inconsistent documentation from the claimant’s physicians were sufficient proof to show that that Reliance Standard’s decision was not arbitrary or capricious.

Disability Insurance Law TV:
MetLife disability denial reversed by court for unreasonable claim handling

In this episode disability insurance attorney Stephen Jessup discusses a recent 7th Circuit Court of Appeals case in which MetLife’s ERISA disability denial was reversed for numerous reasons. This opinion is a great tool for disability insurance claimants…

Disability Blog & Cases:
Broadspire Services terminate long-term disability benefits after paying for 8 years

A Federal Appellate Court recently upheld the decision by Eaton Corporation and Broadspire Services to discontinue the long-term disability benefits to Janice Curry after paying for 8 years. In Curry v. Eaton, the Court ruled that Eaton and Broadspire were not “arbitrary and capricious” in denying continuation of her long-term benefits. The Court found that the review of the treating physicians’ reports conducted by Boroadspire’s companies’ independent physicians was sufficient for their conclusion that Curry was not “disabled” within the terms of the disability plan, even though Curry had been previously approved for Social Security disability benefits. Let’s take a closer look at the background of the case to understand why the Court sided with Eaton and Broadspire Services.

Disability Blog & Cases:
Texas Insurance Commissioner eliminates discretionary clauses in disability insurance policies

On December 6, 2010 the Texas Commission of Insurance adopted a new rule which prohibits discretionary clauses in disability insurance policies. This is a major victory for disability insurance claimants and hopefully a trend that will continue in every state…

Disability Blog & Cases:
Companion Life wrongfully relies on 22 minutes of video surveillance to deny disability insurance benefits 

This long term disability insurance case against Companion Life is another classic example of a disability insurance company’s wrongful use of video surveillance to deny disability insurance benefits.  This claimant won her court battle with Companion Life, but she was forced to survive for more than 4 years without receiving any long term disability benefits. Let’s take a closer look at the case of Gail Lewandowski.

Disability Insurance Law TV:
Unum / Provident / Paul Revere Long & Short Term Disability Claims

In this episode disability insurance attorneys Gregory Dell, Stephen Jessup and Cesar Gavidia of Attorneys Dell & Schaefer discuss Unum and their handling of long term disability insurance claims. Unum has taken over all disability polices sold by Paul Revere, Provident, Unum Provident, and Colonial Life. Unum is the world’s largest provider of disability insurance company and this video is short summary of the company and their disability claim handling tactics.

Disability Blog & Cases:
Pennsylvania Federal Judge orders Prudential Insurance Company to pay disability benefits to woman diagnosed with RSD

Since 2001, Prudential Insurance Company of America has approved and denied the long term disability benefits of Donna Elms on numerous occasions. Despite the approval of SSDI benefits and support from her treating physicians, Prudential wrongfully denied disability benefits. This case is a classic example of the continuous difficulties that a disability company can give a claimant throughout the duration of their disability claim. Fortunately, Ms. Elms did not give up and was successful in making Prudential pay her the disability benefits she was owed. Let’s take a closer look at the Ms. Elms’ 8 year battle with Prudential.

Disability Blog & Cases:
MetLife denies benefits to stockbroker disabled by depression, yet Pennsylvania Federal Judge awards disability benefits

When the Court sends a claim back to the long-term disability insurance company for another review, it is no guarantee that the insurance company will grant long-term disability benefits, as the case of Cheryl Schwarzwaelder demonstrates. In a recent case against Metropolitan Life Insurance Company (MetLife), the court remanded the case back to Metlife for further review, which resulted in another claim denial and years of further delay. Unfortunately, there are numerous cases against Metlife in which the company has repeatedly ignored the recommendations of a disability claimant’s treating physician. Let’s take a closer look at the long term disability insurance claim of this previously successful Pennsylvania stock broker.

Disability Insurance Law TV:
Liberty Mutual Long Term Disability Insurance Claims

In this two part episode disability insurance attorneys Gregory Dell Stephen Jessup and Rachel Alters of Attorneys Dell & Schaefer discuss Liberty Mutual Disability Insurance Company and their handling of long term and short term disability insurance claims.

FAQ: Does my disability insurance lawsuit need to be filed in State or Federal Court?

