Has your ERISA disability insurance claim been denied? The Law Office of Nancy L. Cavey is a nationwide ERISA disability insurance law firm that represents disability insurance policy holders in Kentucky who are disabled.
Attorney Cavey’s father became disabled as result of leukemia and, as a result, he had to stop working and apply for his USF&G long term disability benefits. She knows, first-hand, the financial and emotional consequences of dealing with a disability insurance company.
The Federal Disability Law Known as ERISA
In 1973, the U.S. Congress enacted a law that encouraged employers to provide its employees with pension, life insurance, health insurance and disability insurance benefits. This nationwide law is known as the Employee Retirement Income Security Act or ERISA.
If you work for a company like Humana, Toyota, UPS, Ford, GE, Lexmark or Ferrellgas, your short or long term disability insurance claim will most likely be governed by ERISA. Your case will fall under the jurisdiction of the federal court in Kentucky and the jurisdiction of the U.S. Federal Court of Appeal for the Sixth Circuit, located in Cincinnati, Ohio.
Since your claim is based on federal and not Kentucky state law, you don’t need an attorney located in Kentucky to help you file a claim, appeal a wrongful denial of your claim or file a law suit in Federal court.
ERISA is a complex area of the law. Most attorneys don’t understand the law and, often mistakenly, think of a disability insurance claim is just another Kentucky state law breach of contract case. That can spell disaster for you. That is just one of the many reasons you should be represented by an expert in ERISA.
ERISA has strict regulations and deadlines. The failure to follow the ERISA procedure can destroy your claim.
Has your Long Term Disability claim been denied in Kentucky?
If your claim has been denied, you must file an appeal within 180 days of the initial denial. Writing an appeal is like writing a Ph.D. thesis and it is the trial of your case. You can’t hold your evidence for your day in court! There is no day in court where you and your doctor can testify.
At Cavey Law, our appeals are 25 to 65 pages long and are chock full of medical and vocational evidence, statements of you and your doctor, a vocational report and even a functional capacity evaluation. We take on the disability insurance carrier’s denial step by step, fact by fact, and issue by issue.
What Happens if the Disability Insurance Carrier Upholds a Denial or Termination in Kentucky
Disability insurance carriers are not in the business of paying disability claims as they promised in their policy. If the disability carrier upholds the claims denial because they just don’t want to pay the disability benefits they owe, a denied ERISA disability policy holder has just two choices:
Give up or
File a law suit in federal court in Kentucky.
Federal court is a scary place! Most lawyers, even if they understand ERISA, just don’t want to be in federal court, where the big boys play.
We handle disability insurance applications, appeals of denied ERISA disability claims, filing a law suit in federal court in Kentucky, if need be, and even appeal a wrongful denial to the Sixth Circuit.
Call 727-894-3188 to Learn More
Kentucky State Law and the Standard of Review in ERISA Disability Insurance Claims
The most important question that must be initially answered is “What is the standard of review?” Every federal circuit has its own standard of review that the court must follow when it reviews a disability insurance company decision to deny benefits.
Most ERISA disability insurance policies and plans reserve discretion to interpret the terms of your policy or plan and decide if you are entitled to benefits. We think of the standard of review as golden hands cuffs on federal judges.
Kentucky state law can impact the standard of review. Many states, like Kentucky, have recognized that discretionary clauses are a license to steal and have begun to ban discretionary clauses. That puts you on a level playing field with the disability insurance company.
Kentucky Revised Statute Section 304.14-120 requires that all insurance companies file their policies with the Kentucky Insurance Commissioner for review. The Kentucky Department of Insurance has taken the position that there are problems with discretionary clauses and that policies with those clauses may be disapproved.
Unfortunately, the Sixth Circuit has taken a different view and has not interpreted the “may be disapproved” language of the Kentucky Department of Insurance advisory opinion as an outright ban on discretionary clauses. You can learn more about the Sixth Circuit’s approach (link to 6th Circuit page).
For example, in the case of Rose v. Liberty Life Assur. Co. of Boston, 2016 WL 1178801 (W.D. Ky. March 23, 2016), the court found that Rose’s policy didn’t have a discretionary clause because it was issued in Michigan which prohibits discretionary clauses. However, the plan and the summary plan descriptions had discretionary clauses and the court said, “too bad, so sad” and applied the arbitrary and capricious golden handcuff standard of review.
What You Need to Do If Your Kentucky Disability Insurance Claim has been Delayed or Denied
Experienced ERISA disability attorney Nancy Cavey can provide you with assistance at all stages of your case. She recovers benefits or a settlement for Kentucky clients at all stages of an ERISA claim and regularly takes on Aetna, Liberty Mutual, CIGNA, Dearborn National, Hartford, Lincoln National, Mutual of Omaha, Reliance Standard, and Sun Life.
Call us at 727-894-3188 to set up a free consultation to talk about your personal situation. You Pay Nothing Unless We Get You Benefits or a Settlement.