Disability Representation For Your Disability Claim


Call Us For Free Consultation Now


MassMutual Disability Claims Lawyer > MassMutual Disability Claims Lawyer

massmutual disability lawyerExpert MassMutual Disability Claims Attorneys

You bought your MassMutual disability insurance policy with the promise that MassMutual would be there for you and your family if you become disabled and unable to work. You thought you were buying financial peace of mind. If you were denied a disability claim with MassMutual, hire an experienced MassMutual Disability Claims Lawyer like Nancy Cavey to get the help you need.

A History of MassMutual

Massachusetts Mutual Life (MassMutual) is owned by MassMutual Financial Group. It was founded in 1851 and during the gold rush sold high premium insurance policies to railway and steamship workers and gold rush miners. As the country grew, so did MassMutual. It even had offices in San Francisco before the Transcontinental Railroad was completed in 1869.

MassMutual has, over the years, developed a diversified financial services company and offered a wide range of financial products, including pensions and other retirement products. They also invented the waiver of premiums in the case of disability.

Tremont Capital Management and Bernie Madoff

Tremont Capital Management was a feeder fund that invested in Bernie Madoff’s Ponzi schemes and ultimately lost 3. 3 billion dollars. It has paid a settlement of over 1 billion dollars to the receiver who is recovering money from the Ponzi scheme. It is one of the largest private disability insurance companies in the United States and offers what is called an individual disability or ID policy to doctors, dentists, and other professionals to protect not only their income but their lifestyle.

Common Disputes with MassMutual

Some of the many disputes that arise are the date of disability, claims for residual disability when the professional continues to work, the occupation the policyholder is performing when they became disabled, total disability and the coordination of the MassMutual policy with other ID policies or ERISA group disability policies the policyholder may own. That coordination is a key issue since many of my MassMutual clients have more than one disability policies with different carriers. It is like untangling Christmas tree lights before you plug them in.

I have written the go-to book for professionals called, “The Disability Insurance Claim Survival Guide for Professionals“.

You owe it to yourself and your family to get a copy of the book before you stop working and apply for benefits.   After all, you have spent hundreds of thousands of dollars in schooling and training and you need to know if you have adequately protected your career. While you may work regularly with insurance companies, you are not an expert on disability insurance. In fact, fewer than 200 lawyers in the United States are what I would call an expert and I am one of them.

What You Can Expect from MassMutual:

  • Use in-house nurses to review medical records and reach medical conclusions about the policy-holders restrictions and limitations even though those nurses may have no training in or qualifications to render any opinions about the policyholder’s medical conditions,
  • Use biased medical peer review providers to create medical justifications for a claim’s denial so Mass Mutual can claim that you are capable of performing the material and substantial duties of your occupation,
  • Use in house accountants to determine your pre-disability earnings and calculate your residual benefits, based on their analysis of your books, billings, and schedule,
  • Use surveillance companies to discredit the policyholder’s complaints,
  • Use any excuse to schedule a personal visit to your home to show you “Dancing with the Stars” video they have and give you the “we got you now” award that will result in the termination of a claim.
  • Use in-house vocational evaluators to misclassify your occupation and your ability to perform your occupation, perform questionable transferrable skills analysis and misinterpret the wages of and availability of other occupations it will claim the policyholder can do to justify the denial or termination of benefits.

MassMutual is also known to make endless and multiple requests for medical, financial, and vocational information before it figures out a way to deny benefits. This delay and denial strategy drains the policy holder’s bank accounts as they try to stay financially afloat. Your claim is a very expensive claim and will cost them big bucks. MassMutual has nothing to lose! You need an experienced lawyer, like myself, who battles MassMutual daily.

What You Can Expect from MassMutual Disability Claims Attorney, Nancy Cavey:

  • A thorough review of your policies,
  • A thorough review of your medical records,
  • The creation of a pre-claim strategy to obtain your benefits on the first application,
  • An appeal in response to a wrongful denial or termination by drafting an appeal letter 25 to 60 pages long that is the trial of your case and goes to Mass Mutual inbox,
  • A dedication to protecting you from Mass Mutual’s aggressive claims handling process, including the delay game, we need more information game, we want to take your statement game or we want to have you under an independent medical examination or FCE,
  • Aggressively litigating your case, if need be.

