How Your Insurance Company Uses Surveillance in Disability Claims
Some disability insurance companies use surveillance and other probing techniques to demonstrate that a claimant is not disabled. Insurers are waiting and watching for those moments that might “prove” that the patient in question is actually capable of working. Many insurers actively search for evidence of fabricating or feigning disability, as grounds to deny disability benefits or terminate existing benefits. Video surveillance and “cyber” intelligence are common tactics used to deny disability claims. Video Surveillance in Disability Claims Denials Insurance providers often have private investigators on the payroll to observe the insured and monitor their activities for periods of time. The goal is …
How Medical Reviews by Insurance Companies Cause LTD Claim Denial
https://www.youtube.com/embed/emTQe4OQe2M Biased 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 slanted medical reviews by insurance companies and subsequent mishandling or distortion of the evidence. Independent Medical Exams (IME) and Medical Reviews by Insurance Companies In most disability claims, an insurer will use an in-house doctor (or nurse) or will hire a third party consultant to review a claimant’s medical records. Sometimes the medical reviewer is not a doctor at all. In most cases, the medical reviewer forms opinions that are …
ERISA Traps to Watch for in Group Disability Claims
The federal ERISA statute is filled with technicalities, hidden pitfalls and land mines — so much so, the unrepresented claimant has little chance of successfully fighting a wrongful denial of benefits. Group disability insurance claims can be successfully handled when an experienced ERISA lawyer is in your corner fighting for you. Our law firm is entirely familiar with claim denials involving ERISA-based disability policies, and are able to help you in any stage of the process. Eight ERISA Traps (just waiting to bedevil your LTD benefits) ERISA Trap #1: The insurance company (not you) is highly favored. Under ERISA law, the plan administrator is …
After I’ve Made an LTD Benefits Claim, Will The Insurance Company Talk To My Friends and Neighbors?
Insurance companies are run to make a profit. To them, having to pay long term disability benefits to a policyholder who's become too ill or injured to work is a loss. To avoid a loss, the insurance company will often go to great lengths to show the policyholder is not disabled and can work, even spying on them while at home or out in public. They'll clutch at any straw — even quoting the unsubstantiated gossip of friends, family or neighbors — as an excuse to avoid their responsibilities to their policyholders. If an insurance company has relied on questionable evidence …
What is ERISA and What Does it Have to Do with My LTD Claim?
ERISA is a federal law that regulates the handling of Employee Benefit Plans. The term is an acronym for the Employee Retirement Income Security Act of 1974. By definition, ERISA covers practically all group disability, health, and retirement plans within private industry. https://www.youtube.com/embed/_eNI29nrwRI Without a doubt, ERISA is a hot button issue in disability insurance law. If your long-term disability coverage is a group plan, take note! As you read the following, think of how you can best prepare for potential problems in the event you must file a claim for benefits. Which Laws Regulate Your Disability Claim? Knowing what laws govern your insurance …
Resolve Your Group Disability Claim – The Right Way
Today’s video outlines the possible outcomes of a disability case under ERISA law. Resolving your group disability claim may encompass any of the following: Reaching a Settlement: Your insurance provider agrees to settle the case for a “settled on” amount of money. Moving for a Motion for Summary Judgment: You request the judge to decide your case without litigation. Proceeding to a Bench Trial: A federal ERISA judge reviews your case and makes a decision based on the existing administrative record. There is no jury, and you do not personally attend “trial.” Going Back for a New Administrative Appeal: A judge may find that …
Administrative Appeal in Group Disability Claims
In 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. ERISA disability claims can be difficult to win. The information below explains just a few ways the deck is stacked against claimants in an ERISA-based disability claim. Only with an experienced attorney …
How ERISA Denies Due Process (Justice) in Disability Claims
Long 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. So when we say the federal ERISA law – The Employee Retirement Income Security Act of …
How ERISA Limits Legal Remedies in Group Disability Claims
Has 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 Federal ERISA Limits Legal Remedies (as …
Discretionary Clauses in Disability Insurance Policies
The 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. This is due to the unending conflicts of interest that result in cases where an insurance company basically gives itself discretionary powers to both interpret the terms of the policy and to pay or deny claims. Under discretionary provisions, the insurance carrier is often able to explain away confusing or …
Understanding ERISA Settlements and Court Awards in LTD Claims
https://youtu.be/GScrf5sZQJo What 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 …
What Is ERISA Preemption in a Group Disability Claim?
The 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. The real significance of ERISA preemption is, if your insurer acts in bad faith and engages in fraudulent claim denials, you lose …
The Key to Winning ERISA-based Disability Claims
This 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. The Disability Appeal in ERISA-based Disability Claims When someone comes to us for help, the first thing we do is tell them how important a well-developed administrative appeal is with ERISA disability claims. How you build and handle the appeal is key to getting your claim …
Your Individual Disability Income Claim Is Not Subject to ERISA
As 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 …
ERISA Disability Lawsuits: No Jury, No Trial, No New Evidence
In 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. ERISA disability lawsuits are never argued in front of a jury. Instead, “employee benefit claims” are paper reviews, adjudicated by one federal judge who in …
Recovering Attorney Fees in ERISA Disability Claims
If 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: If a lawyer helps you prepare the administrative appeal and you win, you must pay the attorney’s fees.Even if you win your case in court, the decision of recovering attorney fees in ERISA disability claims is left up to a judge’s discretion. This includes the amount (percentage) of attorney fees the insurer might be …
How a Social Security Disability Offset Can Cut LTD Insurance Benefits
Does Your LTD Policy contain a Social Security Disability Offset and Reimbursement Clause? Today’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. Contact our social security claim denial attorney today! Group policies are drafted to (1) require that you file for SSDI benefits, and (2) …
What Are Disability Payment Offsets to LTD Insurance Benefits?
https://www.youtube.com/embed/oCMjNt2Xb1k Disability 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. But SSDI is not the only source of income that can reduce your LTD award. What are those other sources …
What the Denial Letter from Your LTD Insurer Does Not Tell You!
https://www.youtube.com/embed/8-pKR-XCks0 Have 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. While not all disability claim denials are wrongful, many of them are. Insurance companies resort to proven tactics and strategies by which they reject rightful claims. …
Filing an LTD Appeal – What You Need to Know
“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. Insurance companies want to reduce the claims they pay out. By denying a valid disability claim, insurers stand to gain far more than they lose. This is especially true for group claims under ERISA law. If a case ends up in federal court and the …
Disability Insurance Appeal: Group vs. Individual
To 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. Group LTD coverage is a “one size fits …
Does the Court Award Attorney Fees in ERISA LTD Claims?
