The Employee Retirement Income Security Act (ERISA) is extremely broad in its scope. It affects both retirement benefits and other employee benefits such as health insurance in the majority of workplaces in the United States. However, there are exceptions – government employees are exempted from ERISA, meaning that benefits involving federal, state and municipal employees […]
Proving an entitlement to disability benefits on account of headaches can be extremely challenging. Unlike many other disabilities that can be objectively diagnosed by MRI, x-ray, or blood tests, “objective” proof of headaches can be elusive. The proof difficulties can be even more challenging if the benefit plan requires objective medical evidence. How then can […]
Awareness of Post Traumatic Stress Disorder has increased in recent years, especially in light of news reports about veterans and warriors suffering from the condition after serving our country. What many people are not aware of is the fact the PTSD is not solely linked to military service. Any terrifying or traumatic event can serve […]
Although the approval of a claim for disability benefits does not guarantee payment of the claim forever, a recent federal case illustrates the problems insurers may experience when they attempt to terminate benefits without evidence that the claimant’s medical condition has improved. The case of Hart v. Unum Life Insurance Company of America, 2017 WL […]
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. […]
Attorneys Mark DeBofsky and Bridget O’Ryan secured a victory in the U.S. Court of Appeals on May 18, 2017 in a disability benefit case involving fibromyalgia – Kennedy v. Lilly Extended Disability Plan, 2017 WL 2178091 (7th Cir. May 18, 2017)(available at Final Opinion). The court began its ruling by announcing that this case is about fibromyalgia, and […]
Insurance companies often hire private investigators to find ways to deny or discontinue payment of disability insurance benefits. The tactics that big business uses to develop evidence seems to expand as technology changes. For years, insurance companies have sent investigators to conduct undercover surveillance stake outs, hoping to secure video evidence that a claimant is not really disabled, […]
A recent decision issued by the U.S. Court of Appeals for the Fifth Circuit illuminates the importance of the standard of judicial review applied to resolution of cases seeking benefits under ERISA. In Ariana M v. Humana Health Plan of Texas, Inc., 2017 WL 1423765 (5th Cir. April 21, 2017), although the court of appeals […]
DeBofsky Law recently received a ruling from Judge Robert Dow, Jr. of the U.S. District Court for the Northern District of Illinois in Harding v. Hartford Life and Accident Insurance Company, 2017 WL 1316264 (N.D. Ill. April 10, 2017), which thoughtfully analyzed the scope of available discovery in an ERISA action adjudicated under the de novo standard of judicial review.
The value of functional capacity evaluations in establishing entitlement to disability benefits was made evident by Madison v. Greater Georgia Life Insurance Co., 2016 WL 8648862 (N.D. Ga. Dec. 21, 2016), a recent federal court decision from Georgia. The case involved Ricky Madison, a transport driver for an oil company who applied for disability benefits […]
A recent ruling from the 1st U.S. Circuit Court of Appeals upheld an insurance company’s denial of health-care benefits for psychiatric treatment. Although the underlying facts are compelling, the most interesting aspect of the ruling was the court’s discussion of civil procedure and judicial standards of review under the Employee Retirement Income Security Act.
New research indicates that the rate of people experiencing a stroke prior to the age of 55 has increased in recent years. The average age of people experiencing a first-time stroke has dropped by nearly 2.5 years between 2000 and 2012. The study indicates that while the overall stroke rate in the U.S. has decreased, […]