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ERISA

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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Requirements For Filing A Long Term Disability (LTD) Insurance Claim

What You Need To Know To File A Long Term Disability Claim Under ERISA: Q.   On what day did you become a plan member? This is very important because some plans require a waiting period before you become a plan member. The Plan may require you be employed 90 days before you become a …

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Have you heard of ERISA?

Have You Heard of ERISA? It’s important to have familiarity with the Employment Retirement Security Act (ERISA) if you receive employee benefits through your employer. Established in 1974, ERISA sets minimum standards for private industry to protect individuals in employee benefit plans, including pension and welfare benefit plans. Welfare benefit plans may include benefits in …

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ERISA Explained (The Employee Retirement Income Security Act)

What is ERISA In 1974 Gerald Ford signed the employee retirement income security act (ERISA) into law in the rose garden on labor day. It was truly a momentous occasion. If you’re old enough to remember what was happening in the economy back in the 70’s, you might remember that we had a lot of …

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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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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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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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Court Decides Liberty’s Denial of Our Client’s Waiver of Life Insurance Premium Did Not Meet “Full and Fair Review” Standard Under ERISA

Under ERISA, one of the rights you have as a part of your disability benefits claim is the right to a “full and fair review” by the insurance company. In providing a “full and fair review” the insurance company cannot cut corners or rely on generalizations to evaluate your claim.  Instead, the insurance company has …

Court Decides Liberty’s Denial of Our Client’s Waiver of Life Insurance Premium Did Not Meet “Full and Fair Review” Standard Under ERISA Read More »