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New Jersey Disability Lawyer Blog

Oral argument set for May 20th at Third Circuit to Defend our Success for Disabled Bank Employee
Bonny G. Rafel, LLC

In Stevens v. Liberty Mutual together with esteemed attorney, Mark D. DeBofsky, Esq. of DeBofsky & Associates, P.C. we continue our battle against Liberty to reverse their denial of disability benefits to a disabled bank employee. We won our motion for summary judgment in January, and the Court ordered that Liberty pay Mr. Stevens his…

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ERISA Insurers Must Consider the Actual Job Duties of The Occupation In Determining Disability
Bonny G. Rafel, LLC

Often our clients are denied disability benefits on the basis of the insurers’ conclusion that they can work in a “sedentary occupation.” Insurers also base their analysis often on something known as the “national economy.” By ignoring the demands of our client’s individual job workplace and environment, the insurers misclassify a job and the duties…

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Prudential’s Attempt to Toll The Deadline for ERISA Appeal Determination Rejected
Bonny G. Rafel, LLC

A recent ruling received by Bonny G. Rafel, LLC examined the recent habit of insurers tampering with the ERISA regulated mandates for deciding appeals of denied ERISA claims. We have received many letters from insurers advising us that they will not start the appeal review until we notify them that we will not be furnishing…

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Time Limitation In Welfare Benefit Plan Strictly Enforced
Bonny G. Rafel, LLC

In general, if a group insurance benefits plan pays benefits such as medical bills or disability benefits related to an event caused by another “third party”, such as an automobile accident, the plan has the right to recoup their payment from the claimant’s collection of money (“recovery”) from the “third party.” This often stymies the…

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Deadline for Filing Lawsuit Applies Even If Insurer Agrees to Voluntarily Review An Appeal Filed Late
Bonny G. Rafel, LLC

The 11th Circuit recently decided an important case in the grey area of when does the deadline for filing litigation expire in a disability claim. In Witt v. MetLife,2014 U.S. App. LEXIS 22321 (11th Circuit 11/25/14), Mr. Witt was denied benefits in 1997 but did not contact MetLife to contest the denial until 12 years…

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Disability By Mental Illness Is Underappreciated By Insurance Industry
Bonny G. Rafel, LLC

In light of Robin Williams’ passing this year, mental health has returned to the headlines. As described in Arianna Huffington’s article “Robin Williams, Connectedness and the Need to End the Stigma Around Mental Illness,” Williams’ suicide was undoubtedly linked to his struggle with depression and anxiety. In fact, as Huffington reports, “90 percent of those…

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Insurer Must Consider the Occupation As It Was Performed When Disability Commences
Bonny G. Rafel, LLC

Oftentimes, when reviewing a disability claim, the insurer will not consider how the insured was actually required to perform his occupation. Instead, the insurer, relying on the clause in its policy “the Covered Person’s occupation is as it is normally performed in the local economy” will define “own occupation” solely be reference to how the…

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Cigna Denial Reversed! Hormone Therapy is Not Treatment That Limits Cancer Disability Claim Coverage
Bonny G. Rafel, LLC

Insurers are still permitted to include “pre-existing” limiting provisions in its disability policies. Cigna policies provide that ” The Insurance Company will not pay Disability Benefits for any period of Disability caused or contributed to by, or resulting from a Pre-Existing Condition.” A “Pre-existing Condition” means “any Injury or Sickness for which medical treatment, care…

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Disability Caused by Multiple Sclerosis
Bonny G. Rafel, LLC

Multiple Sclerosis is an autoimmune disease where the individual’s autoimmune system attacks healthy tissue in the brain and spinal cord, damaging nerve fibers. Typical symptoms include muscle spasms pain and tingling, numbness, cognitive impairment, vision problems and difficulties with balance and walking. An estimated 400,000 Americans have this disease. The New York Times recently highlighted…

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Temporary Improvement Does Not Signify Ability To Work
Bonny G. Rafel, LLC

Recipients of long term disability benefits often experience improvement in their condition when they stop working. For example, a construction worker who experiences severe back pain may experience a health improvement when he is not engaged in intensive physical activity on a daily basis. When you have been approved for long term disability, the benefits…

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Client Reviews

I was an Engineer in a Research and Development division of a major corporation, putting in longer hours with the same workload. An unrelated episode landed me in the hospital, where I was DXd with Primary Progressive Multiple Sclerosis, which explained my decline at work. I then learned that I had...

Charlie

I would like to re-acknowledge what a difference your work has made in my life. When forced to retire 5 years ago, you dedication to helping me enroll into my disability policy has made all of the world of difference.

George

I cannot thank you enough for successfully appealing my disability benefits. My special thanks also to Eileen for all of their assistance, support and expertise. Your legal expertise of disability benefit entitlement was evidenced by your comprehensive and knowledgeable litigation of my appeal. I...

MaryJo