There are times when a court may award attorney fees in ERISA disability cases. If your group disability claim enters into the litigation phase after the administrative appeal has been exhausted, you have the right petition the court to have the other side pay attorney fees. But there’s a catch. As our video states, the decision to award attorney fees and court costs to the claimant is completely up to the judge. You need to show “some degree of success on the merits” of your case. The judge also sets the percentage of the fees the insurance company must pay. This …
IME – TSA Insurance Denial Tactic Used by Insurance Companies
How Insurance Companies Combine the Independent Medical Exam (IME) withthe Transferable Skills Analysis (TSA) to deny your ERISA long term disability claim. One thing most ERISA disability insurance companies don’t want you to know is that they have a playbook of denial tactics used to protect their financial interests. It is one of the main reasons it’s so hard to prove your claim and win the disability benefits that are rightfully yours. A common tactic we often help our claimants fight in their battle to win their disability claim is the IME - TSA insurance denial tactic. The Strategy behind an IME - …
Erisa Disability Claim Litigation and Limited Discovery
In the video above, attorney Marc Whitehead explains why group disability insurance claims that have reached the Erisa disability claim litigation stage can be difficult to litigate in court. If your insurance company denies your disability claim, there is a big difference in what you can do depending on whether your claim is under a group disability policy, or is a private disability policy. The only way a group disability claim can reach the litigation stage is by exhausting the administrative appeal process. In other words, if the insurer denies your original application for benefits, you must seek approval by following the …
Is Your Insurer Ignoring Evidence of Disability in Your LTD Claim?
In the video above we discuss the insurance company’s tactic of “cherry picking” the records for evidence of your ability to work. This likely means the insurer is suppressing or ignoring evidence of disability as well. You can call it many things – cherry picking, rejecting inconvenient evidence, selective observation, slanting, dismissing contrary evidence – but it all boils down to ignoring critical evidence. By doing so, an insurer is able to smother the relevant facts that prove you are unable to work. Ignoring Evidence Is Rampant in ERISA-based Disability Insurance Claims Ignoring a claimant’s proof of disability often goes hand-in-hand with group …
How Objective Medical Evidence Affects Your Disability Claim
https://www.youtube.com/embed/-NUbVIx3a9k Insurers frequently deny disability benefits based on the lack of “objective medical evidence.” This can make or break your claim. Our video begins with a reminder that disability insurance companies are always looking for ways to reduce their liability. They want to cut costs, and so have developed strategies and tactics by which they are able to reduce long term disability benefits – and even deny benefits altogether, or terminate existing benefits. One practice insurers often use is to continually ask you for objective medical evidence of disability. This strategy works particularly well if a disability is based on self-reported symptoms – …
Trustmark Disability Insurance Claim Lawyer
At Marc Whitehead & Associates, we frequently receive inquiries about Trustmark disability insurance claim denials. Our attorneys represent policyholders in disputes regarding Trustmark claim delays, denials and terminations. The people we help come from a diverse range of industries and professions. Our clients suffer from all manner of disabling conditions. Whether you were denied disability benefits by Trustmark, or you’re just now filing – the right legal guidance can make the difference in your case. If you have received notice of denial from Trustmark, need assistance in a long term disability claim dispute, or would like professional assistance with your initial disability …
Ameritas, Union Central Disability Claim Lawyers
If you need help getting the disability benefits you deserve in a claim against Union Central, now Ameritas, consult with our disability attorneys as soon as possible. If your disability claim was wrongly denied or has been unreasonably delayed, you have options. To prevail against big insurance, you must make the best and most thorough effort you can in every step of the appeal. A good disability lawyer is prepared to immediately take over all efforts required for a successful disability appeal or lawsuit. Our experienced team will help ensure that everything possible is done to get the benefits you have earned. Disability …
Sedgwick CMS Disability Claim Attorney
Marc Whitehead & Associates law firm is dedicated to fighting claims management companies like Sedgwick CMS against wrongful denials of disability insurance claims. Sedgwick Claims Management Services, Inc. – Sedgwick CMS – is what is known in the insurance industry as a Third Party Administrator (TPA). Sedgwick does not actually sell or provide disability insurance. Rather, insurance companies and employers subcontract Sedgwick to handle disability claim applications and the entire claim management process, including deciding whether to award or deny benefits and handling all disability appeals. You may work for a company who uses Sedgwick to administer short and long term disability benefits. …
Reliance Standard Disability Insurance Claim Denial
Has Reliance Standard wrongfully handled your disability insurance claim? It’s not uncommon for insurance companies to resort to resourceful ways to cut costs – including not paying the claims they should. Insurers often put great effort into denying claims in the hope the claimant will give up and go away. Don’t let that happen to you! Fortunately, an insurance denial is not the end of your claim. If Reliance Standard has denied or terminated your disability claim, you may appeal their decision. Let your insurer know that they cannot run over you. Contact Marc Whitehead & Associates for a free case evaluation. There …
Why Does the Definition of Disability Shift in Group LTD Plans?
https://player.vimeo.com/video/90683920 Our video explains that in long term disability insurance claims, there is no single, comprehensive legal definition of disability. Each insurance company writes its own definitions. As a claimant, you will receive disability benefits only if you satisfy the precise description of disability as stated in your policy. Why is it then that so many insureds are awarded short term disability (STD) benefits, only to have the benefits cut off, or denied for long term disability (LTD) benefits – under the same policy? This is because most group disability policies have two definitions of disability: one for short term, and one for …
What Is a Pre-Existing Condition Exclusion in Disability Insurance Claims?
https://www.youtube.com/embed/Oppz2OQtIm8 Most long term disability insurance policies have limits in what they cover. These limits are written into the policy, and are called exclusions. Their purpose is to eliminate coverage for certain risks the insurance company is not willing to take on. One very common example is the pre-existing condition exclusion. If you have a mental or physical condition that existed prior to the effective date of your disability insurance policy, that is a pre-existing condition. The exclusion clause in your policy prevents you from being eligible for LTD benefits for an illness or injury that existed, and that you knew about, prior to …
Macular Edema Disability Insurance Lawyer
If your insurance company has wrongly denied your claim for macular edema disability, or you have questions about the disability claim process for vision loss, we urge you to contact us. At the law firm of Marc Whitehead & Associates, we understand the many difficulties macular edema can bring, and your need to obtain long term disability benefits. Vision loss from macular edema threatens your ability to engage in a host of daily activities such as working, driving, reading, and a multitude of routine and simple tasks, and can ultimately lead to blindness. Our attorneys’ undivided focus is disability insurance and ERISA …
A Disability Insurance Paper Review Can Harm Your Physical Disability Claim
Recently we discussed the impact a disability insurance paper review can have on ERISA disability claims. A “paper review” is where the insurance company doesn’t even bother having their own medical professional perform a personal examination, but instead rejects someone’s case based on the documentation they provide. Though these paper reviews aren’t as accepted in mental health cases, they are a fairly common practice for insurers when the claimant is complaining of a physical impairment. Claimants’ attorneys have tried to fight back against this practice in physical disability cases, but for the most part, they have had little luck. Courts Back Disability Insurance …
Mental Health Disability Claims Denied Using Paper Reviews – ERISA Law
If you are suffering from a mental health disability and your insurer tries to deny your claim without having a medical professional personally examine you, it is vital that you have a representative on your side who knows how to fight back. In order to get the long term disability benefits that you need to live a relatively normal life, chances are good that you are going to need to provide substantial medical evidence and undergo numerous tests in order to prove you truly are suffering. How frustrating is it, then, that in many cases insurance companies have the ability to reject …
Forensic Psychiatrists and Your Long Term Disability Insurance Claim
Chances are pretty good that your regular physician wouldn’t diagnose you with a specific ailment without seeing you first, right? Why, then, is it considered okay for forensic psychiatrists to offer their professional opinion on a person – an opinion that may go a long way towards deciding whether or not that individual gets the long term disability insurance benefits they need – without conducting a personal examination? The answer is that it isn’t considered okay – usually. Ethic Guidelines for Forensic Psychiatrists The American Academy of Psychiatry and the Law demands that practicing psychiatrists always strive for objectivity, honesty, and adequacy when …
Northwestern Mutual Disability Claim Lawyer
If you feel your Northwestern Mutual disability claim was wrongly denied, contact our law firm for assistance. Disability insurance is an asset that is key to your prosperity and peace of mind. The best way to prevail in your claim is to consult an experienced disability lawyer and clearly understand your options. Marc Whitehead & Associates is prepared to help you prove your disability claim either through an administrative appeal or in litigation. We will advise you with exceptional legal guidance in accordance with the highest standards of the law. About The Northwestern Mutual Life Insurance Company A Fortune 500 company, Northwestern Mutual …
Mass Mutual Financial Group
Our attorneys have considerable experience appealing Mass Mutual disability income claim denials. We know how to effectively deal with this insurance provider. Contact Marc Whitehead & Associates now at 800-562-9830 to discuss your claim. Do not give in! We can assist you in any stage of the claim filing or appeals process. Massachusetts Mutual Life Insurance Company (MassMutual) is based in Springfield, MA. The 160 year-old company sells various disability insurance plans. The company also markets annuities, retirement and long term care plans, and other financial products. Mass Mutual has a large individual Disability Income (DI) insurance market. Many physicians, dentists, finance …
Jefferson Pilot Disability Claim Denial and Appeals Lawyer
Marc Whitehead & Associates law firm reviews Jefferson Pilot disability claim denials, and handles Jefferson Pilot disability appeals. This company has sold individual and group short term and long term disability insurance throughout the United States for decades. Many Jefferson Pilot disability claims we see are filed on individual policies sold to doctors, dentists, executives and other high earning professionals. We also handle Jefferson Pilot group disability insurance appeals. If you have a denied group claim, it is likely your plan was sold to your employer via one of Jefferson Pilot’s group benefit brokers or subsidiary employee benefit firms. Jefferson Pilot is Now …
Were You Denied Disability Benefits for Lyme Disease?
