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ERISA

The difference between ‘Any Occupation’ and ‘Own Occupation’

Own Occupation & Any Occupation In Long Term Disability Insurance The Misunderstood ‘own occupation’ & ‘any occupation’ definitions in Long Term Disability Insurance policies. Own occupation is typically defined in most insurance contracts as your job as it appears in the national economy. So if your particular job has a feature in it that most …

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What is the difference between Social Security (SS) and Long Term Disability (LTD)

What is the difference between social security and long term disability? Long term disability is an insurance benefit typically provided by your employer as an employee benefit. The LTD plan document will lay out all the terms and conditions you must meet to receive disability insurance if you become disabled. Long Term Disability Insurance will …

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Do Not Appeal Your Long Term Disability Insurance Denial Without An ERISA Attorney

If the insurance company sends you a denial, you have the legal right to an appeal in a long term disability case. The denial letter is really important because that denial letter is going to tell you that you have an ability to appeal. And the ability to appeal is not something that the insurance …

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Most Long Term Disabilities Are Caused By Chronic Conditions

Chronic Conditions are the Root of Most Long Term Disability Cases Most Long Term Disability Insurance cases are the result of chronic conditions, rather than accidents or injuries. In our experience representing clients in Long Term Disability Insurance cases, very few disabilities are caused by injuries resulting from an accident. Most of our clients have …

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Proposed Changes to Rules Governing ERISA Long Term Disability Claims

Recently the Department of Labor (DOL) proposed some amendments to Section 503 of ERISA (Employee Retirement Income Security Act), to improve the current rules governing Long Term Disability claims and appeals.  Joe sent his comments and recommendations to the DOL with the hope of improving the disability claims process for all of our clients. Here are …

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experienced disability lawyers

HIRING AN EXPERIENCED LONG-TERM DISABILITY/ ERISA LAWYER

ERISA is a unique statute that applies to employee benefit disputes.   Under the ERISA statute, if your employer-sponsored disability plan denies your disability claim, the case will be litigated in Federal Court under a unique set of rules that often favor insurance companies and Long Term Disability Plan administrators.  So you need to make sure …

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Long-Term Disability Denials of POTS Syndrome Claims

Over the past few years we have represented many clients who have had Long Term Disability Insurance Denials of their POTS Syndrome claims. POTS or “Postural Orthostatic Tachycardia Syndrome” is an unusual condition that causes the Autonomic Nervous System to malfunction. POTS symptoms can include tachycardia, heart palpitations, chest pain, fainting, nausea, rapid gastric emptying, …

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Pulmonary Lung Disease Testing for Long Term Disability Claims

Obstructive & Restrictive Lung Diseases:  The Importance of FEV¹ & FVC test results for Long Term Disability Insurance Claims If you have a pulmonary disorder, one of the most important tests that you will take is a PFT or Pulmonary Function Test.  This test is somewhat complicated and measures many aspects of lung function.  The …

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Long Term Disability & the Undiagnosed Condition

LONG TERM DISABILITY & THE UNDIAGNOSED CONDITION One of the most difficult cases in our long-term disability practice is the individual who does not have   a diagnosis. It is very common in medicine for claimants to go longer than a year without receiving a proper diagnosis. This is not the fault of physicians, but …

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Missing Pieces of the Administrative Record – Full & Fair Review under ERISA?

ERISA “Full & Fair Review” & the Missing Pieces of the ADMINISTRATIVE RECORD One of the most important pieces in a long-term disability case is the “administrative record.” The administrative record is defined as: everything that the insurance company considered in the denial of your claim. It also includes any appeal that you might submit, …

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