Lisa Pakovich and her former employer’s long-term disability plan had been in and out of court for almost five years when Judge Michael Reagan listened to arguments between Pakovich’s disability attorneys and Verizon Long-term Disability Plan on March 24, 2010. It was the third time he had considered this case in less than a year. He’s not the first judge to consider Pakovich’s claim. Three U.S. Court of Appeals, Seventh Circuit judges heard arguments in Pakovich v. Broadspire Services, Inc., 535 F. 3d 601 in April 2008. The decision rendered on July 25, 2008 has been cited in a number of decisions that have involved disability insurance claims since then.

The matter before Judge Reagan this time was which side’s motion for summary judgment should be granted by the Court. In order to prepare a fair memorandum and order, a review of the history of Pakovich’s claim, while redundant to the Judge, remained important to a decision that could stand as a separate document.

→ Continue reading Disability battle against Verizon and Broadspire long-term disability plan lingers in courts for years

Physician’s Failure to Fill Out Functional Limitations Paperwork Costs Man Rightful Benefits

A supporting physician is essential for any claimant to receive long-term disability benefits. However, a treating physician must do far more than just diagnosis a disabling medical condition. The decision rendered by the U.S. Court of Appeals, Seventh Circuit in Williams v. Aetna Life Insurance Company continues to have an impact on long-term disability decisions in U.S. Courts even though it has been over two years since Lee K. Williams lost his appeal against Aetna Life Insurance Company (Aetna) and The Sysco Corporation Group Benefit Plan (Plan). Williams’ unsuccessful attempt to secure a Court reversal of his long-term disability denial for chronic fatigue syndrome (CFS) continues to shape the strategies of disability attorneys as they help their clients perfect their claims for this non-objective ailment.

→ Continue reading Aetna denial of long-term disability benefits for chronic fatigue syndrome upheld by Court

Frequently, a disability attorney finds that additional information is needed before he or she can demonstrate that a conflict of interest has motivated the denial of benefits by an ERISA governed disability insurance company. In order to secure this information, the disability insurance attorney files a Motion to Compel Discovery. In response, the disability insurance company inevitably contests the need to provide this information.

→ Continue reading Court orders Citigroup and MetLife to answer discovery request exposing conflict of interest in long-term disability benefit denial

Disability Insurance Attorney Gregory Dell was retained to help an industrial salesman negotiate a lump-sum buyout offer with Life Insurance Company of North America (LINA), also knwon as CIGNA Group Insurance.

Our client had been on claim for several years as a result of a cardiac condition. His claim had not been smooth as he had previosuly been denied by LINA and was forced to file an appeal in order to reinstate his benefits. His policy paid him long-term disability benefits until age 65 if he remained disabled.

→ Continue reading Life Insurance Company of North America (CIGNA) lump sum settlement buyout offer obtained for former salesman

When Barbara Sterio’s disability attorney presented arguments on February 11, 2010 before the Ninth Circuit United States Court of Appeals, he was unsuccessful in convincing the court to review her denial of benefits under the de novo standard of review. But the three judges reviewing Sterio’s claim, found that even though the District Court had been correct in choosing to use the abuse of discretion standard of review, that standard had not been applied correctly. A review of the background behind Sterio’s disability benefits application will demonstrate why the Court of Appeals reversed the decision of the District Court.

→ Continue reading HM Life and Broadspire wrongfully deny disability insurance benefits to a receptionist and 9th Circuit Court of Appeals reverses claim denial

On September 2, 2009, District Judge William E. Smith of the Rhode Island U.S. District Court filed a Memorandum and Order, delaying his final judgment on the case of D & H Therapy Associates v. Boston Mutual Life Insurance Co. until all of the matters which were not under the jurisdiction of the Employee Retirement Income Security Act (ERISA) could be resolved (you may find the arguments presented to Judge Smith of interest; we discussed them in an earlier article titled Was Boston Mutual’s Decision to Terminate Long-Term Disability Insurance Correct?). On March 8, 2010, both sides asked Judge Smith to reconsider his earlier order.

→ Continue reading Boston Mutual can not recover $163,000 overpayment to long-term disability claimant (Part II)

The case we are going to look at here highlights the importance of involving a disability insurance attorney in your disability insurance policy purchasing decision. The language in disability insurance policies is complex and can often be turned against you when you most need the benefits. It is never safe to trust the assurances of the disability insurance company that a policy meets your requirements. The following case clearly demonstrates this reality.

→ Continue reading Was Boston Mutual’s decision to terminate long-term disability insurance correct? (Part I)

On May 24, 2010, the United States Supreme Court rendered an opinion in the case of Hardt V. Reliance Standard, which is a major victory for disability insurance claimants that have a long-term disability policy governed by ERISA. Reliance Standard, a disability insurance carrier attempted to argue that a disability claimant was not entitled to attorney fees because she was not a "prevailing party" after her case was remanded back to Reliance

→ Continue reading ERISA disability claimants can receive attorney fees with "some degree of success"

A case heard recently before the U.S. District Court in the District of Massachusetts highlights the fact that a long-term disability plan administrator can choose to deny a claim even though the person making the claim may not be able to find employment. The plan administrator does not claim to offer unemployment benefits, so if the long-term disability plan finds that the claimant can work, the plan may refuse to extend benefits.

This is what happened to Andrew Gross, an employee of Federal Express Corporation (FedEx) until he suffered a heart attack in October 2003. He had been a full-time checker/sorter since 1989. In order to fulfill the duties of his job, he had to be able to lift up to 75 lbs. When his doctor checked him out of the hospital, it was with clear instructions to lift no more than 25 lbs. His doctor also ordered a leave from work.

→ Continue reading FedEx employee disability plan wrongfully denies LTD benefits without proving job exists for man to fill

Our disability insurance law firm was recently contacted by a woman that has been denied long-term disability benefits by Hartford. The claim is currently pending, but I asked if I could share her story so that others could learn about the real actions taken by disability companies such as Hartford. I strongly advise all disability claimants to never submit for a field interview without the presence of an attorney.

→ Continue reading Hartford pays disability benefits for 12 years and then uses video surveillance to deny benefits