Years ago, the United States Supreme Court made the decision to allow insurance companies to “reserve discretion” for benefits available under disability insurance plans sponsored by employers. If you see the phrase, “we have discretion to determine benefits,” in your policy, you need to recognize that these are dangerous words. This discretionary clause often causes [...]
You would think that if you suffered an injury or illness and you could not perform the actual duties that your own boss required you to do that you would be able to recover under your employer’s long-term disability policy. Most employer-sponsored long-term disability policies aren't worth the paper they're printed on. Many will define [...]
I'm surprised by how many people let the insurance company get their medical records before they look at the records themselves. You need to know what your doctors have actually said BEFORE you file for long-term disability benefits. There are many reasons it is better for you to review your medical records before you submit [...]
Long-term disability policies are confusing, even for some attorneys. It can be difficult to read between the lines, in fact, the language is meant to be hard to understand. Your employer's long-term disability plan documents may say this: “ERISA requires that you go through the Company's administrative review process before pursuing any legal action challenging [...]
Employers purchase group long-term disability policies to provide a benefit to their employees. This benefit is designed to pay a portion of the employee's lost wages should the employee not be able to work in the future due to injury or illness. What very frequently happens when an employee applies for benefits, however, is that [...]
A new client opens a file with an experienced ERISA law firm. The first thing they see? A lengthy investigative report that starts with screen shots of his celebrating his physical prowess while vacationing! The investigators didn't have to work very hard to find it. They just clicked, and there it was, in all its [...]
There is so much that we don't understand about certain diseases. Doctors and scientists are working around the clock, trying to understand Lyme disease, fibromyalgia, and even chronic migraines. Traditional testing provides little insight into these conditions, and few tests exist to "prove" individuals have illnesses like these. Even if a doctor diagnoses your disease, [...]
I've Been Denied by My Insurer. What Now? The answer to this question is simply: if your claim is governed by ERISA, obtain legal representation. Let me explain to you why it is so very important to get an attorney involved, and why it is important to do so immediately. If your claim is governed [...]
If you have a disability insurance policy from your employer, it is most likely governed by ERISA. (Employee Retirement Income Security Act.) Your attorney fees can be recovered if you sue and win. It will be up to the judge to determine whether the insurance company should pay your attorney fees. Under ERISA, a claimant [...]
It is rare that an insurance company will be awarded its attorney fees in defending your long-term disability claim in federal court. While the law allows the insurance company to apply for payment of its attorney fees if it wins your disability case, it is rare that a court will make you pay. In one [...]
