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wrongful disability denial

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

February 9, 2020 / By

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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Sjögren’s Syndrome & Long Term Disability

February 27, 2018 / By

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 cause …

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Long-Term Disability Denials of POTS Syndrome Claims

September 9, 2015 / By

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

July 14, 2014 / By

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

August 20, 2013 / By

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 »

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

February 5, 2013 / By

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

March 11, 2009 / By

“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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