There are challenges to getting long term disability benefits for Lyme disease. Although many who suffer from this debilitating illness are unable to work, it is not generally accepted as a “disabling condition” by insurance companies. So if your claim for long term disability insurance was denied for Lyme disease, you are not alone. You must not give up, because the insurer may not be acting in good faith or responsibly by denying your claim. As your attorney, I will fight to help you get the disability benefits for Lyme disease you are entitled to, even when the odds are stacked against …
Lawyer for Knee Disorder Disability Claim
A chronic knee disorder can develop from an inherent physical condition, a serious injury, or be the side effect of an illness. Knee pain and impairments of the knee joint can affect just about anyone. If your claim for long term disability insurance benefits for knee pain or knee joint impairment was denied, you need an experienced attorney to get you the benefits you deserve. The attorneys at Marc Whitehead & Associates can help. How Do You Appeal a Denied Disability Claim for Knee Disorder? You do not have to accept that your rightful claim has been denied. You can and should appeal the …
Irritable Bowel Disability Claim Attorney
Our disability insurance lawyers can assist with your irritable bowel disability claim. Irritable Bowel Syndrome, or IBS, affects millions of Americans. We understand how stressful and tormenting this impairment can be. Our legal team is here to help you get the insurance benefits you need. Cases of IBS vary in severity, and can present assorted symptoms. Common problems are chronic and severe diarrhea, constipation, and abdominal pain, cramping and bloating. While there is often significant pain, the condition is not labeled as a life threatening or serious disease. IBS can be a chronic condition spanning the rest of one’s life. Many times …
Insomnia Disability Insurance Claim Denial
If your insomnia disability insurance claim was denied unfairly, do not be surprised. Above all, do not give up on your claim. Insomnia is a common disorder causing the inability to fall asleep, stay asleep, or both. If you suffer from chronic or severe insomnia, you know how crippling this condition can be. Extreme sleep deprivation can make it impossible to do your job with any amount of precision or stability. Insomnia sufferers often live with mental and physical stress and fatigue, memory problems, headaches, double or blurred vision, anxiety, and hallucinations. Many people dealing with the condition experience the sensation of …
Lawyers Handling Voya Financial Disability Claims & Appeals
Voya Financial / ReliaStar / ING Disability Insurance Claim Denials Marc Whitehead & Associates represent claimants in actions against Voya for unfair denials of disability insurance claims. If your Voya claim was denied, talk with a disability attorney at our firm about how we may be able to assist you in appealing the denial. Our free consultation can begin the process of overturning Voya’s decision to deny or terminate your rightful benefits. We have successfully helped hundreds of disabled claimants in their battles against the nation’s largest disability insurance companies. As your law firm, we will do everything possible to make the process …
Lawyer Representing Illinois Mutual Disability Claim Denials
If you filed an Illinois Mutual disability claim and the company denied benefits, it is important to seek legal counsel without delay. All insurance companies may deny claims for various reasons; some deny claims unfairly. Illinois Mutual is headquartered in Peoria, IL. The company provides disability income insurance, worksite or group disability insurance and life insurance. It has been servicing customers for over 100 years, and markets its disability insurance products to most of the U.S. If you feel your claim was wrongly denied by this insurer, contact our law firm. Whether due to an adjuster’s error or a wrongful denial of …
Attorneys Handling HM Insurance Group Disability Claim Denials
HM Life Insurance Company / HM Insurance Group If you were wrongly denied benefits under an HM Life Insurance Company or HM Insurance Group disability claim, our attorneys can help you take swift legal action to get the benefits you deserve. Employers often provide long-term disability (LTD) insurance and other benefits to their employees. If your employee disability benefits are being denied by HM Insurance, it is likely those claim disputes will fall under the Employee Retirement Security Act of 1974 (ERISA). To appeal the denial, ERISA requires that you follow strict procedures and rigid deadlines, according to the HM insurance plan. The …
What Are the New ERISA Disability Regulations?
How will new ERISA rules affect your disability claim or appeal? Beginning January 1, 2018, the regulations that control ERISA claims and appeals will change. This is good news, because the new ERISA disability regulations will give short and long term disability claimants a much needed layer of protection. It is well-known that group disability claims are fraught with deceptive practices. This is largely because existing ERISA regulations make it easy for insurers to deny valid disability claims without penalties. Under ERISA, legal remedies and due process for claimants are very limited. The new ERISA disability regulations will help level the playing field …
Individual Disability Insurance Policy or Group Disability Plan?
Our video shares what we consider to be ten important features to consider when choosing long term disability (LTD) insurance. There are two basic types of coverage: an individual disability insurance policy or a group disability insurance plan. What are the differences? Do they offer the same protection? The most prevalent type of LTD insurance is group disability coverage through an employer. Even so, most employees are not aware of the limitations and hidden costs of group disability coverage, or the amount of coverage they will actually get. Individual disability insurance (IDI) is a policy that you privately buy from an insurance agent. …
Are there Hidden Costs in Group Disability Claims?
