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Insurance Denial

Long Term Disability & The Comorbidities Of EDS, POTS & MCAS

Over the years we have represented many clients in Long Term Disability Insurance claims for POTS (Postural orthostatic tachycardia syndrome)  or EDS (Ehlers-Danlos syndrome)or MCAS (Mast Cell Activation Syndrome). Then we started to notice a rise in cases where 2 or all 3 syndromes had been diagnosed. In 2016 Researchers found a genetic mutation that links Ehlers-Danlos …

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Stiff Person Syndrome

Stiff person syndrome (SPS) Stiff person syndrome (SPS) is a rare, progressive syndrome that affects the nervous system, specifically the brain and spinal cord.  Although very rare (Stiff Person Syndrome affects only 1 in a million people), McDonald & McDonald has represented several Long Term Disability Insurance clients who have suffered from SPS. The cause of stiff person syndrome is unknown, …

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Mental Health, Bipolar 1 & Long Term Disability Denials

Mental Health, Bipolar 1 & Long Term Disability Denials In our experience, when Long Term Disability (LTD) insurance companies evaluate mental health cases, such as Bipolar 1, they typically attempt to redefine the illness and ignore their own definition of disability under the disability insurance policy. Nearly all long-term disability (LTD) policies cover mental health …

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Important Shifts in Fibromyalgia Proof for LTD cases 2017

Fibromyalgia Claims Fibromyalgia is a disease that does not offer any objective evidence or test results. It has been difficult to “prove” for long-term disability claims in the past. In 2017 there were two strong decisions which overturned long-term disability benefit denials. Disabled claimants were entitled to long-term disability benefits for fibromyalgia. The 2017 rulings represent important …

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Everything You Need To Know About Lupus

Systemic Lupus Erythematosus has been called The Great Pretender in certain medical circles. Here is some information on one of our most commonly represented illnesses. The Great Pretender Many people who suffer from Lupus go through long periods of misdiagnosis. Lupus can pretend to be many other illnesses, so depending on the symptoms, it is …

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How Can I Be Disabled Yet Still Denied My Disability Insurance Benefits?

How can I be disabled but still be denied my insurance disability benefits? This is really a good question and the person asking the question is typically the disabled person. You have a lot of scenarios where the individual literally, genuinely, feels like they’re not going to be able to work. If you wanted a …

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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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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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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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