Articles Posted in Recent Court Decisions of Interest

Disability Insurer Unum is required to pay lifetime benefits to Endodontist with repetitive stress injuries to her hands

Disability insurance companies must consider the global demands of working full time when considering claims

We regularly file appeals of disability insurance denials of long term disability claims. Our clients are bound by ERISA regulations which require that all appeals must be filed within 180 days of the insurance company denial. We meet with our clients as early as possible following their receipt of the denial, to strategize what evidence…

For those of us handling long term disability claims for people suffering from chronic back conditions, a clause in the MetLife LTD policies has caused us much tsuris (Yiddish word, “worry”). Their policies contain a limitation for “neuromuscular disorders” providing coverage for only two years for disorders of the spine unless one of six exceptions…

Our clients often ask how to retain employee benefits while on disability leave. A source of this information should be an employee handbook or summary of benefits available from the employer. Often all benefits such as medical coverage or life insurance continues while the employee is on short term disability. Then if the employee does…

An action taken by the U.S. Department of Labor to protect the disabled fortunately passed on December 19, 2016, on the eve of the Obama’s departure and will go into effect January 1, 2018. Claimants counsel breathed a sigh of relief when the amendments to the Employee Retirement Income Security Act of 1974 (ERISA) remained…

We have been following the Courts’ treatment of mental or nervous disorders limitations in group long term disability policies. (See blog, Disability Caused by Physical Impairment, July 2015) Recently, the 6th Circuit Court of Appeals joined other courts holding that a claimant is disabled by physical conditions alone, then the mere presence of a psychiatric…

Insurers often balk at paying a disability claim for a condition that has existed for a long time before the individual stops working. It seems that people that struggle to continue working despite progressive medical impairment are not rewarded for their heroism. An interesting case was recently published in California regarding a woman suffering from…

Physician Association Plans Qualify for Safe Harbor Protection

Disability insurers love to deny claims based on their medical consultant’s conclusion that the claimant has “sedentary capacity.” The insurer’s vocational counselor swiftly identifies various jobs that the claimant can allegedly perform without performing a full or fair investigation of the transferable skills. Does the inquiry end at the point it is established that the…