If you are filing a claim for LTD benefits, you need to know there may be some hidden costs with group disability claims. Specifically, (1) if your income includes a base salary plus bonus income, the bonus income may not be covered, and (2) you may have to pay taxes on your benefits. As explained in the video above, most group disability policies pay a percentage of the salary you were earning before you became disabled. If you are awarded disability benefits, this “salary percentage” provision can work to your advantage. The provision ensures that you would collect a percentage of your …
Headaches, Migraines and Your Disability Insurance Claim
If you suffer from chronic headaches or migraines, you know how incapacitating these afflictions can be. Most of us know someone who struggles with this illness. In fact – as reported by the Migraine Research Foundation, Worldwide, migraine is the 3rd most widespread infirmityAbout 1 in 4 U.S. households have a family member suffering with migraineOver four million people have chronic daily migraine, with a minimum of 15 “migraine days” every month.Over 90% of patients are unable to work or function normally during a migraine. Episodes generally last from 4 hours to 72 hours. But if you have ever dealt with the …
Attorney for Eye Disorders – Disability Claims for Vision Loss
Numerous conditions cause eye disorders and impaired vision. Loss of eyesight can present a tremendous obstacle to earning a living. If your claim for disability benefits for an eye impairment was denied, do not hesitate to contact us. We help disabled workers and veterans fight back and win denied long term disability benefits for blindness, various levels of visual impairment, eye disease and other chronic eye problems. If you were unjustly denied disability benefits, do not give up. What seems like an uphill battle can be fought and won, with an experienced and focused legal team at your side. Over 50 named eye …
Epstein-Barr Virus – Disability Insurance Claims Lawyer
If your long term disability claim for Epstein-Barr virus (EBV) was denied, the attorneys at Marc Whitehead & Associates may be able to help. Many times, claims for this illness are denied on the initial filing. If this has happened to you, do not lose hope. When you are unable to work as a result of contracting EBV or from complications of this disease, you must consider hiring a skilled disability attorney to assist you. There are numerous hurdles and concerns that you will not be aware of. Experienced counsel can best protect your rights. What Is Epstein-Barr Virus? EPV is an infection …
Ear Disorders – Hearing Loss, Balance Disability Claims Lawyer
A ruptured eardrum, an infection of the outer or middle ear, vestibular and inner ear disorders (such as vertigo and Meniere’s disease) or hearing impairment can seriously disable an otherwise healthy, hardworking individual. Those who suffer from incessant or recurring dizziness and balance problems, or the limitations of hearing loss, ringing in the ear and other chronic symptoms, have real problems functioning at work. These and other symptoms can prohibit someone from performing the material duties of their occupation, impair concentration, and also become safety hazards. If you suffer from chronic ear disorders and find you cannot continue working due to the …
Companion Life Disability Claim Attorney
Marc Whitehead & Associates represent claimants in actions against Companion Life for wrongful denials of disability insurance claims. Our free consultation can be the start of reversing Companion Life’s decision to deny or terminate your benefits. Companion Life markets both short and long term group disability insurance packages with diverse options. Disability plans under Companion Life are group disability plans, and claim denials are governed by rigid federal law titled the Employee Retirement Income Security Act (E.R.I.S.A.) To fight a Companion Life disability denial or termination of benefits, ERISA requires disabled claimants to submit an administrative appeal back to the insurer, under …
Boston Mutual Disability Benefits Denial and Claim Help
Marc Whitehead & Associates represents claimants across the United States in their appeals of denied claims for Boston Mutual disability benefits, or termination of benefits. Boston Mutual sells group and individual disability insurance plans for both short and long term coverage. We can help you with any of the following types of disability claims, either at the initial application or when you must appeal a disability claim denial by this company. About Boston Mutual Life Insurance Company For over 125 years, Boston Mutual Life Insurance Company has sold diverse insurance products including life, accident, critical illness and disability insurance. The company is based …
Anthem Life Disability Claim
If you were wrongly denied benefits under an Anthem Life Disability claim, as LTD insurance lawyers we can help you take legal action to get the benefits you need and deserve. Anthem Life Insurance Company is a subsidiary of Anthem Inc., a billion dollar health care and insurance company. Anthem Inc. merged with WellPoint Health Networks, Inc. According to the AMA, Anthem Inc. is the nation’s largest health insurer in many local markets. Anthem Life is in the Blue Cross and Blue Shield network of companies. In the disability insurance market, Anthem Life offers Group short-term disability insurance Group long term disability insurance Voluntary short …
Why Report Your Actual Job Duties in a Group LTD Claim?
When filing a long term disability claim under an employer-sponsored plan, it is important to describe the job duties that you really do. Not realizing the importance of this, many applicants write in their job title and the brief, standardized job description provided by their HR department. Often these descriptions are too general or not representative of the work you truly do each and every day. Those who become disabled and can no longer do their jobs are surprised when the insurance companies deny their claims. Little do they know that how they portray their occupation can play an important role in …
What Is the Dictionary of Occupational Titles in LTD Claims?
When you are fighting to receive disability benefits, you may hear reference to the Dictionary of Occupational Titles, or DOT. The above video mentions this as a source of vocational definitions. The DOT is a database that identifies and defines the skills and knowledge a person needs to normally perform an occupation in the U.S. economy. DOT is actually no longer updated – in fact, the last update was in 1999. Information now is often sourced from the Occupational Information Network (O*Net) – which technically replaces the Dictionary of Occupational Titles (DOT). As you can see, each database links to the other …
American United Life Disability Insurance Benefits Lawyers
In many cases, a delayed or denied claim for American United Life disability benefits can be overturned and won, with the right help. If you received a denial letter, if they’re giving you the runaround, or if you are about to file for disability benefits with this insurer, contact us for a Free Case Evaluation. Our disability insurance attorneys actively represent claimants nationwide that were denied benefits by America United Life Insurance Company, or AUL. About American United Life Insurance Co. AUL is one of several companies under the umbrella group, OneAmerica Financial Partners, Inc. OneAmerica is a powerhouse in the insurance and financial …
AIG Disability Insurance Claim Denial Lawyers
If you are a victim of a wrongfully denied AIG disability insurance claim, we may be able to help. Don’t accept or give up on a rejected claim without talking to us first. Marc Whitehead & Associates has helped hundreds of claimants fight back to win their rightful LTD insurance benefits. Our experienced legal team can help you in every aspect of your AIG claim, from application to appealing a denial, or a lawsuit in federal or state court. A History of AIG Disability Insurance Claim Denial Tactics You may be trying to understand the unreasonable nature of AIG’s denial of your claim. This …
How Do Disability Appeal Lawyers Win Denied LTD Claims
https://www.youtube.com/embed/MW5u_EEnmis Today’s video explains how disability appeal lawyers can really help when the insurance company denies your claim. One of the main ways we assist is to fully “load the administrative record” with favorable evidence during the appeals process. What does “load the record” mean, and why is it so important? You know that to file a successful initial disability claim includes a lot more than just filling out forms. This holds true for appealing a long term disability insurance denial. Appeals require insight and knowledge of how to use the forms – and also how to supplement the appeal beyond the insurance company’s …
How to Set Your Initial LTD Claim Up For Success!