Don’t let MassMutual make you a victim like Bernie Madoff’s former clients.

MassMutual plays games with initial applications and makes endless and multiple requests for medical, financial, and vocational information before it figures out a way to deny benefits. This delay and denial strategy drains the policy holder’s bank accounts as they try to stay financially afloat. It is their business model.

MassMutual uses “liar for hire” doctors who give them the ammunition it needs to justify a claim’s denial or termination. MassMutual rarely tells a denied policyholder the real reasons the claim was denied. Worse yet, MassMutual hopes you just give up getting the disability benefits you deserve!

Don’t think that MassMutual doesn’t play the claims delay, denial, or termination game with individual disability policies. They are and the policy benefits at stake are often much high so there is much more to lose if you aren’t represented by a MassMutual individual disability attorney like me. Worse yet, MassMutual fails to fully explain what you need to submit to successfully win an appeal.

That’s why it is crucial that you be represented at both the initial application and appeal stages of a MassMutual claim by an experienced disability lawyer who battles MassMutual on a daily basis.

Don’t Face MassMutual Alone

Once the appeals process is exhausted (and that really means you are exhausted by the endless requests for information and battling with MassMutual), the only recourse is to file a lawsuit. If you purchased your insurance through your employer, the policy is most likely governed by ERISA (Employee Retirement Income Security Act).

Given its name, the ERISA statute and regulations are ironically NOT policyholder friendly.  You CANNOT add anything to the claims file after the last denial so all the Federal judge gets to see is what is in MassMutual’s file which is stuffed with medical and vocational opinions that are favorable to MassMutual. If you didn’t know enough to get the claims file when you appealed, didn’t know enough to add medical, vocational, or lay evidence to the file, or didn’t make the right arguments, you have all but destroyed your case.

An appeal of a denied MassMutual claim is the trial of your case. Taking on a tough insurance company like MassMutual is an endeavor for a specialist. A federal judge will give MassMutual the benefit of the doubt because MassMutual policy requires you to prove they are wrong and not the other way around. You owe it to yourself and your family to have an experienced disability attorney, like me, take on MassMutual. After all, this is about getting the disability benefits you deserve and you paid for.

Some policyholders have bought their own disability policy through an agent and that is known as an individual disability insurance policy. The game is the same but the playing field is more level because any claims denial can be challenged in state court which is a friendlier place to be if you have to sue MassMutual. Don’t think that MassMutual isn’t playing the claims delay, denial, or termination game with individual disability policies. They are, and the policy benefits at stake are high. There is much more to lose if you aren’t represented by a MassMutual individual disability attorney like me.

MassMutual Offers Three Types of Disability Policies:

The kind of policy that you have will tell you what your rights are and determine if you are being treated fairly.

1) Group ERISA Disability Insurance

MassMutual offers disability policies through employers governed by ERISA. A MassMutual ERISA policy generally has the following:

  • very strict definitions of occupation and disability,
  • limitations on how long payment will be made for mental conditions or subjective conditions like  headaches, pain, fibromyalgia or chronic fatigue,
  • “other income” provisions that allow for a dollar for dollar reduction for the receipt of Social Security disability benefits, workers’ compensation benefits, and personal injury settlements, and
  • A “golden handcuff” on a judge that only allows for a claims denial or termination reversal if MassMutual’s decision is “arbitrary and capricious.”

2) Group Non-ERISA Disability Insurance

However, a group plan offered by a church plan, such as the Catholic Church, or by a municipal employer like the City of Baltimore, Baltimore County, or the State of Maryland is NOT generally covered by ERISA. The policy terms are much like those of an ERISA plan but there is one CRUCIAL difference. A claim’s denial or termination can be challenged in state court and new evidence can be submitted at trial.

State law courts are a much friendlier place for a policyholder than Federal court. You are entitled to a jury trial in a state law claim and not some Federal judge just making a decision based on MassMutual’s file stuffed full of things that are unfavorable for you!

3) Individual Disability (ID) Insurance

Without a doubt, the best and most expensive policy is a private individual disability policy known as an ID policy. The policy terms and coverage are broader and more generous. But that means a high monthly premium and a lot of financial exposure that MassMutual has if you become disabled.

