Recovering Attorney Fees in ERISA Disability Claims
/0 Comments/in ERISA Disability Claims /by MarcIf you ultimately win a disability dispute, you might think the insurance company will be instructed to pay the attorney fees, even in ERISA disability claims.
However, that is not how it usually goes. This video describes yet another way ERISA disability claimants must fight an uphill battle:
Your Individual Disability Income Claim Is Not Subject to ERISA
/0 Comments/in ERISA Disability Claims /by MarcAs our video explains, a wrongly denied individual disability income claim is not fettered by federal ERISA law. If your disability insurance policy is one you bought and paid for yourself, things are much more in your favor. You have many more legal remedies available to you when there is a dispute.
Also referred to as individual disability insurance (IDI), disability income protection and private disability insurance, these policies are not part of an employee benefits package. They are purchased independently from an insurance broker by self-employed professionals such as doctors, dentists, architects, executives – any lucrative profession where an employer or professional association does not provide group disability coverage.
ERISA Disability Lawsuits: No Jury, No Trial, No New Evidence
/0 Comments/in ERISA Disability Claims /by MarcIn ERISA disability lawsuits, the insurance company (defendant) will not face a jury. In fact, as the video explains, if your claim continues to be denied on appeal and your case goes to Court, in most cases you will not be entitled to a trial at all.
No jury will be able to hear your live testimony, or your doctor’s confirmation of your disabling condition, or a vocational expert’s validation of your inability to perform any occupation.
The Key to Winning ERISA-based Disability Claims
/0 Comments/in ERISA Disability Claims /by MarcThis article explains the ways we help our clients win benefits in their ERISA-based disability claims.
In the video above, we explain how ERISA law makes gaining disability insurance benefits extremely difficult for claimants who are covered by employer-sponsored group insurance plans. But there are ways to get the benefits you deserve, even when your claim is denied.
What Is ERISA Preemption in a Group Disability Claim?
/0 Comments/in ERISA Disability Claims, Uncategorized /by MarcThe topic of today’s video is ERISA preemption. ERISA stands for the Employee Retirement Income Security Act of 1974. It is the federal law that governs most group long term disability claims.
To preempt means to displace something. ERISA preemption means that in a dispute over a group disability claim, federal ERISA law displaces state law and commandeers the entire process. All state laws (that otherwise would play a role in insurance disputes) become void in an ERISA disability case.
Understanding ERISA Settlements and Court Awards in LTD Claims
/0 Comments/in ERISA Disability Claims /by MarcWhat awards can you expect in ERISA settlements or court decisions, if you appeal a long term disability denial and win against your insurance company? As the above video explains, the money coming to you is limited, because there are no compensatory or punitive damage remedies available in ERISA cases.
This is not implying that ERISA settlements or court decisions are paltry; indeed they can produce substantial monetary payments that mean the difference between living disabled in financial ruin or with a secure and stable future. But when compared to other types of court cases, ERISA-based claim awards are limited for insureds.
Discretionary Clauses in Disability Insurance Policies
/0 Comments/in ERISA Disability Claims /by MarcThe ban on discretionary clauses in long term disability insurance plans has been going on for years, with more states pushing for change.
In addition to Texas, many states have amended their state insurance codes to limit or ban the use of discretionary clauses in both individual disability and group disability insurance policies.
How ERISA Limits Legal Remedies in Group Disability Claims
/0 Comments/in ERISA Disability Claims /by MarcHas your group disability claim been denied? If so, you need to know that your claim is governed by the federal law known as ERISA. Not only does this limit your lawsuit causes of action; ERISA limits legal remedies in response to the insurance company’s violations.
In the video above, disability attorney Marc Whitehead explains how LTD insurers will use ERISA law to their advantage to deny your disability claim. It is actually the lack of legal remedies available in ERISA-based cases that hurts claimants—and the insurance companies are fully prepared to capitalize on that.
How ERISA Denies Due Process (Justice) in Disability Claims
/0 Comments/in ERISA Disability Claims /by MarcLong term disability insurance for employees is regulated by federal ERISA law. As shown in our video above, it is clear that ERISA denies due process in group disability claims – allowing insurers to deny you the benefits you deserve.
What exactly is “due process” as it applies to disability insurance benefits? Due process of law refers to the constitutional guarantee to all persons of fair treatment through the normal judicial system. It is a basic principle of fairness in legal matters, especially in the courts.
Administrative Appeal in Group Disability Claims
/0 Comments/in ERISA Disability Claims, FAQ /by MarcIn our video above, disability attorney Marc Whitehead discusses the importance of the administrative appeal in group disability claims.
Group insurance plans are governed by federal ERISA law. There are key differences between what you must do to prevail in a claim for group disability benefits under ERISA rules, versus the state contract laws that you would follow if your claim were filed under a private long term disability policy.
How a Social Security Disability Offset Can Cut LTD Insurance Benefits
/0 Comments/in ERISA Disability Claims, FAQ /by MarcToday’s video brings shocking news to many group disability claimants: If you are awarded disability benefits by Social Security as a lump sum (in addition to your group LTD insurance benefits), your insurance carrier can ask that you turn over your SSDI lump sum award to them.
