Disability Insurance Lawyer Blog

Court Finds In Favor Of Claimant With Vestibular Disorder/Vertigo

A Federal Judge has determined that a claimant is entitled to her benefits from Liberty Mutual, after her claim had been terminated and her appeal denied. The Court, weighing the evidence on a de novo review, determined that the claimant’s medical support was of more quality than the evidence developed by Liberty Life, which included surveillance obtained over eight (8) days, a peer review by a hired doctor, and an examination performed by a doctor hired by Liberty Mutual. The claimant, who left work several months after suffering from vertigo and dizziness, when her symptoms significantly worsened, worked in a sedentary desk job that required near constant use of a computer. While on claim, Liberty Mutual obtained surveillance of her – a common tactic by Liberty Mutual – which showed her driving short distances, carrying groceries and running errands. The Court, however, was not persuaded by the surveillance, noting that these activities...
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Claimant Wins In Federal Court Litigation in Pursuit Of LTD Benefits Against Aetna

A claimant has succeeded in getting a Federal Court to overturn a decision by Aetna to terminate benefits to a claimant who suffered from cancer and later from significant orthopedic conditions of the cervical and lumbar spine as well as depression. Aetna terminated the claim after a peer review, when a doctor is hired to review records only and the doctor does not examine or meet the claimant. On appeal of the terminated claim, Aetna again engaged various peer reviews, none of whom met or examined the claimant. The Court determined that Aetna had improperly terminated benefits, finding that the support from the claimant’s physician was “sounder than those presented by the peer reviewers,” which the Court found were largely presented in conclusory fashion, making it unclear how they reached such starkly contrasting results from those of the claimant’s provider. Another factor leading the Court’s decision was Aetna’s...
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Vocational Rehabilitation Specialists – Time to Get Them Back to Work

We were intrigued to read an opinion piece calling for the return of the vocational rehabilitation specialist (VRS) to long term disability claims management. The article outlined the role that VRS’ held in long term disability insurance claims in the past. Once, the VRS played a large part in working with physicians and claims experts as “part of a multidisciplinary team” focused on managing the duration of the claim and getting a disabled individual back to work. According to the article, today the VRS is way low on the totem pole, with far fewer numbers of VRS involved in the claims decisions. The severely diminished role of the VRS means that insurance company doctors and claims adjusters do not fully understand how the disabilities impact on the claimant’s ability to perform the duties of their occupations. Today, the claims process relies on a different...
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An Epic Disaster of National Proportion: Handing SSDI Over to the Insurance Sector

We can only hope that no one takes this analysis/opinion in the Washington Times seriously. It’s from a senior analyst at The Heritage Foundation’s Center for Data Analysis. The Heritage Foundation is a right wing think tank that promotes public policies and is considered one of the world’s most influential public policy research institutes. Maybe that’s why we find this so troubling. Simply put, this is a dangerous idea and our hope is that airing it out will deflate it – quickly. Social Security Disability Insurance (SSDI) is close to running out of money in the near future, and the result will be across the board cuts in benefits, possibly by 20%. This writer proposes that SSDI incorporate an optional, private disability component to ease the financial problems of SSDI. For the record, our firm does not represent Social Security Disability Insurance claimants. We understand the...
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