People submitting long-term disability claims for fibromyalgia are frequently denied benefits and those who have taken their claims to court have found that judges often side with insurers. Why is fibromyalgia so frequently viewed as a non-disabling condition? Niemuth...
ERISA
Right-to-know prevents insurer from bringing new evidence to court
We recently wrote about a case where, through exceptional determination, an ERISA claimant was able to challenge a denial of benefits and win a chance at another appeal after the insurance company attempted to amend their denial of benefits in court with previously...
A lesson in persistence when challenging ERISA claim denials
Resolute determination resulted in a recent court victory in an ERISA denial case. In Collier v. Lincoln Life Assurance Co. of Bos., the plaintiff's attorneys overcame denials from both plan administrators and a district court judge to revive their client's claim for...
‘Own occupation’ vs. ‘any occupation’ in long-term disability
Two recent cases - Bedwell v. Schlumberger Grp. Welfare Benefits Plan and Logan v. The Prudential Ins. Co. of Am. - have highlighted the small but pivotal distinction between one’s ability to perform duties in their “own occupation” versus “any occupation” regarding...
Can your insurance company watch you for claim denial evidence?
A common scene in TV shows and movies is a couple of guys sitting in a van down the street from an unsuspecting person’s home, conducting surveillance. Usually it’s law enforcement, but sometimes it’s a private company. Does this happen in real life? Absolutely....
A doctor’s poor notes resulted in the loss of disability benefits
An insurance company’s decision to end a patient’s long-term disability benefits was upheld in a recent ruling due to his doctor’s poor post-appointment report. The case is a prime example of how something as simple as quickly dashed-off notes can be weaponized by...
Claimants must meet filing deadlines for ERISA disability
Employees in New Jersey who are covered by employer-sponsored disability insurance plans must exercise their rights within the deadlines outlined in the Employee Retirement Income Security Act of 1974 (ERISA). This act establishes your rights to access benefits and...
What to do when your insurer refuses to pay
Insurance companies in New Jersey are not always as willing to provide coverage as you may feel they've led you to believe. Your claim might be a minor incident or a significant medical situation requiring extensive care. No matter the type of claim, it's never a...
Mistakes to avoid during an ERISA claim
If you have been diagnosed with a serious illness or have an injury which prevents you from doing your job, you may be able to apply for long-term disability insurance benefits under either an individual disability income insurance policy you may have purchased...
Why people benefit from hiring lawyers for their ERISA claims
Private long-term disability insurance claims, either individual or group claims, are only available to a tiny percentage of people who actually have disability insurance coverage. Yet insuring your ability to continue to earn a living in relative terms can be more...