https://www.youtube.com/embed/yTYoJkpQEOI In the video above, we explain the first steps in filing a group disability claim. But what’s the secret to filing an initial LTD claim that is successful? Most people find the process of applying for disability insurance benefits — and actually getting the monthly payments they need — to be far more difficult and distressing than they ever expected. The complex nature of the application process, and the documentation required to prove you are disabled, is overwhelming. Many have turned to our disability law firm for help with their initial long term disability application. What’s the Secret to a Winning Initial LTD …
Lawsuits Against Unum
The Disability Benefits Attorneys at Marc Whitehead & Associates have helped thousands of disabled workers all across the U.S. get the disability benefits they deserve when they are unable to work due to an illness or injury. Most employee long term disability plans are governed by the Employee Retirement Income Security Act of 1974, or ERISA. ERISA was passed to protect short and long term disability benefits as well as retirement savings from mismanagement and abuse. It provides policyholders with the right to appeal a denial of benefits, including filing a lawsuit in federal court if they feel their claim as …
Liberty Mutual Disability Claims
As leading national disability attorneys, Marc Whitehead & Associates have represented policyholders across the U.S who have had their Liberty Mutual disability claims unfairly denied. Founded in 1912, the Liberty Mutual Group currently ranks 68th on the Fortune 100 list of largest corporations in the United States based on 2017 revenue. In addition to group disability insurance, the Liberty Mutual Group's product line also includes auto, homeowners, workers compensation, liability, and fire insurance. The Liberty Mutual Group is headquartered in Boston, Massachusetts, but their insurance policies are sold through independent agents and brokers across the United States and around the world. Liberty …
MetLife Disability Claims Denial
If you or a loved one is a policyholder of MetLife disability insurance and your claim has been denied, you only have a limited time in which to act. Contact the nationally recognized law firm of Marc Whitehead & Associates without delay to schedule a free case evaluation with one of our long term disability benefits attorneys. Experienced MetLife Disability Claims Denial & Appeal Attorneys Marc Whitehead & Associates is a nationally recognized disability benefits law firm dedicated to protecting the rights of sick and injured workers who have had their disability claims unfairly denied or terminated by insurance companies like MetLife. When …
The Hartford – Disability Claims Denial Lawyer
The Disability Claims Denial Attorneys at Marc Whitehead & Associates have successfully represented numerous The Hartford policyholders all over the U.S. in their disputes with the insurance company over unjust denials and terminations of disability benefits. The Hartford Financial Services Group, Inc. was founded in 1810 and is one of the world's oldest and largest providers of group and employee benefits, life insurance, business insurance, auto and homeowners insurance. A Fortune 500 company, The Hartford is ranked No. 1 in fully insured disability sales and the No. 2 group life and disability insurer. According to their website, The Hartford's 2018 revenues …
Long Term Disability: Why ERISA Disability Insurers Abandoned DSM-IV to Diagnose Mental Disorders
The DSM-IV has been used by the medical community and long term disability ERISA insurers trying to define mental disorders since the year 2000, so changing over to the DSM-V was no small task. However, it was a change that many welcomed because of a number of problems – both perceived and real – with the DSM-IV. Whether or not the relatively small changes made in DSM-V will actually fix the issues that bothered people about the previous Diagnostic Manual remains to be seen, but there were plenty of reasons to want to move on from the DSM-IV. Click to call …
Sedentary Work is Still Eligible for ERISA Disability Claim Benefits
When you look at the definitions for how much physical labor a job requires, it’s pretty easy to see how someone with a disability might have difficulty with most of them. After all, you probably don’t imagine someone in a wheelchair transporting boxes constantly, or an individual who can’t lift his or her arms operating heavy machinery. And then there are Sedentary jobs. By definition, these are positions where workers sit for at least two-thirds of the time and only rarely exert themselves physically, lifting up to a relatively paltry 10 pounds when they do. At first glance, it seems like …
ERISA Disability Insurance: Be Careful What You Say to Insurers
When someone gets arrested, the police are required by law to read them their Miranda Rights, one of which is “You have the right to remain silent. Anything you say can and will be used against you…” In actuality, this is a good rule for anyone embroiled in any kind of legal action, including making a claim with your insurance company. It applies in a number of ways, from not Tweeting out pictures of yourself doing things you shouldn’t be doing with your disability to making sure that you have an experienced disability attorney handle all of your correspondence with your …
Can You Get Punitive Damages For a Denied Long Term Disability Claim?
Having your long term disability claim wrongfully denied by your insurer is one of the most frustrating things that anyone can go through. How can companies that are supposed to be there for you when things go wrong bend and sometimes even break laws – all just to avoid giving their customers the benefits that they deserve? If you or someone you love is in a situation like this, there’s a good chance that you not only want to get the benefits that you asked for in the first place, but also punish your insurer by making them pay punitive …
ERISA Law Provisions in Your Long Term Disability Policy
I began this series on understanding your long term disability policy by saying that it’s not as simple as merely paying your premium and filling out the application after you start suffering from problems. Every policy has specific ERISA requirements that you have to meet in order to qualify for benefits, and so far we’ve covered some of the most common provisions. After detailing the definition of disability in the first part of the series and covering elimination periods, earnings caps, and more in part two, today the focus is going to be on policy limitations and appeals issues. Click to call …
How is The Term Disabled Defined in Your Long Term Disability Policy?
If you know that you have long-term disability benefits as part of your insurance policy, you might think that getting those benefits is as simple as completing an application. Unfortunately, as part of an experienced long-term disability law firm, I can tell you that is decidedly not the case for long-term disability policy benefits. Click to call for a FREE consultation! There are specific terms that you have to meet in order to qualify, and those terms differ depending on the policy itself. However, there are a number of provisions that are typical to most long term disability policies. Today, we’re going …
What to Know about the ERISA Administrative Appeal Procedure
Filing an ERISA claim and receiving benefits is not an overnight process, and the ERISA administrative appeal procedure alone can take up to a year. Here’s what anyone filing an ERISA claim should know about the administrative appeal process and the statute of limitations. Under federal law, a claimant cannot bring a claim under judicial review until an internal review is carried out. This internal review, or presuit administrative appeals procedure, begins when a claimant submits their proof of loss. At that point, the Plan has a set amount of time to carry out an internal review before the claim is …
What to Do If You’re Told Your Disability Insurance Is ERISA
There’s an unfortunate trend happening right now where companies that offer disability insurance are suddenly telling policyholders that their plan is governed by the Employees Retirement Income Security Act when they file a claim – even though this fact was never mentioned anywhere before then! Why’s this going on? Because insurers know that they’re far more protected from legal liability under the Employee Retirement Act than they would be if the plan in question was independent. This has led them to attempt to retroactively alter plans so that they are covered under the federal rule, and sometimes even bend the truth …
Long Term Disability and the Two Prongs of the Miller Test
Last time, I talked a lot about discretionary clauses and how they can hurt your ability to effectively challenge your insurance company on a denied claim and win. These clauses basically allow insurers to “construe” the language of your policy however they see fit when deciding whether or not to award your claim, which gives them quite a bit of wiggle room to deny benefits unless they are very clearly and expressly offered in your specific situation – and sometimes even when they are! Call now for a FREE consultation! I mentioned how states are trying to fight back against these clauses, …
ERISA Plans, Discretionary Clauses, and Long Term Disability
More and more over the past several years, states have been trying to fight back against one of the more frustrating inclusions to ERISA policies and ERISA plans. What is this inclusion? It’s called a discretionary clause, and basically it’s language in the policy that says insurers have sole discretion in construing the terms of the plan when they’re deciding whether or not to award a claim. In theory, states still have the power to regulate insurance policies for their citizens, but their recent attempts to get rid of these discretionary clauses have proven to be less than successful so far. …
5 More Ways to Avoid ERISA Preemption in your Disability Claim
Recently we told you about how your lawsuit against your insurer can be “preempted” by ERISA if the type of policy you have falls under the guidelines for that law. This means that your case would be pulled out of a normal state court and tried in a federal one where the laws are far less friendly towards people fighting against insurance companies behaving badly. Obviously, this is not something that you want, but there isn’t much you can do to keep it from happening. Whether or not a lawsuit will be tried under ERISA depends wholly on the type of …
Avoiding ERISA Preemption with a Disability Claim (Part 1)
Most people don’t know that they have an insurance policy that’s covered under ERISA law until they experience a problem with their insurer and decide to try to fight a denied claim. Instead of being allowed to sue for bad faith and get damages above and beyond what their policy is supposed to cover like someone with a non-ERISA plan, their case will be “preempted” and forced into courts that handle ERISA matters. This means that that the actions available to you will become far more limited – as will the amount that you can expect to get if you win …
Disability Insurance: What ERISA Remedies Are Available?
