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New Jersey Disability Claimants Will Benefit From New Law

New Jersey joins Pennsylvania as a state in the Third Circuit and benefits when a PA case is successful before the Third Circuit. A case in point is Kosiba v. Merck & Co. which found that Unum acted arbitrarily and capriciously in denying benefits to a claimant suffering from fibromyalgia…

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Helping Prove Your Disability Claim with Your Physician’s Help

We often are retained once a claim has been denied. All too often, the denial is based on a breakdown in communication between the patient’s doctors and the administrator evaluating the claim because the nature and extent of a patient’s disability is not communicated clearly by the claimant’s treating physicians…

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Disability Caused by Chronic Fatigue? Wall Street Journal Reports that Chronic Fatigue Research Continues

Many of our clients suffer from Chronic fatigue syndrome. Several years ago, the Centers for Disease Control and Prevention issued some protocols for establishing that a patient has the condition. Nevertheless insurance companies regularly deny disability claims based on CFS, often using the excuse that there is “no objective evidence”…

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Four Largest United States For-Profit Health Insurers Increase Coverage Denials Based on Pre-existing Condition

A Congressional investigation released last month found that the four largest U.S. for-profit health insurers denied policies to one in every seven applicants based on prior medical history. The Wall Street Journal reported the companies – Aetna, Inc., Humana, Inc., UnitedHealth Group, Inc., and WellPoint, Inc. – denied coverage to…

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Should A Disabled Employee File A Second Level Appeal Of An ERISA Disability Denial?

When a disabled employee is denied benefits by an insurance company, Federal Regulations, ERISA law requires that they submit a “mandatory” appeal of that denial to the insurance company. The insurance company will typically review the appeal and decide whether to reverse or uphold their decision. Only after the appeal…

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Interplay between Disability Benefits and Bankruptcy

Disabled consumers filing bankruptcy face a dilemma; they need to continue to receive their disability benefits, but are legally obligated to disclose all “assets” on the bankruptcy petition. Consumers should note that by acknowledging this asset to the Bankruptcy court, the trustee in bankruptcy may be able to preserve this…

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Are Insurance Companies Failing to Live Up to Their End of the Bargain in Long-Term Disability Policies?

On September 28, 2010 the United States Senate Finance Committee held a full committee hearing titled, “Do Private Long-Term Disability Policies Provide the Protection They Promise?” The Hearing featured testimony from Chicago-based attorney Mark DeBofsky, a disability law expert, as well as The Honorable William M. Acker, Jr., Senior United…

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