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Disability Insurance Law Blog

Court reverses Prudential Insurance Company's termination of Long-Term Disability benefits

Recently the United States District Court for the District of Colorado determined an insurance provider wrongfully terminated a client's long-term disability (LTD) benefits. Paquin v. The Prudential Insurance Company of America highlights potential issues for others receiving benefits for an extended period.

Court reverses insurance company's claim denial

People in Florida who have long-term disability insurance through their employers or as standalone policies may believe that they will be protected if they are disabled and no longer able to return to their jobs. Unfortunately, some insurance companies routinely deny valid claims. In one case, a federal judge reversed a long-term disability insurance company's denial of a claim by one of its insureds.

In the case, Reliance Standard Life Insurance Company denied a woman's claim for benefits. The 62-year-old woman had worked at a chicken processing plant in Mississippi in an area that was kept at a temperature of no more than 40 degrees Fahrenheit. The woman developed circulatory problems and Reynaud's disease, and her doctor said that she could not return to her job because exposure to cold temperatures could cause her veins to spasm and potentially result in gangrene.

Fighting for appropriate benefits for disabled nurses

Florida nurses face complex risks and hazards every time they clock in for work. Health care is an ever-changing and difficult industry, and the men and women who work in this field as nurses may face certain physical risks on the job. Nursing can be hazardous, no matter the particular environment, and some nurses experience incidents that leave them unable to return to work.

If you are a nurse and you consider yourself disabled after a work accident, you may have grounds to seek disability benefits through either a group disability plan or an individual policy. However, navigating insurance matters is quite complex. Many applicants find it difficult to get the help they need, even with a valid claim.

CTE, Concussions, and Proving a Disability Claim

In a clip from FRONTLINE's League of Denial, neuropathologist Dr. Ann McKee discusses the brain of Penn football player Owen Thomas, who took his own life at age 21. After Thomas's death, Dr. McKee studied Mr. Thomas's brain and was shocked to find evidence of Chronic Traumatic Encephalopathy.

Why are long-term care insurance claims denied?

Nursing home care, assisted living care, home care and other types of long-term care can all carry high costs. One thing some individuals do to try to reduce the financial impact future long-term care needs would have on them and their family is to get a long-term care policy.

Unfortunately, some individuals end up encountering an unpleasant surprise when they make a claim under such a policy. Sometimes, insurers deny such claims.

Why was the insurance claim for my eating disorder denied?

It took far too long for the medical community to realize that eating disorders require the same attention, compassion and treatment as any other disease or disorder. It took even longer to understand that there is more than just a physical component to these disorders. Those affected also need psychological support as well.

Even though insurance companies may provide benefits for both the physical and mental aspects of recovery, they may be separate under a policy. This could present a challenge when making a claim since many case managers do not understand the need for both aspects of care. For this reason, you may find yourself facing a denial of benefits.

Prepare to battle for coverage of eating disorder treatment

Without a doubt, you have had some frightening moments in the recent past. Perhaps you have sat in an emergency room on more than one occasion or called for an ambulance for your unresponsive loved one. Certainly, you had more than one argument with your child, an argument that ended in you tearfully pleading for him or her to just eat something.

While it may be difficult for you to understand the motivation behind your son's or daughter's refusal to eat, what is not difficult to understand is that your child needs help. You likely did research into the numerous Florida area treatment centers for eating disorders, and you found a place that agreed to treat your child. Now the question is whether your insurance will cover the claim.

Prudential Denies Disability Benefits based on Severance Agreement

The case Thomas v. The Prudential Insurance Company of America, 2018 WL 211 118020, US Dist. Ct. E.D. Pennsylvania, is a reminder of how important it is to understand the implication and consequences of all terms in a severance agreement. When drafting a severance agreement to be signed by a departing employee, employers include broad language designed to protect them as well as their agents, affiliates, fiduciaries, etc. from any future claims or liabilities, whether known or unknown. The result is that by signing the agreement and taking the severance payment, an employee may forever waive their right to legitimate claims or benefits which arose prior to their termination date.

Disability Approval by MetLife and Guardian Berkshire for Doctor with Neck and Back Pain

DI Law Group was hired by Dr. Brown to assist him with his claim for disability benefits under both the group policy procured for him by his professional medical association and the private disability policies he took out on his own. While Dr. Brown was certainly still functional and able to exercise and live his life, due to significant neck and back pain, particularly while in the bent over positions he was required to sustain during examinations and procedures, he could no longer properly and effectively perform the duties of a medical doctor.

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