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Appeals Court Reverses, Grants Retroactive Benefits

Monday, March 8th, 2010

The Ninth Circuit Court of Appeals seems to “get” it. The Court reversed a decision that was favorable to an insurer, granting the retroactive payment of benefits to a claimant who has had numerous hip revision surgeries, and was getting paid Social Security Disability benefits.

The Court found that the quantity and quality of the medical evidence supports the claim, where the Court rejected the insurer’s argument that a lack of objective evidence existed, where the Court embraced the consistent use of strong paid medication, and where a Functional Capacity Evaluation (“FCE”) supported a finding of impairment. The Court found that the insurer failed to credit reliable evidence. The complete disregard of the Social Security determination further informed the Court’s decision.

Justin C Frankel

Written By:

Justin C. Frankel - Disability Insurance Attorney

Justin Frankel is a founding partner of the disability insurance law firm Frankel & Newfield and is a highly skilled litigator and advocate. He has published numerous articles on the challenges facing clients with private or individual disability insurance policies and those who own group or ERISA disability insurance policies.

Learn more about Justin | See Justin’s Publications

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