Mental vs. Physical Disabilities

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Mental illness and disability

Courts strive to enforce the terms of benefit plans in order to ensure their efficient operation.However, there are times when the provisions of benefit plans make no sense under the circumstances; and Waskiewicz v. Unicare Life and Health Ins. Co., 2015 WL 5751585 (6th Cir. October 2, 2015) illustrates one of those circumstances.  In Waskiewicz, […]

Disability Determinations Require Realistic Assessment of Vocational Capabilities

A man with cerebral palsy and other disabilities recently won an appeal against a disability benefits denial. The panel reviewing his case reminded the SSA to review the specifics of each case and avoid broad generalizations. A recent case serves as a reminder that a claimant’s real world employability must be taken into consideration as opposed to making a disability determination based on broad generalizations that could lead to a denial of benefits.

Federal court revives disability claim for schizoaffective disorder

Most group disability insurance policies limit the duration of benefit payments for mental impairments. An interesting ruling out of Pennsylvania focuses on what constitutes a “mental impairment.” In Berkoben v. Aetna Life Insurance Co., 2014 U.S.Dist.LEXIS 39385 (W.D.Pa., Feb. 21), a magistrate judge’s report and recommendation, the court recommended overturning Aetna’s termination of benefits based […]

Court finds for insured in absence of examination

An insurer’s choice to rely on file reviews in place of examinations can be critical to the outcome of litigation, a lesson taught by Tolstedt v. Standard Ins. Co., 2013 U.S.Dist.LEXIS 134946 (D.Mont. June 24, 2013). There, the plaintiff, Michael Tolstedt, a trial lawyer from Billings, Mont., began taking prescription medication for depression on Sept. […]

More on Freeland v. Unum, a case litigated by DeBofsky Law

Freeland v. Unum Life Ins.Co. of America, 2013 U.S.Dist.LEXIS 116931 (W.D.Wisc. August 19, 2013)(Issue: Risk of Disability)(opinion_and_order.pdf). A key focus of the court’s ruling was on the Unum Regulatory Settlement Agreement of 2004, which required Unum to consider the co-morbidity of multiple impairments and give significant weight to Social Security determinations. Based on those guidelines, […]