Automatic Eligibility for Disability Benefits
In the private disability insurance context — in Illinois and elsewhere — insurers will often deny legitimate disability claims on the basis that the policyholder’s condition is not actually disabling in accordance with the language of the insurance plan. There are no absolute rules that apply to all disability insurance policies — the definition of …
Common Disputes in Short-Term Disability Insurance
Short-term disability insurance provides temporary wage replacement benefits in the event that you are suffering from a disabling condition, though the benefits apply for a very limited period of time — in most cases, short-term disability benefits are only paid out for six months to one year of proven disability. After sufficient time has passed …
Attorneys Fees Awarded to Defendant in ERISA Disability Benefit Claim
By: Jennifer Danish Courts infrequently award attorneys’ fees to defendants for having to defend themselves in ERISA disability benefit claims. Recently though, the Court, in James W. Hackney v. Allmed Healthcare Management, Inc., No. 3:15-CV-00075-GFVT, 2018 WL 1981902 (E.D. Ky. Apr. 27, 2018) ordered an unsuccessful plaintiff to pay the defendant attorneys’ fees and costs, …
Seventh Circuit: ALJ Impermissibly “Played Doctor” In Denying Fibromyalgia Disability Claim
David A. Bryant & Jennifer Danish On April 4, 2018, the Seventh Circuit Court of Appeals issued an opinion vacating the denial of a Supplemental Security Income disability claim brought by 47-year-old Rebecca Ann Akin, who suffered from fibromyalgia, back and neck pain, and headaches. Akin v. Berryhill, 887 F.3d 314 (7th Cir. 2018). On appeal, …
Jennifer Danish Appointed to ABA TIPS Health And Disability Insurance Law Committee
Roy Alan Cohen, The Tort Trial and Insurance Practice (TIPS) Section 2018-2019 Chair, appointed Jennifer Danish to serve as a Immediate Past Chair of the Health and Disability Insurance Law General Committee for 2018-2019 on April 25, 2018. Jennifer has served as the Chair of the Committee 2017-2018 and has accepted the appointment. Mr. Cohen also appointed Jennifer …
How Are Long-Term Disability Benefits Affected By Supplemental Income?
As a long-term disability (LTD) insurance policyholder, you may find yourself in a particularly vulnerable position. Despite the fact that you have been rendered disabled, your insurer may delay, undervalue, or deny your legitimate claim for long term disability benefits. Insurers are always on the lookout for opportunities to minimize their various liabilities. If you …
To Assert or Not To Assert Assignment in Out-Of-Network Payer/Provider Disputes
By: David A. Bryant Two recent federal district court cases highlight the importance of properly pleading (or not pleading) assignment of rights in an out-of-network provider’s state law complaint for payer reimbursement. In the Southern District of New York, plaintiff/provider filed suit in state court against Aetna, bringing various state law claims based upon the …
Do You Qualify for Private Disability Benefits?
Private disability insurance is common — whether obtained through an employer (i.e., a group disability insurance plan, or subsidized individual disability insurance) or independent of one’s employer — and is highly advantageous when compared to public disability options, such as Social Security Disability Income (SSDI). However, many policyholders are unaware of the nature and extent …
Physicians’ Guide to Disability Insurance
By: David A. Bryant Highly compensated professionals, physicians in particular, purchased private individual disability insurance en masse in the 1970s, 80s and 90s. Agents selling Individual Disability Insurance (IDI) policies flooded the market as insurance carriers competed for market share of disability premium, fueled by attractive commission rates. This previously untapped disability market, represented hundreds …
What Doctors DO NOT Know About Their Own Disability Insurance
If you enrolled in a Group Disability Plan you have bought fools’ gold: Only covers 60% at most 80% of your earnings Then reduce that 60-80% by any Social security benefits you might receive, benefits will terminate at 65 years old; Usually limits coverage for any “mental/nervous” claims; and Usually governed by ERISA which preempts …