Entries by J.J. Conway

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ERISA LONG-TERM DISABILITY BASICS: THE CONTINUING PROOF OF LOSS

For those who have successfully fought to have a disability claim approved, they want it to stay that way. When the letter arrives from an insurance company seeking an update in status, most claimants begin to worry – and rightly so. As the Western District of Michigan federal court wisely observed fifteen years ago: The […]

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ERISA Long-Term Disability Basics: The Role of the Treating Physician

“My doctor will support me.” This is one of the most common expressions heard from clients dealing with an ERISA long-term disability insurance claim. Disability claimants know, perhaps without formal recognition, that their disability insurance claim requires a solid evidentiary foundation. Most claimants realize they carry the burden to prove their claim and recognize that […]

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Finally, Some Clarification Regarding What Is Meant By “Clarifying a Right to Future ERISA Benefits”

It is one of the most commonly asked questions by disability claimants who have successfully battled their disability insurance companies to overturn a denied or terminated disability claim. They have won, but there is one lingering question: Can my insurance company cut me off again? Technically, the answer is “yes.” Most disability law practitioners have […]

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ERISA Long-Term Disability Basics: Social Media and Disability Claims – Revisiting “An Online ‘Friend’ You May Not ‘Like'”

Stay off social media if you have a long-term disability claim. We have written about this issue before. See, Long-Term Disability Insurance Update: An Online ‘Friend’ You May Not ‘Like.’ Perhaps one of the most overlooked features about ERISA disability claims is the fact that, since most jurisdictions generally restrict the ability of parties to […]

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ERISA Long-Term Disability Basics: The Number One Mistake Disability Claimants Make

What is the single greatest mistake long term disability claimants make? Preparing their own internal disability appeal. It is that simple. A case worth hundreds of thousands of dollars can be converted to zero – near instantly – when a disability insurance claimant attempts to prepare his or her own administrative appeal.  There are several […]

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The Trend of ERISA Class Actions Against Universities Picks Up Strength as Cornell Workers Class Is Certified

On January 22nd, 2019, a federal district judge certified a class of at least 28,000 participants and beneficiaries of the Cornell University Retirement Plan, consisting of the Employees of the Endowed Colleges at Ithaca Plan and the Cornell University Tax Deferred Annuity Plan, in Cunningham et al. v. Cornell University et al., No. 1:16-cv-06525 (S.D.N.Y., […]

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Federal Court Details Reliance Standard’s Long History Of Abuse In The Handling Of ERISA Long Term Disability Claims

A federal district judge in Mississippi undertook the painstaking steps of collecting and documenting Reliance Standard’s long history of abusive claims practices in disability claims.   The expansive decision of Nichols v. Reliance Standard Life Ins. Co., No. 3:17-CV-42-CWR-FKB, 2018 WL 3213618 (S.D. Miss., June 29, 2018), contains hundreds of citations of cases where reviewing courts […]

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Sixth Circuit Kills ERISA LTD Claim for Failing to File a Benefits Application

The typical scenario in a benefits claim works something like this:  An employee becomes ill or injured.  An employee takes a medical leave of absence.  If the employer has sponsored a disability program, a claim for benefits is filed.  If there is a short-term disability plan, that benefit program may or may not be ERISA-qualified.  […]

Idaho Federal Court Rules That Medical Provider’s Appeal On Patient’s Behalf Can Serve To Exhaust Administrative Remedies Under ERISA

The United States District Court for the District of Idaho has ruled that a medical provider, acting pursuant to a pretreatment authorization and assignment of rights, may appeal an adverse benefit determination on the patient’s behalf for purposes of exhaustion under ERISA.   In Abdilnour v. Blue Cross of Idaho Health Service Inc., Case No. 17-00412 […]