Articles

What Steps Can I take if My Claim for Long-Term Care Insurance Benefits Is Denied?

by Mark Debofsky | Apr 3, 2023 | Long Term Care Insurance

Long-term care (LTC) insurance is very complex. The requirements for receiving coverage are far more demanding than what is needed to qualify for long-term disability insurance – the insured needs to be unable to perform or needs substantial assistance to perform at least two basic activities of daily living such as feeding oneself, dressing, showering or bathing, toileting, or transferring from a seated to standing position or vice versa. Alternatively, a substantial cognitive impairment would qualify someone to receive long term care insurance benefits. […]

Severance Pact Forecloses Right To Pursue Disability Claim Later

by Mark Debofsky | Mar 30, 2023 | Disability Claim, ERISA

Lawyers who represent employees in severance negotiations should be aware and take heed of the recent New York federal court ruling in Schuyler v. Sun Life Assurance Co., 2023 WL 2388757 (S.D. N.Y., March 7, 2023). That case illustrated a dangerous pitfall that may unwittingly result in unintended unfortunate consequences based on the court’s finding that an employee’s release of her employer also waived the employee’s right to sue her disability insurer. […]

Denied Sight-Unseen: Why Are Non-Examining Doctors So Prevalent in the Disability Insurance Industry?

by Martina Sherman | Mar 27, 2023 | Disability Insurance, ERISA

Accessing mental health treatment can be difficult, even with health insurance. Critical laws are in place to expand access to mental health treatment by requiring equal coverage of mental health and medical/surgical care. […]

The Important Role Of Contra Proferentem In ERISA Cases

by Mark Debofsky | Mar 26, 2023 | ERISA

The outcome of Employee Retirement Income Security Act cases often turns on how courts interpret the meaning of specific benefit plan terms. The recently decided case of Stein v. Paul Revere Life Insurance Company, issued by the U.S. District Court for the Eastern District of Pennsylvania on March 16, illustrates what happens when plan terms are unclear and can have different meanings. […]

Disability Benefits for Migraine Headaches

by Matthew Maloney | Mar 26, 2023 | Disability Insurance, Disabling Medical Conditions

Long-term disability is commonly thought to be associated with physical impairments. Yet, one of the most common causes for disability, migraine headaches, is not strictly physical in nature. Rather, it is a neurological condition. […]

The Time Has Come for Disability Insurers to End Discrimination Against Mental Health Conditions

by Mark Debofsky | Mar 16, 2023 | Mental Health Disability, Mental Health Parity

Accessing mental health treatment can be difficult, even with health insurance. Critical laws are in place to expand access to mental health treatment by requiring equal coverage of mental health and medical/surgical care. […]

How Is Mental Health Parity Enforced?

by Marie Casciari | Mar 15, 2023 | Mental Health Disability, Mental Health Parity, Residential Treatment

Accessing mental health treatment can be difficult, even with health insurance. Critical laws are in place to expand access to mental health treatment by requiring equal coverage of mental health and medical/surgical care. […]

How Do Insurance Companies Evaluate Short-Term and Long-Term Disability Claims?

by Mark Debofsky | Mar 10, 2023 | Disability Benefits, Disability Insurance, Long Term Disability, Short Term Disability

Both short-term and long-term disability claims are evaluated using a variety of factors to determine if an individual is eligible to receive benefits. […]

A Comprehensive Guide to Understanding Arthritis and Joint Disease Disability Insurance Claims

by Mark Debofsky | Mar 5, 2023 | Disability Insurance, Medical Conditions

According to the Centers of Disease Control and Prevention (CDC), the leading cause of disability in the U.S. is arthritis. Arthritis is a name given to multiple conditions that result in joint swelling, inflammation, and stiffness, resulting in pain and dysfunction such as an ability to walk or perform job duties requiring hand use. […]

Courts Should Follow 8th Circ. On ERISA Procedure Rules

by Mark Debofsky | Mar 3, 2023 | Accidental Death, ERISA

There is no provision in the Employee Retirement Income Security Act of 1974 mandating that claimants must exhaust internal appeals as a precondition to filing a lawsuit to challenge a claim denial. Nonetheless, most courts have required claimants to exhaust prelitigation appeals before their cases may be heard in court. […]

How Long Does it Take to Appeal a Disability Insurance Benefits Denial?

by Marie Casciari | Feb 26, 2023 | Disability Benefits, Individual Insurance

Disability insurance benefits can protect you and your family from financial hardship by insuring a portion of your income for so long as you remain out of work due to an injury or illness. The disability benefits process can be complicated, particularly if your claim is denied or your benefits are prematurely terminated, so it is essential that you understand your rights and obligations in order to maintain the viability of your claim. […]

Depression Due to Physical Impairments Can Place Disability Claimants in a Catch-22

by Martina Sherman | Feb 19, 2023 | Disability Benefits, Long Term Disability, Mental Health Disability

If you suffer from chronic pain, fatigue, and other symptoms severe enough to interfere with work, there is a good chance you also suffer from depression, anxiety, and other mental health problems. […]