Disability Blog & Cases:
American United Life Insurance disability denial reversed for woman with fibromyalgia, depression and migraines

This disability insurance denial by American United Life Insurance Company (American) and Disability Reinsurance Management Services is a classic example of a disability insurance company’s effort to convert a physical disability claim into a mental nervous claim only. Most disability insurance policies limit disability benefits to 24 months for a mental nervous condition, therefore disability companies will try to argue that a claimant is only disabled by a mental condition and not physical. This argument is frequently raised by insurance companies when a person has a medical condition like fibromyalgia which cannot be verified by any objective testing.

Disability Insurance Law TV:
Mass Mutual Financial Disability Insurance Claims

In this episode disability insurance attorneys Gregory Dell and Cesar Gavidia of Attorneys Dell & Schaefer discuss Mass Mutual Disability Insurance Company and their handling of long term disability insurance claims.

FAQ (Lump Sum Buyout):
Is my disability insurance company required to offer me a lump sum  buyout of my disability policy?

Disability Blog & Cases:
Aetna refuses video recording of IME and threatens to deny disability benefits unless claimant agrees to sign IME doctor’s authorization form

In my opinion Aetna’s handling of our client’s long term disability claim is egregious and unreasonable. We share this story with you in order to continuously educate the public about the conduct of many disability insurance companies.

Disability Blog & Cases:
Prudential ordered by Michigan Court to reconsider long term disability insurance denial

A Michigan Federal Judge recently ruled that Prudential Insurance Company Of America’s denial of long term disability benefits was arbitrary and capricious. The court found that Prudential ignored the claimant’s complaints of pain, failed to evaluate his occupational duties, ignored the opinions of his treating physicians, relied exclusively on a paper review of the medical records rather than examining the claimant, and failed to explain why the claimant could not work. Despite Prudential’s wrongful denial of disability insurance benefits, the court sent the case back to Prudential for further review instead of awarding disability benefits to the claimant. and told them to reevaluate the case. Hopefully this disability claimant will be awarded disability benefits after Prudential conducts another review of the file.

Disability Blog & Cases:
Sun Life disability insurance benefit denial is reversed after 8 years

Eight years of battling Sun Life for long-term benefits and the claimant finally prevails. Sun Life should be ashamed for their lack of respect for this disability claimant and their unreasonable claim handling. Sun Life’s attempt to use hired gun doctors was shot down by the court. This case is an example of a situation where a person could be disabled yet continue to be at work until the day they are fired. This case created challenging contractual issues for the claimant as she claimed that she was disabled at the time she was fired. The Sun Life disability policy and all ERISA governed disability policies require the claimant to be disabled while they are actively employed by their employer. In order to avoid this situation, a claimant should always try to stop working if they believe they will be fired due to their inability to perform their job.

Disability Insurance Law TV:
Sun Life Financial Disability Insurance Claims

In this two-part episode, disability insurance attorneys Gregory Dell and Cesar Gavidia of Attorneys Dell & Schaefer discuss Sun Life Financial Disability Insurance Company and their handling of long term disability insurance claims. More specifically our disability attorneys discuss some lawsuits that have been filed againt Sun Life and we describe Sun Life’s internal disability claims handling resources.

Disability Blog & Cases:
Disability lawsuit filed against The Standard Insurance Company for denial of disability benefits to man suffering with hepatitis C

Our Client, Mr. B worked as a Traffic Central Worker II, often for long hours installing traffic sign throughout Broward County. Despite his strong ambition to work, Mr. B suffered disabling symptoms arising from chronic hepatitis-C, which in turn prevented him from continuing the job he maintained for a number of years.

Disability Blog & Cases:
 Prudential wrongfully denies disability insurance benefits to man with fibromyalgia

 As an employee of Prudential Insurance Company of America (Prudential), Duane Morgan might have expected more of his employer when he had to take advantage of the long-term disability plan offered as part of his employment package. He had been a senior life representative when symptoms of chest pain, palpitations and dizziness, sweating and shaking, numbness in his arms, high blood pressure, difficulty sleeping, and diarrhea forced him to stop working in September 2005.