It isn’t uncommon for MassMutual to invoke a pre-existing exclusion or a medical condition policy rider right out of the box as a way to justify a denial of the claim from the beginning of the claim. That is just one reason why it is so important for a policyholder to contact me BEFORE they stop working and apply for benefits.

You can bet that MassMutual will be looking for a way to say that you are disabled as a result of carpal tunnel syndrome and not a herniated cervical disc. Do you know what your medical records say about your medical history, your carpal tunnel complaints, how your complaints are different because of the herniated cervical disc, or how they impact on your practice is different than your carpal tunnel symptoms?

MassMutual fights an individual disability claim as hard, if not harder than an ERISA claim and costly mistakes can be made at the initial application and appeal stages of a case.

How to File a Disability Claim with MassMutual

Are you preparing to file a disability claim with MassMutual? Make sure you know your rights and obligations. Under the terms of your disability insurance policy, you have a duty to notify MassMutual of your claim in a prompt manner. Please make sure that the company is aware that you are preparing to file for disability benefits. 

To initiate a claim with MassMutual, you should obtain the claim packet. Generally, the best way to do this is by calling MassMutual directly to get the proper forms. If you have an employer-sponsored disability plan, a representative at your company may be able to offer additional guidance. 

Once you have the application packet, be sure that the disability claims forms are completed properly. You must include all necessary supporting documents and records with your claim. As you may already know, medical evidence is key in disability claims. 

MassMutual states that it accepts disability claims forms by mail, fax, or electronically. If you have any specific questions about filing a claim, you should not hesitate to contact an experienced disability attorney. A lawyer can help you put together the initial application packet. 

How Much is MassMutual Disability?

Disability income insurance through MassMutual is designed to provide financial support and protection to people who are no longer able to work due to a medical condition. How much will be paid out in benefits depends on the specific terms of your policy. You will want to make sure that you have enough disability coverage to account for your necessary living expenses. 

As a general rule, MassMutual disability insurance covers between 45 percent and 65 percent of the policyholder’s gross weekly income. Your policy likely carries a maximum weekly benefit. Most MassMutual short-term disability policies provide between 60 days and 120 days of benefits. Long term disability policies typically provide 2, 5, or 10 years of benefits. 

Why Should I Hire A MassMutual Disability Claims Lawyer?

You may run into problems trying to get disability benefits from MassMutual. Sadly, the insurer, like other large corporations, is focused on its own bottom line. If your claim was denied by the insurance company, you should take immediate action to protect your interests. Remember, you can appeal an adverse decision. MassMutual does not get to make the final decision on your claim. A lawyer can help. Among other things, our MassMutual disability attorney is prepared to: 

  • Conduct a free, in-depth evaluation of your MassMutual claim;
  • Investigate your disability case—gathering all evidence and information; 
  • Represent you before MassMutual, including in settlement negotiations; and
  • Take whatever legal action is necessary to protect your rights and get your claim paid. 

Each disability appeal is different. There is no one approach to take to get disability benefits paid. The individual facts of the case always matter. It is imperative that you work with a MassMutual disability claims attorney who will put in the time and resources to understand your case and get you the best possible outcome. 

Contact Our MassMutual Disability Claims Lawyer Today

MassMutual Financial Group has created a disability insurance guide for individuals and families entitled “Disabled? Me? Never!” MassMutual Financial group knows that if you couldn’t work, you are and your family would have difficulty in meeting its financial obligations including paying your mortgage, car payment, utilities, education, and living expenses. They provide a worksheet to help you determine whether or not you have the appropriate disability coverage you need and we applaud MassMutual for their efforts to help educate you regarding your needs. You can find this worksheet here.

Unfortunately, the claims process for MassMutual Financial groups is an education of a different sort. As they point out, “life is full of challenges.” Unfortunately, MassMutual disability claims handling only adds to “life’s challenges.”

If you are a MassMutual Financial Group disability insurance policyholder and are thinking about filing a claim for disability benefits or your claim has been delayed, denied, disputed, or even terminated, MassMutual Financial Group disability attorney, Nancy Cavey, can help. Contact us today for a consultation.