Articles

Disability Claims Denials: Next Steps

by Mark Debofsky | Dec 12, 2018 | Disability Benefits, ERISA

If you’ve been injured in an accident, diagnosed with an illness or had to deal with the prospect of a long recovery following surgery, you might need to be out of work to focus on your health. You could be worried more about the hit your finances will take during a work absence than your recovery. If you need time away from your job for a short-term or long-term disability, you may choose to file a claim with your disability insurer to make up some or all of the income you’ll lose.

Third Circuit Works Through Occupation-Specific Disability Definition

by Mark Debofsky | Dec 6, 2018 | Disability Benefits, Residual/Partial vs. Total Disability

This is the second of a two-part column. The first part was published on Wednesday. In Part 1 of this column, we discussed a disability income insurance claim filed by Dr. Kevin McCann and the ruling issued by the 3rd U.S. Circuit Court of Appeals, focusing on the ERISA aspects of the case. In Part […]

Scope of ERISA and Occupation-Specific Disability

by Mark Debofsky | Dec 5, 2018 | Disability Benefits, ERISA

A new ruling from the 3rd U.S. Circuit Court of Appeals raises a number of interesting issues regarding the limits of coverage under the Employee Retirement Income Security Act as well as how occupation-specific disability is analyzed.

Disability Claims and Complex Regional Pain Syndrome

by Mark Debofsky | Nov 29, 2018 | Disability Benefits, Pain and Disability

Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD) is a chronic pain syndrome that can occur after an injury, and its persistence is often significantly worse than the original injury. It is a difficult condition to diagnose and common for disability insurance companies to refute or deny as a compensable disability […]

Disability Due to Pain Is Difficult to Prove

by Mark Debofsky | Nov 15, 2018 | Disability Benefits, Pain and Disability

Proving an entitlement to disability benefits on account of pain can be challenging as a recent federal court ruling from Massachusetts recognized. The case of Kamerer v. Unum Life Insurance Company of America, 2018 WL 4539693 (D. Mass., Sept. 21, 2018), involved a claim brought by Judith Kamerer, a former employee of Accenture, who became disabled in 2004 due to fibromyalgia and depression.

Federal Court Argues for Right to Jury to Pursue ERISA Claims

by Mark Debofsky | Nov 8, 2018 | Civil Procedure, ERISA

While it’s generally accepted that Employee Retirement Income Security Act benefit claimants are not entitled to jury trials, rarely does anyone question the reason why.

The Problem With Pain

by Mark Debofsky | Oct 3, 2018 | Disability Benefits, Pain and Disability

According to the National Institutes of Health, approximately one in 10 Americans experience severe pain every day. This pain could be the result of any number of conditions. Because pain is a subjective experience, not every condition that causes pain is known — but what is known is that pain can drastically affect your quality […]

Review Your Employee Benefits Every Three Years

by Mark Debofsky | Jul 27, 2018 | ERISA, Fiduciary Duties

We have all seen the letters in the mail. Your employer is updating their benefits policies, and by law, you are required to receive notification summarizing the changes. These notices contain a lot of legal jargon and fine print, and you probably threw them away without much more than a cursory glance. Although these updates […]

Misuse of Occupational Titles Dictionary Draws Judge’s Ire

by Mark Debofsky | Jul 18, 2018 | Disability Benefits, Long Term Disability

A recent ruling issued by U.S. District Judge Carlton W. Reeves of the Southern District of Mississippi described a history and pattern of bad-faith disability benefit claim denials. The case of Nichols v. Reliance Standard Life Insurance Co., 2018 WL 3213618, 2018 U.S. Dist. LEXIS 109526 (S.D. Miss., June 20, 2018), involved Juanita Nichols, a […]

401(k) Litigation Is Rising. What Could Change?

by Mark Debofsky | Jun 29, 2018 | ERISA, Fiduciary Duties, Pension Plans

According to USA Today, the stock market gained 20 percent last year, making 2017 one of the best years for stocks since Y2K. A natural result of these gains was a rise in the value of 401(k) or 403(b) investments for consumers around the country. While the money in 401(k) and 403(b) accounts grew, so […]

Amputation Cause Is Case Law Worth Reading

by Mark Debofsky | Jun 11, 2018 | Accidental Death, Pre-Existing Condition

Accidental death and dismemberment insurance frequently present fascinating issues, as illustrated by a recent ruling from the 9th U.S. Circuit Court of Appeals. In Dowdy v. Metropolitan Life Insurance Co., 2018 WL 2223722 (9th Cir. May 16, 2018).

Judge Takes Insurer to Task for Denying Claimant With MS

by Mark Debofsky | May 17, 2018 | Disability Benefits, Long Term Disability, Pain and Disability

A recent federal court ruling from Washington state was harshly critical of a disability insurer’s treatment of a benefit claimant suffering from multiple sclerosis. The case, Gorena v. Aetna Life Insurance Co., 2018 WL 2113952 (W.D. Wash., May 8, 2018), involved Sarah Gorena, who worked as a staff analyst at Boeing for more than 10 […]