Resources

In this article, you can discover: The duration and coverage of short-term disability plans. ERISA eligibility and common reasons for short-term disability claim denials. Steps to take when your short-term disability claim is denied and the role of an attorney in an ERISA appeal. How Long Is Short-Term Disability? The maximum benefit period for short-term disability depends on your benefit plan. Short-term disability can be as brief as 11 weeks or last up to 52 weeks. However, most plans offer a duration of 180 days or six months. What Illnesses And Injuries Are Covered? All illnesses and injuries are covered under short-term disability benefits unless specifically excluded by the plan. Could A Short-Term Disability Plan Be Exempt From ERISA? Indeed,… Read More

In this article, you can discover: Reasons for long-term disability being delayed or denied. Why you need a lawyer to obtain long-term disability. How insurance companies play a role in disability claims. Reasons it may be worth appealing a denial for disability benefits. Why Might A Long-Term Disability Claim Be Denied? A claim can be denied for many reasons… Perhaps the medical evidence is insufficient, or the condition does not meet the criteria for disability. Alternatively, the claimant's physician may not agree that the claimant is disabled or that their medical condition prevents them from working. In some cases, a pre-existing exclusion in the policy may apply. Or, the insurance company may determine that the claimant can perform another occupation.… Read More

In this article, you can discover: Necessary conditions to qualify for long-term disability. The approval process for long-term disability. Whether mental illness is covered under long-term disability. Factors that may get in the way of being approved for long-term disability. Which Conditions Are Considered A Disability? Many factors go into determining whether or not a person is disabled. It is not simply based on having a medical condition but rather a combination of medical, vocational, and functional impairment. Almost any medical condition could be considered disabling depending on how it affects the person’s ability to function. The impact of the medical condition on the ability to work will determine whether or not it is a long-term disabling condition. What Is… Read More

Should I File An ERISA Disability Claim If I Am Still Working? You can file an ERISA disability claim while you are still working. However, you may not always want to. Most disability plans require “an inability to perform the duties of your occupation” before benefits become payable. Therefore, you might be hard-pressed to prove that you cannot perform the duties of your occupation if you are still working. What Tactics Will Insurance Companies Use To Deny My ERISA Disability Claim? Insurance companies use a variety of tactics to improperly deny ERISA disability claims. For instance, surveillance is a tool often used by insurance companies to deny a disability claim. However, you should beware of this tactic. While you might… Read More

Denied his disability insurance claim four times, Dr. John Doe – ‘John Doe’ is a substitute for the real name of our client to preserve his anonymity – could have given up, but he didn’t. Luckily, he was referred to our firm and we began digging deep into how this 36-year old radiologist’s health condition ended a bright career and turned the tables on his insurance company’s denial. As a radiologist interpreting X-rays, MRI’s, and other types of medical imagining, Dr. John is a specialist, with more than a decade of medical education and training. As a diagnostic radiologist, Dr. John needs acute vision and cognitive functioning skills to perform his duties. Radiologists work weekends, evenings, and irregular hours and… Read More

Death due to coronavirus exposure would almost certainly not be covered under an accidental death insurance policy. BUT – and here’s the tricky part – there CAN BE an exception depending on how and when the virus was contracted. The leading case reaches back to 1931 in Chase v. Business Men’s Assurance Co, 51 F.2d 34 (10th Cir. 1931). The case involved an accidental death claim brought by the insurer’s beneficiary. The insurer contracted typhoid fever as a result of drinking contaminated water. The court determined the plain language of the policy “does not cover death resulting from typhoid fever not caused or brought about by accidental bodily injuries, unless it was intended that the word ‘disease’ should not include… Read More