Vocational Issues

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How Denial of Autism Care Coverage Can Breach ERISA Duty

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. […]

If sufficient medical evidence absent, consider vocational skill level

Many disability insurance policies evaluate an insured’s earning capacity to determine entitlement to benefits. For an insurance company to be able to assess earning capacity, the insured’s education and work experience are critical factors. A recent ruling from the federal court in Chicago, Contreras v. United of Omaha Life Insurance Co., 2017 WL 1493701 (N.D. […]

Occupation review should look into the past

Kaelin v. Tenet Employee Benefit Plan, 2007 U.S.Dist.LEXIS 86063 (E.D.Pa. Nov. 21), has had a long and tortured history. Before this final ruling, the district court had issued two earlier rulings: Kaelin v. Tenet Employee Benefit Plan, 405 F. Supp. 2d 562 (E.D. Pa. 2005), and Kaelin v. Tenet Employee Benefit Plan, 2006 U.S.Dist.LEXIS 14858 […]

Line between a job and an occupation

In Weiss v. Prudential Ins.Co. of America, 2007 U.S.Dist.LEXIS 56357 (D.N.J. Aug. 2), the plaintiff, who worked for a country vocational board of education as a food services instructor for special education students was injured when he slipped and fell in a freezer at work and herniated a disk in his back. Weiss had disability […]