08 April

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My Long-Term Disability Claim Has Been Denied Do I Have to Exhaust All Levels of Appeal Even If My Appeal Won’t Matter?

Long Term Disability Appeal Court Claims

You paid your premiums, filed your claim when you were no longer able to work, and waited for your check. But instead of a check, you got a letter denying your claim. A long-term disability claim denial can be devastating. Alternatively, your claim might have been accepted, but now you’ve gotten a letter from the disability carrier terminating your benefits. The denial or termination letter should explain the basis of the denial or termination, your rights, and your obligation to file an appeal of the denial or termination. Do I have to Exhaust All Levels of Appeal before Going to Court? The short answer...

30 March

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Must You File an Appeal of Your Denied Long-Term Disability Claim or Can You Just File a Lawsuit?

Posted by Nancy Cavey

in Appeals, Long Term Disability

File an Appeal of Your Denied Long-Term Disability Claim Lawsuit

The answer is “Yes,” you must file an appeal first before you file a lawsuit. Fighting your long-term disability carrier can be exhausting. Delay, endless requests for more information, not so “independent” a “medical evaluation,” surveillance and denial, are all designed to wear you out. You might be tempted to say “nuts” to that and just file a lawsuit in court. Unfortunately, that can destroy your case. What Are Your Obligations to File an Appeal of a Denied Long Term Disability Claim? Every disability policy or plan has a requirement that an appeal of a denied claim be filed before suing to get the...

14 January

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Nurse Anesthetist‘s Opioid Addiction and Long-Term Disability Insurance from United Heritage Life

Posted by Nancy Cavey

in Anesthetists, Long Term Disability, Occupations

Anesthetists Nurse ERISA Disability Insurance Claims

It is not uncommon for disability policy holders to develop opioid pain medication addiction after undergoing surgery. Opioid addiction can be even more problematic when the policy holder is a medical professional like a certified registered nurse anesthetist. The American Association of Nurse Anesthetists has a return to work program for recovering nurses to re-enter the work force which provides, in part, that nurses “may return to work in a ‘supervised setting’ following treatment for addiction” recognizing “more time away from the workplace may be needed to reduce risk of relapse.” The Guidelines recommend that a recovering nurse may practice under supervision. How Do...

09 September

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What You Need To Know About Aetna’s Application Of The “Any Occupation” Definition In Its Disability Policies

Posted by Nancy Cavey

in Aetna

Own Occupation Aetna Disability Policy Claims

Many disability carriers, such as Aetna, have a two-tiered definition of disability. For example, Aetna's policy provides that for the first 24 months, you're entitled to your benefits if you can't perform the material duties of your own occupation. However, after 24 months of disability, the monthly benefits are payable if you "are unable to work in any reasonable occupation solely because of an illness, injury or any pregnancy-related condition." The policy also defines "reasonable occupation" as "any gainful activity for which you are or may reasonably become fitted by education, training or experience and which results in or can be...

20 August

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New ERISA Regulations #7: Carriers Can No Longer Play The “Delay Game”

Posted by Nancy Cavey

in ERISA

https://youtu.be/Lvukhk760jo...

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