Group disability insurance policies often come under the umbrella of the federal Employee Retirement Income Security Act (ERISA), which establishes a separate regulatory scheme for such benefits plans. Policyholders in ERISA-governed disability plans are subject to a number of unique limitations and entitlements that can seem confusing to those who do not have prior experience handling claims and disputes in the group insurance context. ERISA-Governed Plans and the Administrative Exhaustion Principle If your plan is governed by ERISA — in other words, if your disability insurance plan is employer-sponsored and your employer is neither a public entity nor a qualified […]
In the short-term disability insurance context, it’s rather common for disability claimants to feel as though their insurer is mishandling their claim — and this belief is certainly not formed without good reason. Insurers are fundamentally incentivized to deny, delay, and otherwise mishandle short-term disability claims so that they don’t have to payout the benefits that you are rightfully owed. Short-term disability claimants, generally speaking, are less likely to push forward and attempt to secure benefits when the insurer has denied a claim, as the claimant is likely attempting to recover as soon as possible from their condition and return […]
Whether you are suffering from a mental health condition that has rendered you incapable of performing the duties of your occupation (or, perhaps, that has even prevented you from securing gainful alternative employment in another occupation), or are suffering from a disabling physical condition that also has had a significant impact on your overall mental health, there’s a good chance that you’ll be faced with some conflict when engaging your disability insurance carrier. Long-term disability insurers are often incentivized to redefine your disabling condition as a mental health problem so as to minimize their liabilities — some insurance policies include […]
In the private disability insurance context, disability benefits (and the definitions necessary for qualification) can vary quite substantially from policy-to-policy. Whether the definition of disability is broad or narrow is itself typically an indication of the “premium” nature of the plan. If you have purchased expensive disability insurance coverage, then chances are that it includes a looser definition of disability so that it is easier to qualify for such benefits. Variable Definitions From Plan-to-Plan Generally speaking, there are two definition categories of “disability” for private disability insurance policies: 1) own-occupation, and 2) any-occupation. Own-occupation policies have a narrower definition of […]
If you are suffering from an injury, illness, or other condition that has rendered you incapable of performing the duties of your occupation — even if only partially — then you may be entitled to significant benefits under your private disability insurance policy. Depending on the particularities of your insurance plan, residual or partial benefits may be available. Let’s take a look at how residual benefits work. Recovering Benefits Without a Total Disability Some disability insurance policies include a partial (residual) disability benefits rider, which allows for the recovery of a percentage of your total benefits amount, depending on the […]
The Chicago Law Bulletin Publishing Company selected Jennifer Danish as one of the 40 Under Forty Attorneys to Watch out of more than 1,500 nominations for attorneys throughout Illinois. Lawyers nominating her cite her hard work and: “What distinguishes Jennifer is her passion and genuine desire to help our clients through the difficult maze of federal and private disability claims.” Digital copy of the publication is available: http://digital.olivesoftware.com/Olive/ODN/LBSpecialSections/
If you are suffering from a disability and have had your benefits claim denied by your private disability insurer, then you may be entitled to bring an action against your insurer — whether your insurance coverage was purchased individually or provided as part of an employer-sponsored plan. Insurers are often quite aggressive in denying private disability benefits. In many cases, the insurer understands that if they deny a “difficult” or “ambiguous” benefits claim for which they can provide a reasonable justification, a number of claimants will simply refrain from any further attempts to secure their rightful benefits. This strategy saves […]
United States Magistrate Judge David E. Jones of the Eastern District of Wisconsin issued a Decision and Order on September 26, 2018 awarding disability benefits. Attorney of record for Plaintiff is Jennifer Danish. EDWARD PIOTROWSKI, Plaintiff, v. NANCY A. BERRYHILL, Deputy Comm’r of Operations, Soc. Sec. Admin., Defendant., 17-CV-1286, 2018 WL 4616457 (E.D. Wis. Sept. 26, 2018).
United States District Judge Sara Darrow of the Central District of Illinois, Urbana Division, issued an Order on September 21, 2018 granting Plaintiff’s Motion for Summary Judgment in so far as it sought a remand. Campbell v. Berryhill, No. 2:17-cv-02036-SLD-EIL (C.D. Ill. Sept. 21, 2018).
Insured Succeeds Against MetLife Even Under Arbitrary and Capricious Standard of Review in the Seventh CircuitOct 3, 2018 | Blog | Share
By: Stephen A. Jackson Hennen v. Metro. Life Ins. Co., 17-3080, 2018 WL 4376994 (7th Cir. Sept. 14, 2018). Hennen worked as a sales specialist for NCR when she sought treatment for a back injury. She was covered under her employer’s long-term disability plan insured by MetLife. When physical therapy and surgery failed to resolve her injury Hennen applied for LTD benefits under the plan. Acting as the administrator, MetLife agreed Hennen was disabled and paid benefits for two years. However, the plan had a two-year limit for neuromusculoskeletal disorders subject to several exceptions, one applies to radiculopathy. Hennen argued […]