29 August

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Disabled Teleworkers Dissed by ERISA Disability Carriers and Plans and the Three Ways to Challenge a Telecommuting Denial

The COVID 19 pandemic normalized telecommuting. That was helpful to many of my disabled ERISA disability policyholders because it either allowed them to hide their disability and work around their limitations while keeping their jobs or work at reduced hours within their restrictions and limitations. What was beneficial at the “own occupation” stage of a disability claim is backfiring at the “any occupation” stage of a disability claim. What is the Any Occupation Stage of A Disability Claim? Disability policies or plans will typically pay disability benefits for the first two years if you are unable to engage in the ”material and substantial duties...

06 February

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Does Discrimination and the Disenfranchisement of Women in the Health Care System Impact an ERISA Disability Insurance Claim?

Posted by Nancy Cavey

in ERISA

A recent study, “Women’s Experiences of Health-Related Communicative Disenfranchisement,” published in Health Communication, confirms that many women’s health concerns are often dismissed by physicians. According to the study, many women’s health concerns are met with disbelief that “discredits, silences and/or stereotypes one’s… experiences.” This is “medical gaslighting.” By “gaslighting,” I mean the tendency to treat someone’s complaints as if they were unimportant or just imaginary. It is a way of dismissing someone’s concerns as if they weren’t real. This dismissal, disbelief and being written off as just anxious or depressed, is all too common in my experience with women who have reproductive...

08 July

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The Ten Mistakes You Can Make That Can Destroy Your ERISA Disability Claim

Posted by Nancy Cavey

in ERISA

Short and long-term disability insurance claims are often made because of chronic heart problems. But if you have chronic heart issues and were thinking about leaving work and applying for disability benefits, there are some common problems you should be aware of before you do that. The case of Adams-Runion v. UNUM Life Ins. Co. of Am., 2022 WL 1050097 (E.D. Cal. Apr. 7, 2022) illustrates these problems. Adams-Runion was the Director of Laboratory Services at Doctors’ Hospital of Manteca, California, which required her to sit at least six hours per day. Her job was very stressful. She had undergone heart surgery in...

06 January

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First Circuit Clarifies What a “Full and Fair Review” Means to a Denied ERISA Disability Claim

Posted by Nancy Cavey

in ERISA

The Employee Retirement Income Security Act, which governs employer sponsored benefits like disability insurance, is not friendly to the very people it is designed to benefit – you! However, one of the saving graces in ERISA are the ERISA claim regulations which require that a denied policy holder or plan beneficiary be given a “full and fair review” during the claim review process. Let me tell you a typical story so you understand the games the disability plans or carriers play. Ms. Jette was a legal assistant who had back problems for which she underwent back surgery. Jette was paid short and...

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...

01 June

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ERISA Disability Carriers Must Meet ERISA Claims Denial Deadlines

Posted by Nancy Cavey

in ERISA

If you purchased your disability policy through your employer, that policy is most likely governed by the civil enforcement provisions of the Employer Retirement Income Security Act 1974 (ERISA), 29 USC §1132. In the case of Perry v. Metropolitan Life Ins. Co., No. 4:16-CV-135 (CDL), 2016 WL 4536441 (M.D. GA. August 30, 2016), Ms. Perry was employed by Synovus Financial Corporation where she was covered under a Long Term Disability policy issued by MetLife disability. MetLife paid her benefits and then denied her claim on the basis that she no longer met the standard of disability. Her policy required that she submit...

27 March

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What Every Disability Policy Holder Needs To Know About an ERISA Disability Plan

Posted by Nancy Cavey

in ERISA

[vc_row triangle_shape="no"][vc_column][vc_column_text]You may have purchased your disability policy through your employer and , if so, you need to understand the basics of an ERISA Plan. ERISA stands for the Employer Retirement Income Act. The ERISA statute was enacted in 1974 as a result of the Jimmy Hoffa pension scandals. ERISA was designed to provide and protect employee pensions and other employee benefits such as group health, disability and life insurance. An employer is not required to have any type of benefit plan. It’s a voluntary act by the employer or sponsor. A plan can be amended, changed or even terminated at any...

14 March

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You Don’t Want to Hire an Inexperienced Attorney to Represent you in Your ERISA Claim

Posted by Nancy Cavey

in ERISA

[vc_row triangle_shape="no"][vc_column][vc_column_text]Did you know that, for the most part, benefits that you receive from work are governed by a Federal Statute known as the Employee Retirement Income Security Act of 1974 of ERISA. Employee benefits, which could include life, health, retirement and disability benefits are governed by ERISA. Unfortunately, many garden variety lawyers don’t understand the difference between an ERISA claim and a State law breach of contract claim. There’s a misconception among the public and lawyers that when you receive health, life or disability benefits through an employer payroll deduction, you have a contract with the Insurance Company. If the...