Disability Insurance and ERISA Articles

Avoid a Claim Killer – Retain An ERISA Disability Attorney Before You Appeal a Claim Denial

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The most common and fatal mistake people make in their ERISA disability claim is not consulting with and retaining, an experienced ERISA attorney soon after their claim is denied.  People make this mistake for various reasons including the insurance company not informing you to retain an attorney and your not knowing you can and should retain an attorney at that time.  Others may believe their insurance company made a mistake which can be easily fixed with their only appeal.  Finally, some people believe they are “saving money” by not retaining a lawyer.

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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

Beware of Working Part Time In The Months Before Filing a Disability Claim

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By Scott E. Davis, Disability Attorney

For many people who are struggling to work due to an acute unexpected medical condition, they do not have the opportunity to prepare or plan for filing a short and or long term disability claim.  My experience is that most people who eventually file disability claims, have chronic medical conditions which have been ongoing for months and even years. Continue reading

Beware Of And Avoid This Disability Policy Trap!

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By Scott E. Davis, Disability Attorney

The title of this article could also be named, “how to avoid the psychological benefit limitation” that is likely lurking in your company’s disability policy.

When people are unable to work and their short and/or long term disability claim is approved, whenever it can, the disability insurance company often uses a psychological diagnosis as the basis for paying the claim regardless of any physical diagnoses which you may believe are disabling.  Indeed, even if you filed your disability claim based on a physical diagnosis, if you also have much smaller psychological issues such as depression or anxiety as a result of your inability to work, the insurance company can say that it is approving your claim based on the psychological diagnosis. Continue reading

What Is ERISA? Why Is It So Bad?

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By Scott E. Davis, Disability Attorney

ERISA is the acronym for the Employee Retirement Income Security Act of 1974.  ERISA is a very broad, far reaching and complex federal law that governs every American employee’s benefits at their workplace.

Since it is federal law, ERISA supersedes and replaces state law, even though your state law may provide you with more consumer protections than ERISA does.  Over the course of the last four decades, a law that was initially meant to provide protections to American workers has become employer and insurance company friendly while providing few obvious protections for American workers.  While ERISA does charge your insurance company or employer with a fiduciary duty to administer your employee benefits in a full and fair manner, the reality is, this does not occur. Continue reading

Is Your Insurance Company Allowed to Disregard Your Doctor’s Statement That You Are Disabled?

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By Scott E. Davis, Disability Attorney

Many people, as well as their medical professionals, mistakenly believe that when they file a claim for short and/or long-term disability benefits, their disability insurance company has to accept their medical professional’s (doctor’s) statement that they are disabled.  Common sense suggests this is a reasonable assumption – but it couldn’t be further from the truth.  Why? Because so many insurance companies simply do not want to pay people’s disability claims and when armed with discretionary language in the policy as they frequently are – the insurance company has the final and only say on whether you are disabled, not your doctor.

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Why Do Insurance Companies Say You Are Disabled Due to a Psychological Disorder?

 

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By Scott E. Davis, Disability Attorney

When people are unable to work and their short and/or long term disability claim is approved, the disability insurance company often uses a psychological diagnosis regardless of a physical diagnosis. This if often true even though you may have primarily physical diagnoses and have filed your claim on that basis. So, why would an insurance company do this? Continue reading

Why Does Your Insurance Company Often Terminate Benefits When the Definition of Disability Changes ?

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By Scott E. Davis, Disability Attorney

A dirty little secret in ERISA disability claims is that benefits are frequently terminated when the definition of disability in the policy changes.

We receive phone calls every week from confused individuals who tell us their benefits were terminated after several years of the insurance company paying the claim.  Individuals who are receiving disability benefits are often never aware that at some point (i.e. usually after 24 months and sometimes 12 months) in the overwhelming majority of ERISA disability policies, the reason for the termination of benefits is because the definition of disability changes to one that is much more difficult to meet. Continue reading