Disability Case:
Hartford misleads disability insurance claimant’s doctor which results in benefit denial

In a recent long term disability insurance case against Hartford Life and Accident Insurance Company (Hartford), Glenn Pauley alleged that Hartford wrongfully denied his long-term disability benefits. This case is a classic example of the frequent tactic used by Hartford to deny long term disability claims. On numerous Hartford claim denials we have seen Hartford draft undisclosed one-sided letters to the treating physician of a disability claimant. These letters are drafted with specific questions designed to establish a denial of a claimant’s long term disability benefits. In most cases, a claimant’s treating physician will not discuss the questions with a claimant and will not understand the consequences of the answers they choose to provide. A treating physician should always discuss any letters from a disability company with the patient. This case may never have ended up in court had Pauley’s doctor been advised of the significance of the letter that Hartford secretively sent him.

FAQ:
Do disability insurance companies handle a claim differently when a lawyer is involved?

Disability attorney Gregory Dell discusses how disability insurance companies evaluate a claimant’s eligibility for disability benefits on a month to month basis and how a disability lawyer can assist a claimant throughout the process.

Disability Case:
Does Fibromyalgia Have a Credibility Problem in Disability Insurance Claims?

A recent article posted by CNN Health addresses the lack of support women who suffer from fibromyalgia can face personally, professionally and even from their own physicians as they try to cope with this debilitating and often misunderstood disease.

Disability Attorneys Dell & Schaefer have represented numerous long term disability claimants that have been unable to work as a result of suffering from fibromyalgia.

FAQ / ERISA Information:
How long does the disability insurance company have to make a claim decision once the application for ERISA long term disability benefits is submitted?

The Department of Labor has drafted regulations which provide that a disability claim must be resolved, at the initial level, within 45 days of receipt of a complete application; a plan may, however, extend that decisionmaking period for an additional 30 days for reasons beyond the control of the plan.

If, after extending the time period for a first period of 30 days, the plan administrator determines that it will still be unable, for reasons beyond the control of the plan, to make the decision within the extension period, the plan may extend decisionmaking for a second 30-day period

FAQ / ERISA Information:
Why is ERISA an unfair law for disability insurance claimants?

ERISA stands for the Employer Retirement Income Security Act and it was a Federal law that was passed in the early 1970s which was supposed to make it more affordable for employers to be able to offer long term disability coverage as well as health insurance for employees.

Disability Insurance Attorneys Gregory Dell and Stephen Jessup discuss the numerous reasons that ERISA is an unfair law that can negatively impact the thousands of people that file disability insurance claims each year.

Disability Case:
First Unum terminates long-term disability benefits after 4 years of paying and SSDI approval

In a recent Federal Court decision in favor of First Unum, the Court validated the right of a long-term disability insurance plans to rely upon functional capacity evaluations (FCE) as a basis for determining whether or not the claimant has the right to continue receiving disability insurance benefits. In VanWright v. First Unum, VanWright’s long-term disability attorney pointed to another case, Alfano v. Unum, as a reason that the Court should not find First Unum Insurance Company’s decision to terminate his client’s disability benefits reasonable. It appears that disability benefits were appropriately terminated in this case as the disability claimant was performing activities that far exceeded the restrictions and limitations indentified by his treating physician. A look into the background of this case will show why the Court took Unum’s side in its decision.

Dearborn National, a multi-billion dollar insurance company that sells long term disability insurance products, recently hired a law firm to prohibit Disability Insurance Attorneys Dell & Schaefer from displaying the Dearborn National on a webpage that discusses the company. Dearborn National was concerned that consumers may believe “that there is a connection, affiliation, endorsement or relationship between Dearborn National and Attorneys Dell & Schaefer.” Obviously no one that visits diattorney.com is confused as every page of the website says “representing Disability Insurance Claimants.” Disability Attorneys Dell & Schaefer never represent disability insurance companies.

Dearborn National is obviously aware that more and more disability claimants around the country are learning about the legal services offered by Disability Attorneys Dell & Schaefer. It is our opinion that Dearborn National is concerned that some of their potential customers may actually locate our firm’s website and learn the importance of having a disability lawyer for any disability insurance claim. The logo of Dearborn National appeared on the Attorneys Dell & Schaefer website so that consumers could have further confirmation of the company that was being discussed with the associated text.

Dearborn National also indicated in their letter that they did not want any text that appeared on their website describing their company to appear at diattorney.com. It seems strange to our law firm that Dearborn National would not want us to describe their company in the same manner as they have chosen. Disability attorneys Dell & Schaefer do not have the time to dispute Dearborn National’s request to remove their logo from the website, therefore we have agreed to remove the logo and modify the text describing Dearborn.

About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.