ERISA insurance plan recipients who have been following me for any length of time probably know that they don’t have as many options available to them in regards to suing their insurers. You can’t punish them for acting in bad faith. You can’t get damages. You can’t sue for pain and suffering. In fact, the only thing that you can really expect if you win your appeal is to get the benefits you should have gotten in the first place and (if you’re lucky) have the insurer pay your legal costs. Still, there are several different codes defining the “remedies” that …
How Does Your ERISA Plan Work?
If you’re having trouble with your employer-sponsored health plan for a long term disability issue, you’re not alone. Lots of Americans have their claims denied or receive confusing answers from their insurers, and because they don’t really understand how a health plan covered under ERISA law works, they often don’t know what to do to fix the problem. That’s why I decided to break down the basics of how most plans under ERISA are set up. It’s not going to make you an expert, and you definitely still want to work with an attorney if you need to file a lawsuit …
Non-ERISA Plans – Where Are They?
When Congress created the Employment Retirement Income Security Act in 1974 (ERISA), the stated intention was to “protect…participants in employee benefit plans and their beneficiaries…by establishing standards of conduct…and by providing for appropriate remedies.” Basically, the law was supposed to make things better for people in big group health plans by demanding that they all follow the same federal rules. While they certainly knew that ERISA regulations would cover a lot of people, they still meant for there to be plenty of non-ERISA plans. Unfortunately, the people who actually wrote the language of the law made it so vague that today …
ERISA Statute: How Fee Awards Are Calculated
While it’s notoriously difficult to get the other side to pay for your attorney fees in an ERISA lawsuit, that doesn’t mean it’s impossible. Some judges are more willing to engage in this practice, and a few even follow the rule present in other types of cases but missing in ERISA that the winning party deserves to have the losing side pay. Because of this, it seemed useful to talk about how the actual amount of your monetary award is calculated. The Lodestar Method and How It Works To get the lodestar figure, the district court has to look at 12 lodestar …
Paying Disability Claim Lawyer Fees: Five Factor ERISA Test
If you’ve been paying attention to our updates on long term disability, you already know that it’s extremely difficult to convince judges to force insurers to pay your attorney fees. And you also know that even if you are awarded fees, the award may only partially cover what you owe for the trial and legally can’t include anything you owe for using a lawyer through the administrative process. The whole thing blatantly favors insurance companies and we’re long overdue for a change in the law, but in order for that to happen, enough people have to complain to Congress. Until that …
ERISA Long Term Disability Claims-Texas Outlaws Discretionary Clauses
Texas has passed amended the Texas Insurance Code to prohibit what are known as discretionary clauses in insurance disability insurance contracts. This applies even to insurance policies governed under restrictive federal ERISA law. Under the terms of most disability policies, the insurance company administers the appeals process and retains the sole authority to grant or deny benefits to applicants. Because the insurance company both pays benefits and retains the sole authority to grant or deny benefits, the disability insurance company has an inherent conflict of interest. Call now for a FREE consultation! Under ERISA the insurance company has a fiduciary duty to …
What Does it Mean That ERISA Plans Have No State Law Claims?
To put it bluntly, ERISA plans favor the insurance companies quite a bit in a number of ways. One of the prominent examples of this is the fact that you are not allowed to file any state law claims against the insurer for engaging in bad business practices with you during your time with them. What does that really mean, though? How much does it matter in the grand scheme of things? Hopefully it won’t matter at all for you in your disability insurance claim, but the blanket refusal of state law claims forbids you from going after your insurance company …
What Does It Mean That ERISA Law Remedies are Limited?
Another way that the ERISA law actually favors insurance companies over individual policyholders is in the fact that your “remedies are limited” if you ever have any problems with your insurer on your disability claim. Basically, what it means in layman’s terms is that when your insurance comes through your employer, there’s not much that you can do to punish your insurance company if they treat you poorly or otherwise violate the terms of your policy or even the law. Someone who buys their own policy on the free market, for example, could then take their insurer to court if they …
How Can Cherry Picking Evidence Affect Your Long Term Disability Claim?
The disability laws and ERISA regulations keep insurance companies from engaging in a number of negative practices that can hurt you, but they still can’t stop them from attempting to harm your case with deception. One of the most common things that insurers try to do is cherry-pick which evidence they decide to use from medical and vocational experts. Click to call for a FREE consultation! What is cherry picking? Quite simply, it’s when someone looks at a number of findings, often confusing or conflicting, and chooses only those findings that support their argument. In the case of insurance companies fighting a …
ERISA Law: What Is Your Skill Level?
If you’re fighting a denial on an ERISA law disability claim, there’s a pretty good chance that your insurers have used terminology such as your “skill level” without actually explaining what it means. Generally speaking, jobs are broken down into three skill level groups: unskilled or semi-skilled, skilled, and very skilled. These jobs are then further categorized by numbers ranging from 1 to 9. Jobs in the 1-3 range are considered “unskilled” or “semi-skilled.” Those that fall between 4 and 6 are called “skilled,” and “very skilled” jobs rate between 7 and 9. How Is Your Skill Level Decided? In ERISA disability insurance …
How Can Your Long Term Disability Insurance Company Ignore Your Treating Physician’s Opinion?
When you claim a long term disability, chances are good that you’re doing so under the advice of your doctor, who has probably already told you that you have a disability and may have even filled out paperwork for you to this effect. Basically, you’re acting on the professional advice of a medical expert. Logic would follow that the opinion of such a person would have to be taken into account. After all, that’s how it works if you’re filing a disability claim with Social Security. They are required to treat your doctor’s findings with respect, and if they are to …
What Is The Salary Percentage Requirement Under Erisa
Some clauses in a long term disability insurance policy can actually favor the claimant. Some policies have a Salary Percentage Requirement included in the any occupation definition of disability. This provision in the policy is the requirement that your insurance company can’t just say that you qualify for any job at any wage and deny you disability benefits based off of that. In most cases that percentage has to be 60-80 percent or more of the income that you were earning in your previous position. For example, let’s say that a registered nurse was making $70,000 a year and started suffering …
Are Some Long Term Disability Insurance Policies NOT Limited by ERISA Law?
