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Injured Victims Suffer Twice Under McCutchen Ruling on ERISA Subrogation Claims

June 24, 2013 / By

INJURED VICTIMS SUFFER TWICE UNDER McCUTCHEN RULING Congress needs to fix resulting unfair outcomes under ERISA subrogation claims (Yes, the tail finally does wag the dog!) On April 16, 2013, the United States Supreme Court issued its long awaited decision in the case of U.S. Airways v. McCutchen,  (No. 11-1285). The case involved a subrogation …

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McDonald & McDonald – Long Term Disability Appeals in Ohio and 6 Nearby States

February 27, 2013 / By

Long Term Disability Appeals in Ohio and 6 Nearby States At McDonald & McDonald, we practice ERISA / long-term disability insurance law in several states throughout the Midwest, Mid-Atlantic, & the South.  Our clients have come from a variety of locations and cities. Our law firm is headquartered in Centerville, Ohio, but . . we have …

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Reinstating your Long Term Disability Benefit: The ERISA 502(a) Lawsuit

February 5, 2013 / By

Most individuals become familiar with the phrase 502(a) lawsuit by receiving a letter from an insurance company denying access to their long-term disability benefits. The traditional language often used by long-term disability insurers advises clients that they have “exhausted their administrative remedies”, and now have the ability to file a lawsuit under Section 502(a) of …

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Long Term Disability – Defining “your job” vs. “your occupation”

September 21, 2012 / By

Long Term Disability Insurance – “your job” vs. “your occupation” – understand the difference: THE VOCATIONAL SIDE OF LONG-TERM DISABILITY Frequently, long-term disability contracts provide us with definitions for disabling conditions. These definitions embrace the idea that your illness or disability affects your ability to perform “your job.”  Occasionally, policies also refer to “your occupation.” …

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Long Term Disability: “Exhaustion of Administrative Remedies”

May 24, 2012 / By

Reaching back into our history, I thought the following might be a good decision to share. This case primarily deals with the often under-litigated issues of exhaustion of administrative remedies and timeliness of the Plaintiff’s Complaint under 502(a) of ERISA. In general, each Long Term Disability plan that issues a denial must have rules that …

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Don’t Accept the Social Security Representative Recommended to You By Your Long Term Disability Insurer

March 31, 2012 / By

You are not obligated to accept the preferred Social Security representative recommended to you by your Long Term Disability carrier. When you apply for long-term disability benefits, many plans will require that you also apply for and pursue Social Security disability benefits. The logic behind this request is simple. They will take an offset for any …

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Long Term Disability Appeal Cancer Win

Long Term Disability Appeal For Cancer Denial – Client Wins!

March 8, 2012 / By

Long Term Disability Appeal For Cancer Denial – Client Wins! McDonald & McDonald Wins Long Term Disability case in Federal Court for Disabled Client! See Spina v. CVS Long Term Disability et al In 2011 the United States District Court for the Southern District of Ohio ruled in favor of our client, who suffers from …

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Surveillance and the Functional Capacity Evaluation

October 28, 2011 / By

This has been on my mind for some time and I have been trying to let my clients and perspective clients know about this so they can respond appropriately. Many insurance companies use vendors to conduct video surveillance while the disability claimant is at their home. There is simply no way to tell which files …

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“Physician Peer Reviews” Lead to Wrongful Denial of Disability Insurance Claims

March 11, 2009 / By

“Physician Peer Reviews” Lead to Wrongful Denial of Disability Insurance Claims A Physician Peer Review is NOT the same as a second opinion or independent medical exam (IME). Essentially, a physician peer review is a tool used by the insurance company to review your Dr’s medical records. Physician Peer Reviews are problematic because the peer …

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