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Insurance Denial

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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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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Long-Term Disability Denials of POTS Syndrome Claims

Over the past few years we have represented multiple clients who have been inflicted with POTS or “Postural Orthostatic Tachycardia Syndrome”.  POTS 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, blood pooling in the extremities, sleep abnormalities,…

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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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