First things first – most people don’t have non-ERISA insurance policies. If you get your insurance from an employee benefit plan, you fall under the giant umbrella of ERISA and have to follow the guidelines outlined by that law. Those of you who individually pay for your own insurance, though (freelancers, small business owners, and so on) are not governed by ERISA. Congratulations, because it’s a law that’s designed to protect the insurance companies at the expense of policyholders. By having your own individual plan, you’ve given yourself far more of an ability to stand up to your insurer and fight …
Does ERISA Code Allow for a Jury Trial?
Most group disability policies provided by employers are regulated by a federal law, the Employee Retirement Income Security Act, known as ERISA. If you’re fighting an insurance company’s denial of your medical disability claim, you’re probably wondering what happens in court and whether ERISA law allows you to argue your case in front of a jury of your peers. After all, that’s what we see all the time on TV, right? The little guy was wronged by the big corporation and now the corporation has to answer for their crimes in front of a group of regular Americans. It’s how …
Will My Legal Fees Be Paid If I Win My ERISA Case?
ERISA does allow for your legal fees to be paid, but that happens a lot more in theory than in practice. Why? Because the way the disability laws are written makes it very hard for anyone to get their attorney paid for – even if they win their claim! What Does ERISA Say About Attorneys’ Fees? The language in this part of the statute is yet another way that this law hurts policyholders. Not only is the decision about whether or not your fees are covered left to the judge’s discretion, he or she has the ability to decide on the amount …
Why Is It a Good Idea to File an Administrative Appeal When Your Claim is Denied?
Many people come to me after they have had their disability claim denied, and they’re not sure whether or not ERISA law makes it worth fighting the decision of their insurance company. After all, if a big company has looked at all the facts and decided that there is no reason you should be getting benefits, how can you really argue with that? Isn’t it possible that they’re just right? Sure, it’s possible. But what you have to remember is that insurers aren’t paying your medical bills and helping with your disability out of the kindness of their hearts. They are …
What are the Four Possible Outcomes of an ERISA Disability Claim?
When most people approach me about litigating their ERISA medical disability claim, they don’t really understand how the case might work out. After all, you either win or you lose, right? Not necessarily. In fact, there are actually four different potential outcomes that you might face if you decide to go this route. ERISA: The Four Disability Claim Outcomes Here’s how I lay it out for potential clients when they ask me to represent them in this type of claim. The four different types of outcomes you might have are: Settlement. Instead of going to court to fight your claim, the insurance carrier might …
Can a Hartford denial of your long term disability claim be overturned? Yes it can.
The Hartford has denied your long term disability claim. Can their decision be overturned? The answer: yes, it can — but you might want to get some help. The Employee Retirement Income Security Act of 1974, or ERISA as it is more commonly known, is a federal law that was enacted by Congress to govern pension and insurance companies and protect the policyholders and plan participants. Among other things, ERISA allows policyholders to appeal an insurance company's denial of benefits. Marc Whitehead & Associates recently filed an ERISA lawsuit on behalf of a client in New York who suffered from Relapsing-Remitting Multiple …
Has AETNA Denied Your Long Term Disability Insurance Claim?
Aetna is one of the nation's largest managed health care companies. Aetna sells health care insurance and related services, including short term and long term disability benefits plans, primarily through employer paid insurance plans. Aetna is notorious for denying workers' claims for disability benefits, having one of the highest rate of disability claim denials. In 2018, during an investigation by the California Department of Insurance, a former medical director for Aetna revealed that he never reviewed any patients' medical records when deciding whether to approve or deny claims for coverage. It's easy to understand why the company has been fined millions …
Hartford sued for Denying Claim of Disabled Worker
The nationally recognized disability attorneys at Marc Whitehead & Associates have helped thousands of disabled workers obtain the disability benefits they deserve after The Hartford and other insurance companies unfairly denied their claims. Marc Whitehead recently filed suit on behalf of a disabled 56 year old worker in Arizona, who became severely disabled while covered under a long term disability insurance policy issued and administered by The Hartford. Founded in 1810, The Hartford is one of America's oldest and largest insurance companies, raking in billions in revenue each year. They provide a wide range of group insurance policies, including short term and …
Disability Lawyer Sues Hartford on Behalf of Disabled Worker
The disability attorneys at Marc Whitehead & Associates have helped thousands of disabled workers obtain the disability benefits they deserve after an insurance company unfairly denied their claims. We recently filed suit on behalf of a 59 year old worker from Illinois who became severely disabled while covered under a long term disability insurance policy issued and administered by The Hartford. Founded in 1810, The Hartford is one of America's largest insurance companies, taking in billions in revenue each year. They provide a wide range of group insurance policies, including short term and long term disability insurance. The Hartford does business in …
Long Term Disability Lawyer Sues Met Life on Behalf of Disabled Worker
Disability Lawyer, Marc Whitehead has filed suit on behalf of a disabled 53 year old worker and a resident of Texas, who became severely disabled while covered under a long term disability insurance policy issued and administered by Met Life. Plaintiff is a 53 year old worker and was formerly employed as an Administrative Project Manager. Plaintiff is a resident of Texas and is currently disabled due to pancreatitis, gastrointestinal bleeding, osteoarthritis, Hepatitis C, lupus, PTSD, and fibromyalgia. Met Life is an insurance company doing business in Texas. Venue & Jurisdiction of Long Term Disability Lawsuit Suit was filed in federal court in …
Suit Filed Against Prudential-Long Term Disability Denial
The Disability lawyers at Marc Whitehead & Associates have enabled thousands of clients to secure badly needed benefits after their claims for Long Term Disability Benefits were unfairly denied by Prudential and other insurance companies. We've represented Prudential policyholders through every step of the appeal process, from gathering the documents that support your claim of disability to arguing your case in front of a Judge in Federal Court. Marc Whitehead & Associates were recently forced to file suit on behalf of a disabled worker who became severely disabled while covered under a long term disability insurance policy issued and administered by …
Disability Insurance Claimant’s Rights to COBRA Benefits
Frequently, employers will terminate an employee when their disability insurance company denies the employee their disability benefits. When this unfortunate situation happens, the disabled employee may be forced to seek health benefits under what is known as COBRA. If you qualify for COBRA and your rights have been violated, you need to know. COBRA is the Federal law requiring employers to provide certain employees with continuation of group health coverage. Not all employers are required to offer COBRA and not all employees are eligible for COBRA (i.e. companies with less than 20 employees, certain church and federal government plans are not …
Long-Term Disability Insurance & Secret Video Surveillance
Long-Term Disability Insurance claimants can frequently feel abused by their own insurance companies during the claims process. The Employee Retirement Income Securities Act (ERISA). ERISA applies to most disability insurance claims and therefore claimants have little recourse against such abusive tactics. The most common is secretive video surveillance of the disabled claimant. Secret Video Surveillance in Disability Insurance Claims Some insurance companies make a habit of videotaping claimants after they have received benefits for a year or two. The insurance company will claim that there are “red flags” that indicate a claimant may be working, so an “investigation” is necessary. Often, the …
Disabled Must Prove Insurance Company Abused its Discretion
Long Term Disability Insurance claims can be difficult to pursue in an administrative appeal or in federal court. One of the difficulties for claimants to overcome is the restrictive rules that have evolved from the common law governing the Employee Retirement Income Securities Act (ERISA). ERISA applies to most disability insurance claims. Claimants must prove the insurance company “Abused its Discretion" In a disability insurance claim brought under state law, the disabled claimant only has to prove it is “more likely than not” that they are disabled. This generally only applies to individually purchased policies. Most policies however are obtained through a …
Filing an ERISA Long Term Disability Insurance Lawsuit-Pt. 2
Long Term Disability Insurance claims are usually governed under federal ERISA regulations. If a claimant goes through the administrative appeals process and is denied their disability benefits, their only remedy is to file a civil lawsuit to enforce their rights under the policy. This leads to several important questions. In part one of this two part blog we explored who can sue and who can be sued. In part two we explore where to file your lawsuit and how long you have to get the suit on file. Click to call for a FREE consultation! Where Can I File My Lawsuit? ERISA states …
Filing an ERISA Long Term Disability Lawsuit If Claim Denied
Long Term Disability Insurance claims are usually governed under federal ERISA regulations. If a claimant goes through the administrative appeals process and is denied their disability benefits, their only remedy is to sue and file a civil lawsuit to enforce their rights under the policy. This leads to several important questions. In part one of this two part blog we explore who can sue and who can be sued: Who Can Sue? Any Plan beneficiary or participant may bring suit to enforce their rights under the plan or policy. This generally means the disabled individual but in some cases could be a …
Is Your Disability Insurance Claim Governed by ERISA Law?