Most employer-sponsored long term disability plans are explicitly written so that the insurer benefits when SSA approves a claimant’s SSDI claim.
What Are Disability Payment Offsets to LTD Insurance Benefits?
/0 Comments/in ERISA Disability Claims, FAQ /by MarcDisability insurance plans offered through an employer can provide critical disability benefits. However, there is another important fact about group coverage every employee should realize:
Most group disability plans have provisions that offset (reduce) LTD insurance benefits, if that employee has other sources of income.
The video above explains how an award of Social Security Disability Insurance can offset your LTD monthly benefit amount. As a rule, this stipulation affects long term disability benefits and only in rare situations affects short term benefits.
What the Denial Letter from Your LTD Insurer Does Not Tell You!
/0 Comments/in ERISA Disability Claims, FAQ /by MarcHave you received a denial letter from your long term disability insurance company? Now is not the time to fold in despair; it is time to take action! But first of all, what happened? Why did the insurance carrier deny your claim?
Remember that in group disability claims, your claim information is reviewed and evaluated by claims handlers who work for the insurance company. This reveals an inherent conflict of interest in most group disability cases.
How Medical Reviews by Insurance Companies Cause LTD Claim Denial
/0 Comments/in ERISA Disability Claims, FAQ /by MarcBiased medical reviews and exams can bring down a deserving disability claim. The above video discusses the process to appeal a disability insurance claim denial. Appeals often mean you must argue against the insurance company’s slanted medical reviews and subsequent mishandling or distortion of the evidence.
Filing an LTD Appeal – What You Need to Know
/0 Comments/in ERISA Disability Claims, FAQ /by Marc“Can you appeal a long term disability denial yourself? Yes, but it’s not a good idea.” As stated in the above video, this advice may be a rude awakening for many claimants. Why is filing an LTD appeal yourself a bad decision? The reasons become more apparent when you consider things from the insurer’s point of view.
Group vs. Individual Disability Insurance Appeal – What’s the Difference?
/0 Comments/in ERISA Disability Claims, FAQ /by MarcTo prevail in a long term disability claim dispute, one of the first things to identify is the law that will govern your disability insurance appeal. There is a great difference between appealing a disability claim that is under group coverage, as opposed to individual, or private coverage.
Our video talks about ERISA law. The acronym ERISA stands for the Employee Retirement Income Security Act and is the federal law that governs group disability insurance plans. Group coverage is typically provided by your employer, or in some cases through professional associations and trade groups.
SSDI Benefits for Spinal Cord Disorders – Use SSA Listing 11.08
/0 Comments/in Social Security Disability /by MarcIf you suffer from a spinal cord injury or disease, you may be eligible for Social Security Disability Insurance (SSDI). There are two ways to qualify for SSDI benefits for spinal cord disorders:
• meeting Listing 11.08 as defined by SSA, or
• if the impairment does not meet the criteria of a listing, it can medically equal the criteria of a listing.
In either case, your condition must limit your functioning so much that you cannot work and earn a living. The following presents the basics you need to know about filing for critical SSDI benefits you need and deserve, or appealing a claim denial for SSDI benefits for spinal cord disorders.
Get Social Security Disability Benefits for Cerebral Palsy Using SSA Listing 11.07
/0 Comments/in Social Security Disability /by MarcWhat does Social Security look at when deciding to award disability benefits for cerebral palsy (CP)? Even with the strongest claims, many CP disability cases are initially denied. Having good legal help after a claim denial can make the difference between winning and losing much needed compensation.
Cerebral palsy is an umbrella condition for several different movement disorders. In many cases, it has also been shown to negatively impact hearing, eyesight, speech, and reasoning, and it can also cause seizures. Those with severe cerebral palsy may be able to get disability benefits from Social Security – if they qualify.
Win Weight Loss Disability Benefits Using SSA Listing 5.08
/0 Comments/in Social Security Disability /by MarcHow does Social Security evaluate and award weight loss disability benefits? While many people fight to drop a few pounds, those who have an ongoing weight loss problem know just how frustrating and scary it can be.
Most of the time, persistent trouble maintaining weight is a symptom of a serious medical disease. Depending on the nature of the related medical disorder, you may be experiencing a variety of serious associated symptoms that make it difficult to engage in regular activities of daily living or even concentrate for long periods of time.
Win SSDI Benefits for Short Bowel Syndrome Using SSA Listing 5.07
/0 Comments/in Social Security Disability /by MarcDo you qualify for SSDI benefits for short bowel syndrome? How does Social Security evaluate this digestive system impairment for disability?
Anyone who has short bowel syndrome (SBS) knows how hard it is to live with. Not only are you often weak and tired, you have to deal with frequent heartburn, cramping, and bloating. And, of course, the diarrhea can be so severe it can lead to malnutrition and death if you aren’t properly treated.