Articles

Updates on the latest in benefits news and practical pointers for your benefits-related issues.

How Denial Of Autism Care Coverage Can Breach ERISA Duty

by Mark Debofsky | Apr 8, 2021 | ERISA, Fiduciary Duties, Mental Health Parity, Vocational Issues

According to statistics compiled by the Centers for Disease Control and Prevention, about one in 54 children has been diagnosed with autism spectrum disorder, which is considered a developmental disability associated with social, communication and behavioral issues. Although there is no known cure for autism, children with autism may be helped with behavioral treatment such as applied behavioral analysis, or ABA, and early intensive behavioral intervention, or IBT, a subtype of ABA treatment. […]

What are the reasons why life insurance payments are denied?

by Mark Debofsky | Mar 29, 2021 | Life Insurance

Life insurance seems like a no-brainer. If you buy life insurance and die, your beneficiary receives a payout, right? Not necessarily. There can be several reasons why life insurance is not paid. All policies contain an exclusion that would preclude payment or state grounds that can cause coverage to lapse […]

How Long Does it Take to Get Approved for Long-Term Disability Benefits?

by William Reynolds | Mar 26, 2021 | Disability Benefits, Long Term Disability

The timeline from application to a decision on a long-term disability claim is generally set by the terms of the plan itself. But disability policies that are governed by the Employee Retirement Income Security Act of 1974 (ERISA) must adhere to the Department of Labor’s ERISA claims regulations, which include timelines for issuing a decision […]

What is accidental death insurance?

by Mark Debofsky | Mar 24, 2021 | Accidental Death, AD&D

Accidental death insurance, also known as accidental death & dismemberment (AD&D) insurance, is a type of insurance that supplements basic life insurance coverage. AD&D insurance pays benefits in addition to life insurance if the insured dies as a result of an accident or suffers a catastrophic injury that results in limb amputation or loss of […]

Judge casts doubt over administrative exhaustion doctrine for ERISA claims

by Mark Debofsky | Mar 21, 2021 | ERISA

One of the major differences between insurance litigation in general and litigation of disputes involving health, life or disability insurance under the ERISA law is in relation to preconditions to bringing suit. Even though ERISA cases are not subject to administrative law, federal courts have incorporated the doctrine of administrative […]

Top ten things to look for in a disability benefit/ERISA lawyer

by Mark Debofsky | Mar 18, 2021 | Disability Benefits, ERISA

The following guide to hiring a lawyer is based on positive feedback we have received from our clients. These suggestions are based on our primary practice area but are mostly applicable any time you need to hire a disability lawyer. 1. Knowledgeable In hiring an ERISA lawyer, a potential client should know the lawyer they […]

Can I qualify for disability benefits due to COVID-19?

by Mark Debofsky | Mar 16, 2021 | COVID-19, Short Term Disability

The COVID-19 pandemic which began in early 2020 has caused over 500,000 deaths in the United States by March 2021, along with over 28 million cases of infection. For most individuals who have contracted COVID-19, the symptoms they have experienced have been relatively mild, but a huge number of COVID patients have required […]

How ambiguity can expand employee insurance coverage

by Mark Debofsky | Mar 16, 2021 | ERISA Standard of Review, Long Term Disability

What is contra proferentem? Carlile v. Reliance Standard Life Insurance Co.[1] is a textbook illustration of the doctrine that construes ambiguities in insurance policies in favor of the insured and against the insurer. In February, the U.S. Court of Appeals for the Tenth Circuit affirmed a ruling by the U.S. District Court for the District […]

How to file a winning ERISA claim

by Mark Debofsky | Mar 8, 2021 | ERISA

What is ERISA? ERISA is an acronym for the Employee Retirement Income Security Act, a law passed by Congress in 1974 aimed at protecting the rights of employees who participate in their employers’ benefit plans and their dependents. ERISA applies to a host of employee benefits – pensions, 401k and 403b plans, disability, health, and […]

How long does disability retirement last?

by Martina Sherman | Mar 5, 2021 | Disability Benefits, Pension Plans

If you suffer a disabling injury or illness and are a government employee or participate in a defined benefit pension plan, such as through a union, you may be eligible for a disability retirement pension, as distinct from or in conjunction with disability insurance. Disability pensions provide monthly payments to workers who are not yet […]

Why do I need long term disability insurance?

by Martina Sherman | Feb 23, 2021 | Long Term Disability

It’s estimated that one in four people entering the workforce today will experience a disability lasting a year or more before they reach retirement age. Many of those impacted are eligible for Social Security disability benefits, but Social Security disability insurance has many limitations. First, it typically provides only 50% income […]

What are the top ten mistakes disability insurance claimants make when seeking disability benefits?

by Mark Debofsky | Feb 18, 2021 | Disability Benefits

In our years of experience in representing claimants seeking long-term disability benefits, we have compiled a list of mistakes that claimants can make which can result in a benefit denial. We would like to share that list with others who may be contemplating the need to file a claim for disability benefits: 1. Waiting Too […]

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Updates on the latest in benefits news and practical pointers for your benefits-related issues.

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