Get out your long term disability policy and look for something called the “Discretionary Clause”. It’s a clause that lets the long term disability carrier make the decision and requires that the court defer to its decision. It’s what I call a “get out of jail free card.” Fortunately, there are some states that prohibit […]

You bought your long term disability policy to provide you and your family peace of mind if you were unable to work. You’ve even made the difficult decision to apply for disability benefits knowing that your physician and employer have supported your claim. Yet, you’ve gotten a denial from the long term disability carrier. No

The Employer Retirement Income Security Act of 1974 governs employee welfare benefit plans, including disability insurance plans. ERISA is not a plaintiff friendly statute and, fortunately, there are plans that are not governed by ERISA. These include plans by: • Churches; • Government; • Entities; • Plans maintained for the purposes of complying with Workers’

Your employer should be able to provide you with a copy of the summary plan of description (SPD) which provides you with a description of the benefits that you may be entitled to as a result of disability, the definition of disability and how to make a claim for benefits. You can also request relevant

What you need to know about the claim forms ERISA is shorthand for the Employer Retirement Income Security Act of 1994. It’s Federal legislation that governs how insurance companies handle disability claims and it gives disability carriers a “get out of jail free card.” In most ERISA governed claims, a court can only overturn the

Long term disability carriers play hardball on claims and one of the ways they play hardball is to have you undergo a functional capacity evaluation. Why? If the long term disability carrier can show that you’re capable of engaging at least sedentary work, they will have legitimate grounds to deny your claim for disability benefits,

If you purchased your disability policy through your employer the policy is most likely governed by the ERISA statute. The Employer Retirement Income Security Action (ERISA) of 1994 is Federal legislation that has given a “get of jail free card” to disability insurance companies. In most ERISA governed claims, courts will only overturn the insurance

The long term disability carrier will send your doctor a physician disability form to complete which asks questions about your physical restrictions and limitations. Unfortunately, there is no routine form and many of the forms are designed so that your physician will ultimately opine that you’re capable of sedentary work. Why? The long term disability

You purchased a long term disability policy to provide you with peace of mind. But, when you least can afford it, your disability carrier has denied your benefits and has rejected your appeal. Your next and only recourse is to higher a long term disability attorney to sue your long term disability carrier. Your attorney