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Posts Tagged ‘wrongful disability denial’

Sjögren’s Syndrome & Long Term Disability

Sjögren’s (“SHOW-grins”) Syndrome is a systemic autoimmune disease involving gland dysfunction that can affect the entire body.   Because Sjögren’s Syndrome is an autoimmune syndrome, it is found more commonly in families that have members with other autoimmune illnesses. In autoimmune disorders, the immune system, which normally protects the body from infection and cancers, may…

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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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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…

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

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

“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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