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Info Library

 Clear Information About Long Term Disability Claims

The Info Library is a comprehensive educational resource for people navigating long term disability claims.

Here, you can learn how disability insurers evaluate medical conditions, occupational duties, policy language, medical evidence, appeals, benefit terminations, and litigation. Each guide focuses on a specific issue that may affect your eligibility for benefits or the strength of your claim.

Use the search feature above or browse the topic areas below.

Diagnoses

A medical diagnosis can have a profound impact on your ability to work, but not every diagnosis is evaluated the same way by disability insurance companies.

Our diagnosis guides explain how specific medical conditions may affect your eligibility for long term disability benefits, the evidence insurers typically look for, and the unique challenges claimants often face throughout the claims process.

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Occupations

Your occupation is one of the most important factors in a long term disability claim. Disability insurance companies evaluate more than just your diagnosis; they assess whether your condition prevents you from performing the material duties of your specific occupation.

Our occupation guides explore the unique demands of different professions and the evidence that can help support a successful disability claim. Whether you are filing an initial claim, appealing a denial, or protecting ongoing benefits, understanding how your occupation is evaluated is essential.

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Insurers

The insurance company handling your long term disability claim can significantly impact your experience throughout the claims process. While every insurer evaluates disability claims differently, each has its own procedures, priorities, and common reasons for delaying, denying, or terminating benefits.

Our insurer guides examine the practices of major disability insurance companies, explain the challenges claimants commonly encounter, and provide insight into the strategies that can help strengthen your claim at every stage.

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Policy Terms

Your disability insurance policy is the foundation of your claim. The language in your policy determines who is eligible for benefits, how disability is defined, what limitations or exclusions may apply, and what evidence you need to provide throughout the claims process.

Our policy guides explain the key provisions found in many long term disability policies and help you understand how your policy can affect your eligibility, benefits, and claim strategy.

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Claim Strategies

Every long term disability claim presents unique challenges, and the steps you take throughout the process can have a significant impact on your ability to obtain and maintain benefits. Understanding how disability insurers evaluate claims can help you make informed decisions from the outset.

Our claim strategy guides cover important topics such as documenting your disability, working with your treating physicians, responding to insurer requests, preparing appeals, and protecting your benefits throughout the life of your claim.

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Litigation Issues

If your long term disability claim cannot be resolved during the administrative claims process, the next step may involve litigation or mediation. Understanding how these proceedings work can help you make informed decisions about your legal options and what to expect as your case moves forward.

Our litigation and mediation guides explain important legal concepts, court procedures, settlement discussions, standards of review, and other issues that may arise after a claim has been denied or terminated.

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Topic

Litigation Erisa

Learn About ERISA Long Term Disability Procedural Issues

ERISA

Understanding ERISA disability insurance law can be complicated.  How do you know if it covers your long term disability benefits?  What protections does ERISA offer?  How can an ERISA long term disability attorney help with your disability claim?  These are all questions to consider before starting the long term disability insurance claim process.

Below we answer common questions about ERISA disability insurance law and how ERISA affects your long term disability insurance claim.

 

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New Book on ERISA Disability Claims and Litigation by NYC Attorneys

ERISA News

Our new book, ERISA Disability Claims and Litigation (2021), authored by New York City ERISA attorneys Scott Riemer and Jennifer Hess of 糖心直播, offers expert knowledge to successfully file, appeal, and litigate ERISA disability claims. Published by James Publishing, this latest edition discusses updates to ERISA policies, best practices and procedures when handling claims, and more. 

Below, the authors discuss the most common questions they get about their new book.

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When Can You File Your ERISA Long Term Disability Litigation?

ERISA Preparation for Litigation ERISA's Claims Procedure Regulations Statute of Limitations Complaint Deadlines Exhaustion Requirement

Introduction

Timing is critical for ERISA long term disability litigation 鈥 and a factor claimants often overlook or misunderstand. Failure to file your ERISA litigation at the correct time can have dire consequences for you and your disability benefits.

If you file too early, the court often will dismiss your case, thus costing you valuable time and money spent on preparing your litigation. You may have an opportunity to correct the error of filing too early, as detailed below. However, there are much more serious and permanent consequences if you file your lawsuit too late. If you file after the statute of limitations, your claim will likely be dismissed, and you will be permanently unable to recover your benefits in court.

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ERISA Long Term Disability Lawsuits: What's the Standard of Review?

ERISA Standard of Review Prepare for Litigation

If you file an Employee Retirement Income Security Act (鈥淓RISA鈥) long term disability lawsuit, your success will depend heavily on which legal standard of review the court applies.  The standards are anything but equal.  The one used in your case can have a substantial impact on your success.

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Court Strips Aetna's Discretionary Authority in Long Term Disability Litigation

ERISA News Success Stories Standard of Review Aetna Success Story ERISA's Claims Procedure Regulations

In an ERISA New York disability litigation against Aetna, Riemer Hess successfully argued the Court should review the case under the plaintiff-friendly de novo standard 鈥 substantially increasing the Plaintiff鈥檚 chances of prevailing.  The Court, in following the Second Circuit Court of Appeals鈥 ruling in Halo vs. Yale Health Plan, stripped Aetna of its discretionary authority because it failed to to strictly adhere to the ERISA claims regulations, and its violations were neither inadvertent nor harmless.

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