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Avoid This Huge Mistake by Consulting A Disability Lawyer Early

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By Scott E. Davis, Disability Attorney

The biggest frustration I have as a disability insurance lawyer is being contacted by an individual who needs help in an ERISA disability claim and has a good case- but it may be too late.  ERISA is the acronym for the “Employee Retirement Income Security Act” which is a broad and complex federal law governing all employee benefits (To determine if your claim is governed by ERISA look at the last page or two of your denial letter and it will reference ERISA and your legal rights). Continue reading

“The Importance of Obtaining Neuropsychological Testing to Prove a Disability Claim”

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By Scott E. Davis, Disability Attorney

Case Study:  Carrier vs. Aetna Life Ins. Co., 2015 U.S. DIST. Lexis 97693

Gloria Carrier previously worked for Bank of America and through her employment, the bank provided disability benefits to its employees through a fully insured disability policy with Aetna Life Insurance Company.

After being diagnosed with cancer, Ms. Carrier underwent surgery and chemotherapy which eventually led to neuropathy (nerve damage) and she also became depressed.  As a result, Ms. Carrier took a leave of absence and submitted a claim for short term disability benefits which was granted, and after those benefits were exhausted, she began receiving long term disability benefits from Aetna.

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Case Study: When Is Your Appeal Actually Due?

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By Scott E. Davis, Disability Attorney

In the recent Ninth Circuit case of LeGras v. Aetna Life Ins. Co., 786 F.3d 1233 (9th Cir. 2015), the issue at hand was –  when is an ERISA disability appeal actually due when the 180 day deadline to appeal falls on a weekend or holiday?

After working 23 years as a loyal employee for Federal Express Corporation, Andre LeGras seriously injured himself and filed a claim for long term disability benefits.  Aetna Insurance (Federal Express’s Claim Administrator) initially denied the claim and informed LeGras that he could file an appeal within 180 days – but this was a Saturday.

After working 23 years as a loyal employee for Federal Express Corporation, Andre LeGras seriously injured himself and filed a claim for long term disability benefits.  Aetna Insurance (Federal Express’s Claim Administrator) initially denied the claim and informed LeGras that he could file an appeal within 180 days – but this was a Saturday.

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Affidavits: an important part to your case

Picture a thick stack of papers on the judge’s desk, they will have your medical history from the doctors you have seen during your illness, your work history, etc.

What about your personal history? What about what your illness has done to you emotionally? The toll it’s taken on your family life

An affidavit from a family member, friend or even former co-workers will give the judge a personal look into your illness and your life.

Affidavits are sometimes written by someone who you knew before and after or someone who helps you with your day to day living. When you attend your hearing, your loved ones generally do not testify before the judge so you need to get their perspective in front of the judge and an affidavit does this.

Your loved ones are important because they have seen the havoc your inability to work has caused in your life. By submitting a written affidavit, they will be able speak to the judge and state examples of how you were before your debilitating illness and how you are today. They can attest to how your life has changed.

Quite often these are very hard for your loved ones to write, as well as for you to read – but they are often an important supplement to your medical records and case. If you have any questions or would like some samples, please contact our office.

Contacting your Congressperson to try to speed up your disability claim

Unfortunately, the process of getting disability benefits from Social Security can take a very long time. A question we are often asked is “Why are things taking so long? Why did I hire a disability lawyer in the first place?” An attorney is not able to pressure Social Security to expedite a claim. What an attorney can do is make sure that Social Security has everything they need to make a decision in a claim.

One option that is open to you is contacting your members of Congress. If you feel that your claim has taken too long and you are in dire need, try writing to them. While your Congressperson cannot overstep the SSA in stipulating an approval on your claim, a Congressperson has the authority to inquire your status from Social Security, which will place a flag on your file at the SSA office. While there is no guarantee this will expedite your claim, it’s worth a try. Be aware, though, it is not guaranteed that Social Security will speed up your claim, but they will be aware you have asked for a review by your representative.

Persistence ‘pays’ off

“Tick…tick…tick…tick…” I’m not sure if this is the sound of time slowly wasting away, or that internal bomb about to detonate if Social Security doesn’t soon realize the legitimacy of your claim and pay you the benefits you need and deserve, but whether you are the former or the latter of the two you are not alone. If you have ever filed a Social Security disability claim, you are already aware of this, but if you are just getting ready to file this information may be very useful. Continue reading

“Discretionary Language” is used by insurance companies to deny or terminate ERISA disability claims

What does it mean when an insurance company has written in “discretionary language” to a ERISA disability policy? Simply put, it means the insurance company gets to determine who is eligible for benefits and who is not. The discretionary language clause is often at the end of the insurance company’s disability policy or the summary of benefits you receive from your employer – it looks like another line of legal mumbo jumbo but in reality is the reason many people’s disability claims are denied.

If you get your disability benefits through your employer as most Americans do, your claim will almost certainly be subject to discretionary review. Armed with “discretion” to review your ERISA disability claim, the insurance company who already has a major conflict of interest in that it decides whether you are disabled and also has to pay the claim, is then able to retain its own doctors, aka “hired guns,” to review your claim who usually disagree with you and your doctors that you are disabled.

The insurance company then denies your claim using the “discretion” afforded to it in the ERISA policy after accepting its own doctors’ opinions and rejecting your statements and doctors’ opinions that you are disabled.

Many people are shocked to learn a disability insurance company can reject their treating doctor’s opinion – but these conflicted companies do it every day by hiding behind discretionary language they write in their disability policies.

Never trust that the insurance company has your best interests in mind – they are too conflicted to do so.

ERISA is a very complex area of the law so it is best to consult with an attorney who concentrates their practice on these types of cases. We recover millions of dollars in disability benefits for our clients every year and we represent more ERISA disability claimants in Arizona than any other law firm, call us for a free consultation regardless of where you are in the claim process (602) 482-4300 or in Las Vegas (702) 732-4410.

Does having an attorney determine whether you win or lose your Social Security Disability case?

Did you know you can increase your odds of winning your Social Security (SSA) Disability case by more than 50% if you are represented by an attorney? Simply put, that’s a dramatic difference and one that every Social Security disability applicant should heed.

Congressional and SSA’s own statistics confirm this statement is true. The statistic came to light in November 2001, during Congressional testimony provided by Congressman Robert T. Matsui of California. During the hearing Congressman Matsui provided the following testimony:

“Professional representation is a valuable-and indeed vital-service. The disability determination process is complex. Claimants without professional representation appear to be far less likely to receive the benefits to which they are entitled. For example, in 2000, 64% of claimants represented by an attorney, but only 40% of those without one, were awarded benefits at the hearing level.” [1]

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