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How Disability Carriers Like United of Omaha Use Pre-Existing Condition Clauses To Wrongfully Deny Disability Applicants Their Benefits

United of Omaha Use Pre-Existing Condition Clauses Disability Claims

Christian Hornland hurt his back in a slip and fall accident that fractured his thoracic spine. He had pain management treatment and rehabilitation that allowed him to work. He subsequently became employed as a real estate manager for Thortons and was offered and accepted a long term disability policy through United of Omaha. A few months after he became a real estate agent, Hornland began experiencing back pain and spasms because his job required him to stand 15-20 hours per week. Several months later, he experienced an onset of sharp stabbing pain in his mid-back. He returned to his doctor and got...

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Why Do Insurance Companies Deny Short Term Disability Benefits or Cut Off Benefits During The Short Term Disability Period?

Short Term Disability Period Denial Insurance Company

Unfortunately, it's not uncommon for disability insurance carriers to deny a short term disability claim, or cut off a policy holder during a short term disability period. Why? Most of these policy holders also have long term disability insurance and that creates a significant exposure to the long term disability insurance carrier. The disability carrier is hoping that you get discouraged and don't file an appeal and/or fail to even apply for your long term disability benefits. Why Do Disability Insurance Carriers Deny Short Term Disability Claims I believe that disability insurance companies set up short term disability denials to make it...

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Substance Abuse Limitations and United of Omaha Disability Insurance

Substance Abuse United of Omaha Disability Insurance

Many disability policies will have a 24-month payment limitations for disabilities due to “substance abuse” and it is not uncommon for disability carriers to argue that, notwithstanding physical problems, a policyholder is really disabled because of drug use. In the case of Blount v. United of Omaha Life Ins. Co., No. 16-3672,-F.App’x, 2007 W.L. 2829102 (6th Circuit, June 30, 2017), Ms. Blount, a former hospital controller began receiving long term disability benefits after leaving work in March of 2008. She was paid benefits for seven years as a result of undifferentiated connective tissue disorder. She also suffered from depression and anxiety...

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Long Term Disability Policyholder With Growth Hormone Deficiency Is Entitled To Disability Benefits

Growth Hormone Deficiency Disability Benefits

Disability policyholder Tracy Morgan filed a claim with Hartford for long term disability benefits claiming she was disabled as of April 8, 2015, on the basis that she was suffering from chronic fatigue from infectious mononucleosis or a “flare-up of Epstein-Barr Virus”. Ultimately, serological studies showed a former infection with no current illness despite Morgan’s continued symptoms of fatigue and inability to concentrate. As a result, she was referred an endocrine evaluation and while that evaluation was being completed, Morgan was restricted to working 4 hours per day. She continued to suffer from chronic fatigue and nausea and ultimately an...

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Reliance’s Structural Conflict of Interest Results In Reversal of District Court Order

Reliance Short Term Disability Claims

It’s not uncommon for disability insurance companies, like Reliance, to be responsible for both paying benefits and administrator during the claims process. That’s a conflict! Disability carriers routinely have provisions in the policy that provides them with the discretion to interpret the terms of the policy and make a determination of entitlement to benefits. To overcome that denial, the policy holder has to show an abuse of discretion. The Abuse of Discretion Standard While the fact that disability insurance companies, like Reliance, are responsible for paying benefits and administering the claims process, it won’t alter the standard of review. However, depending on what...

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What Reliance Standard Should Have Done When A Policyholder Couldn’t Attend An In-Person Medical Examination

Reliance Standard IME Claim Denied

It’s not uncommon for the disability insurance companies like Reliance Standard, to schedule an independent medical evaluation. In the case of Mason v. Reliance Standard Life Insurance Company, 14-CV-01415-MSK-NYW, 2015 WL 5719648 (D. Colo. Sept. 30, 2015), the Colorado court found that Reliance’s denial of benefits was arbitrary and capricious. Reliance had scheduled an independent medical evaluation of Mr. Mason and he was unable to attend as he was in the hospital on the scheduled date. Instead of rescheduling, Reliance Standard hired a peer review doctor to conduct a medical review of Mr. Mason’s medical records. Of course, the peer review physician rendered an...

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Hartford Loses Long Term Disability Fibromyalgia Claim

fibromyalgia disability claims attorney Tampa

Disability Carriers don’t like fibromyalgia disability claims and often deny a fibromyalgia claim because of a “lack of objective medical evidence.” So What Happened In Teri Haning’s Claim For Disability Benefits Ms. Haning was treated for over twenty years for fibromyalgia and depression. Yet, Hartford rejected the opinions of her treating physicians and denied her claim. She filed a lawsuit. The Court found that Hartford’s exclusive reliance on a series of file reviewers or paid consultants showed that the benefits termination was arbitrary and capricious. The Court commented “Hartford relied on an overly crabbed view of what constitutes “objective medical evidence” and “documented...

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Prudential Disability Insurance Program Begins a Return to Work Service

One of the many disability carriers in the United States is Prudential Group Insurance which has created a Return to Work Service for employers to assist them with Short Term Disability claims. This program provides employers with assistance in developing a Return to Work Program for employees who are disabled. Disability insurance claim denied attorney Nancy Cavey applauds Prudential’s efforts to begin a Return to Work program to help those who are disabled return to work with assistance in helping employers and disabled employees to return to work in a modified capacity and transitional role. Do you have Prudential disability insurance ? Trying...

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METLIFE LONG-TERM DISABILITY CLAIMS FORMS

If you purchased long-term disability benefits and your doctor has told you that you are unable to work, you should file a long-term disability claim form. There is no uniform disability form, but carriers like MetLife will use an individual disability claim and statement, individual long-term disability assessment, attending physician forms and behavioral assessment as part of the disability claims process. If you have difficulty getting these forms from MetLife, or completing the same, you should contact MetLife denied long-term disability lawyer Nancy Cavey. Nancy is never surprised when MetLife denies a long-term disability claim because carriers like MetLife are always looking for...

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How to Respond to UNUM’s Demand for Your Social Security Disability File

If you are a long term disability policy holder with UNUM and have filed for disability benefits, you might be asked to sign a release of your Social Security file. UNUM routinely rejects claimants who get Social Security Disability benefits and it’s not uncommon to see in their denial letters language that says “after thoroughly giving you due consideration to the findings of the Social Security Administration, I, Dr. Paid to Say No, disagree with the Social Security findings. Social Security didn’t have the benefit of our UNUM peer review providers and they didn’t have the ability to review her activity...

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