Articles
Updates on the latest in benefits news and practical pointers for your benefits-related issues.
Judge delivers a sobering message to wine rep’s disability insurer
The importance of accurate vocational assessments in disability benefit claims cannot be overstated. A physician’s statement listing physical and mental limitations due to medical conditions are only part of the picture – the ultimate question is whether such limitations would affect someone’s ability to perform their regular occupation. That was the lesson taught in Sapp […]
Can Prevailing Defendants in ERISA Cases Recover Attorneys’ Fees?
In a ruling recently secured by DeBofsky Sherman & Casciari, P.C., a federal court definitively ruled that prevailing defendants in ERISA cases are rarely entitled to fees. In Geiger v. Aetna Life Ins. Co., 2016 WL 5391206 (N.D. Ill. September 27, 2016) (opinion), where a court upheld Aetna’s termination of disability benefits (currently on appeal), the court denied the insurer’s application for fees.
Overcoming the fibromyalgia stigma
If you or a loved one has fibromyalgia, you’re probably familiar with how often it is misunderstood and misdiagnosed. Unfortunately, this misunderstanding can often lead to inadequate treatment and denial of disability insurance claims. As medical understanding is improving, widespread discrediting of fibromyalgia symptoms may be waning. Those living with the syndrome in the meantime, […]
Doctor’s sizeable income from insurer raises big question of neutrality
Doctors must maintain neutrality in disability claims, but conflicts of interest can arise due to their relationships with insurers.
Discretion and pre-emption: Unraveling ERISA, state insurance law
The interaction between pre-emption and discretion can make ERISA cases more complex, and require expert legal assistance.
Does a co-morbid psychiatric impairment allow a disability insurer to invoke a policy limitation limiting the duration of benefit payments for psychiatric conditions?
The lesson taught by Okuno v. Reliance Standard Life Ins. Co., 2016 WL 4655741 (6th Cir. September 7, 2016), is that the answer to the question posed by the title of this blog is a resounding NO. The case involved a former art director for a clothing company who became disabled on account of Crohn’s […]
Proving intoxication caused injury more difficult than simple tests
It is not uncommon to find provisions in disability and accidental death insurance policies that exclude coverage in situations where alcohol or drug ingestion causes the injury or death. It is not enough, though, to merely show the insured was intoxicated. According to cases such as Holloway v. J.C. Penney Life Insurance Co., 190 F.3d […]
Not under a doctor’s care when you file? ‘Not a problem’, court rules
On July 27, 2016, the U.S. Court of Appeals for the Seventh Circuit handed down a decision in the case of Berg v. New York Life Ins. Co. reversing an adverse judgment in the district court against DeBofsky Law’s client, Eric Berg. The court of appeals found in Berg’s favor on two significant issues: First, […]
Obtaining LTD benefits often requires legal help
Short-term and long-term disability plans are supposed to provide workers and professionals with coverage to make ends meet when a serious medical impairment or injury takes the person away from work. Not everybody participates in these insurance plans. In fact, the Bureau of Labor Statistics says the roughly 39 percent of people working in private […]
Insurer lambasted for ‘misleading’ court and claimant in disability case
A recent ruling from a federal court in Arizona offers a lesson on the consequences of discovery abuse: The court imposed severe sanctions on an insurer for wrongfully withholding documents requested in discovery. The case of Sell v. Country Life Insurance Co., 2016 WL 3179461 (D. Ariz., June 1, 2016), involved a claim for disability […]
DeBofsky Law successfully challenges forum selection clause
DeBofsky & Associates successfully challenged a forum selection clause in a recent ERISA case.