What is ERISA? ERISA stands for the Employee Retirement Income Security Act of 1974. ERISA is a federal law that regulates the handling of Employee Benefit Plans and the remedies of the beneficiaries of these Plans. ERISA applies to all employees benefit plans established or maintained by an employer engaged in commerce or by an employee organization representing employees engaged in commerce. Practically all long term disability plans offered by a private employer are governed by ERISA. A claimant challenging a disability denial under an ERISA governed plan or policy must bring the claim pursuant to ERISA regulations and procedures. All …
Proving Fibromyalgia Can Cause Permanent Disability
Fibromyalgia Syndrome (FMS) is a leading cause of Social Security Disability and Long Term Disability Insurance Claims. Anyone who comes in contact with patients with FMS knows its disabling effects. However, much about the disease remains unknown. One Social Security Judge referred to it as a “pervading mystery – its cause, duration and functional limitations.” These cases can be won if the symptoms and the functional effects are made clear to the social security judge or the disability insurance company. While the disease is identifiable medically, it can be difficult to prove legally in a Social Security Disability case Fibromyalgia cannot be …
Disability Lawyer Sues Unum on Behalf of Disabled Worker
Unum disability attorneys Marc Whitehead & Associates sometimes have to file suit in federal court on behalf of Unum insurance holders who were unfairly denied their benefits. Millions of workers in the U.S. have bought individual and group disability policies from Unum, one of the largest insurance companies in the world. The plans promise great benefits. However, when one of these workers becomes unable to work due to illness or injury they often encounter difficulties in obtaining these benefits. Big insurance companies like Unum, Cigna, Aetna, Prudential and others often write their policies so to take full advantage of rules and …
Pain and its Mental Limitations as a Disabling Condition
People with Long Term Disability Insurance, ERISA Disability, Social Security Disability or Veterans Disability claims often have psychological problems that limit their ability to work. Many claimants with serious physical problems, especially if they have been having pain for a long time, develop emotional aspects to their physical impairments. It is important that disabled claimants explain any emotional problems because it is often the emotional aspect of pain that interferes the greatest with the ability to work. Common problems include: difficulty concentratingforgetfulnessnervousnessa quick temperdifficulty getting along with othersavoiding other peoplecrying spellsdepression If a disabled claimant has some of these problems, they may …
Legal Standard of Review for Disability Claims
ERISA preempted long term disability insurance, Social Security Disability or Veterans Disability Compensation are the most common benefits available to help disabled workers. The legal standard of review is the criteria the courts look to in deciding whether to uphold or reverse the rulings of a lower court or in the case of most disability claims, the findings of an administrative proceeding. This post will explore the legal standard that the disabled worker must meet to prove their claim in court if they are denied during their administrative appeal. ERISA PREEMPTED LONG TERM DISABILITY INSURANCE POLICIES For ERISA Long Term Disability insurance claims, the legal standard …
Long Term Disability Insurance – The Definition of Disability
Long Term Disability (LTD) insurance companies are notorious for denying legitimate claims based on obscure disability definitions contained in the policy. There is no one legal definition of disability. Every insurance company, the Social Security Administration and the Veterans Administration all have different definitions. Disability is Defined by the Insurance Contract The definition of disability is explained in the insurance policy and will vary from company to company. Usually, it is something along the lines of “due to sickness or injury the employee is unable to perform the material and substantial duties of his or her own occupation.” However, most policies shift …
Long Term Disability Insurance – What Did I Pay For?
Many people think that their long term disability insurance policy will replace their income if they are disabled. Most people are shocked to find how the insurance company has structured its policy to minimize the amount it has to pay to a disabled policyholder. Salary Percentage The majority of long term disability insurance policies pay only 60% of a claimant’s salary if disabled. If a claimant works on a commission or other non-salaried basis, the insurance company will use a calculation described in the policy to arrive at a benefit amount. Call our Long-Term Disability Attorneys today! Partial or Residual Disability https://www.youtube.com/watch?v=lDizTX08fkM&list=PL99Hlbcvpx-DGlsx071F65osZ0E-yMXqT&index=2 Some policies allow a …
Disability Policies-Mental Health & Subjective Symptom Limitations
Most long term disability insurance companies try to limit benefits to the disabled by writing policies that have a mental health limitation. Usually mental health disability benefits are limited to only a short period of time, typically only 12 to 24 months. This means that benefits for mental health conditions such as depression, anxiety or bipolar disorder will only be paid for a limited time period. Many claimants develop depression secondary to chronic pain. The insurance company will try to classify the claimant’s impairment as mental, so that benefits will be paid for only 24 months. The insurance company may …
Disability Insurance Policies – What type Do You Have?
The long term disability policy is the contract between a claimant’s employer and the insurance company. The language and provisions in the contract varies from policy to policy, so it is essential that a claimant get a copy of the policy from Human Resources. Short Term Disability benefits (“STD”) are paid for a limited amount of time, anywhere from one week to six months, depending on your policy. Generally, STD is sometimes paid for by your employer and is usually 100% of your salary. Because STD is usually paid by the employer and is for a limited amount of time, it …
What is ERISA and How Does it Apply to My Long Term Disability Claim?
What is ERISA and how does it apply to my long term disability insurance claim? ERISA stands for the Employee Retirement Income Security Act of 1974. ERISA is a federal law that regulates the handling of Employee Benefit Plans and the remedies of the beneficiaries of these Plans. ERISA applies to all employees benefit plans established or maintained by an employer engaged in commerce or by an employee organization representing employees engaged in commerce. Practically all long term disability plans offered by a private employer are governed by ERISA. A claimant challenging a disability denial under an ERISA governed plan or policy …