ERISA disputes are perhaps the worst-timed legal challenges a person can encounter. People with incapacitating illnesses or injuries, often involving a cognitive impairment, must become proficient in legal jargon and the convoluted world of long-term insurance...
ERISA
Long COVID highlights the ongoing flaws of disability programs
Congress recently voted to end the COVID public health emergency that has been in place for the past three years. While it may seem as if day-to-day life has essentially returned to normal, hundreds of Americans continue to die of COVID complications each week, and...
Be careful what you sign during an ongoing ERISA appeal
In theory, we should never sign anything without reading and understanding its contents. In practice, we are presented with sprawling documents and agreements stuffed with legal jargon that can baffle the best of us on at least a weekly basis. Our instinct is to sign...
Old ERISA benefits cancellation tricks never die
Though the judgment against the insurer was swift, a recent ERISA case is a timely reminder that sometimes insurers will resort to the benefits cancellation equivalent of throwing pasta at a wall, hoping something will stick. In Caudill v. The Hartford Life &...
The distinction between ‘illness and ‘injury’ in ERISA claims
A recent successful appeal highlighted how the sometimes everyday interchangeability of the words “illness” and “injury” can mean the difference between temporary and lifetime ERISA benefits. The thrill of temporary victory In Stein v. Paul Revere Life Ins. Co., the...
Recent ‘own occupation’ vs. ‘any occupation’ cases
Two recent “own occupation” versus “any occupation” judgments, in addition to cases from late last year, while not resounding successes, seem to indicate a trend of the courts favoring claimants over insurers. An insurer’s conflicting determinations In Robinson v....
New ruling nullifies historic ERISA mental health protections
The seismic 2019 ruling in Wit v. United Behavioral Health (UBH), which compelled UBH to reprocess more than 50,000 denied claims for psychiatric conditions due to noncompliance with generally accepted standards of care and treatment, has been undone by a new opinion...
A new report reveals tactics the NFL uses to not pay injured players
An almost unbelievable pattern of deception and misrepresentation has defined the NFL's approach to compensating disabled former players. And players argue that their union has been in on the plot. A familiar ERISA story The Washington Post has published an exhaustive...
Fibromyalgia remains an ERISA long-term disability minefield
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...
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...