Disability Insurance Lawyer Blog

Federal Court Finds Denial of Disability Insurance Benefits Unreasonable

A New York Federal Court has determined that a claimant was wrongfully denied his disability insurance benefits after conducting a bench trial. Met Life was responsible for deciding the eligibility for benefits, and determined that the claimant was not disabled. In reviewing this determination, the Court found that Met Life failed to properly consider the claimant’s vocational abilities and limitations, which supported a finding that it abused its discretion in deciding the claim. Met Life determined the claimant had sedentary functional capacity, but did not undertake any meaningful effort to determine if there were occupations which the claimant were qualified based upon the functional capacity determination. Rather, Met Life denied the claim because it determined the claimant had sedentary functional capacity. This was particularly egregious where Met Life knew the claimant had only a third grade education. Further, the Court found that Met Life speculated about...
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ACI 17th National Conference on Litigating Disability Insurance Claims

The Disability Insurance Lawyer Blog is pleased to have been invited again to serve as the exclusive media partner for the American Conference Institute’s 17th National Conference on Litigating Disability Insurance Claims, held in Philadelphia on January 22 – 23, 2015. The prestigious national conference brings together attorneys, insurance company executives and insurance company attorneys, along with the myriad of other professionals on both sides of the litigation environment in this ever-changing and challenging field of law. The conference presents a great opportunity to learn from the best in disability insurance law, and provides a valuable (and neutral) time when we have a chance to meet our adversaries face-to-face. Jason Newfield will be the only plaintiff’s attorney in a panel discussion on the latest trends in the discovery process in disability claim actions. Hot topics will include Conflict of Interest Discovery, the Scope of the Administrative Record...
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Your Career as an LTD Benefits Manager

We love Craigslist, especially when Long Term Disability insurance companies post job openings. What does it mean to work as a claims benefit manager at an LTD company?
…. to ensure prompt and accurate payment and liability management of moderately complex disability claims.
Based on our experience, ensuring prompt and accurate payment is not exactly the top of the list, either for the company or the benefit manager. But it gets better.
Works with attorneys and insurance carriers regarding 3rd party litigation and/or subrogation issues. Effectively utilizes risk management tools to determine appropriate length of certification and timing of referrals for other income offset opportunities, Consults and reviews clinical information with nurses and Medical Directors to establish the appropriate length of certification given contractual provisions and regulatory requirements.
It sounds so straightforward. Read the contract, work with attorneys, doctors, nurses and determine how long benefits...
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Disability Intervention Solution Designed to Target Psychosocial Risk Factors in Recovery

Yes, you read that headline correctly. A new program has been launched based on research showing that “psychosocial barriers to recovery” account for more than three times the variance in the ability of claimants to recover from injuries. And while this particular program is being targeted to Workers’ Compensation cases, it may be just a matter of time before this program, or something similar to it, shows up in the world of Long Term Disability insurance claims. We’ve got nothing against anything that will get people who are able-bodied to get back to work after an injury. What bothers us is what appears to be a thinly-veiled accusation of malingering. We don’t actually know what “psychosocial barrier identification” means, but in our long years of experience with disability insurance companies, we do know that it’s never a good thing when they start slinging jargon. Here’s...
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