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Home | Archives for Nick Ortiz | Page 12

Nick Ortiz

Director of Software v. Unum – Court Finds Plaintiff Failed To Meet His Burden Of Proof

On April 7, 2023, the United States District Court for the District of Massachusetts decided an ERISA long-term disability insurance case against the Unum Insurance Company of America. The Court ruled in favor of Unum. The claimant worked with Symbiotic LLC Plan as the Director of Software Quality Assurance. He had worked in the computer software and information …

Read moreDirector of Software v. Unum – Court Finds Plaintiff Failed To Meet His Burden Of Proof
Can Your Insurance Company Force You to Use a SSD Claims Service?

Can Your Long-Term Disability Company Force You To Use A Social Security Disability Claims Service? 

If you’re applying for long-term disability insurance, you may be required to apply for Social Security disability benefits along with your LTD claim. You may even be offered the services of companies like Allsup and Advantage 2000 to assist with your claim. However, as a knowledgeable ERISA long-term disability and Social Security disability attorney, I …

Read moreCan Your Long-Term Disability Company Force You To Use A Social Security Disability Claims Service? 

Arenson v. Unum – Court Sides With Unum Under Deferential Standard Of Review

Today we review Arenson v. First Unum Life Insurance Company that was decided by the United States District Court for the Northern District of Illinois. Gregg Arenson was a futures and options trade broker. He sued his former employer’s benefits administrator, First Unum Life Insurance Company (hereinafter “Unum”) under ERISA. He challenged Unum’s denial of his long-term disability …

Read moreArenson v. Unum – Court Sides With Unum Under Deferential Standard Of Review

Moseley v. Unum – Unum Should Have Ordered IME

Unum paid long-term disability (LTD) insurance benefits to Susan Moseley, but stopped paying after a period of time pursuant to the mental illness limitation in her long-term disability policy (a policy is also called a “plan” of benefits). Moseley appealed the case all the way to federal court, arguing that Unum abused its discretion as …

Read moreMoseley v. Unum – Unum Should Have Ordered IME
Opening an Encrypted CD from the SSA

Opening An Encrypted CD From The SSA

The Social Security Administration maintains all Social Security disability claim files in an electronic format. The instructions below will walk you through the process of obtaining and opening an encrypted CD from the SSA. How Do I Get a Copy of My Social Security Disability File? A claimant and/or an authorized representative has the right …

Read moreOpening An Encrypted CD From The SSA

Marselle v. Unum – Kentucky District Court Finds Unum Made A Reasoned Determination

Jonni Marselle was covered for long-term disability (LTD) benefits under a group plan provided to Humana, Marselle’s former employer. Marselle was a consultant with Humana. The position was sedentary as it required her to constantly sit, occasionally stand, and occasionally walk. She mostly did computer work. Her disabilities included immunodeficiency, serious back pain, sinus infections, …

Read moreMarselle v. Unum – Kentucky District Court Finds Unum Made A Reasoned Determination

Foss v. Standard – “Own Occ” Is With Any Employer, Not A Specific Employer

I’ve been away from case summaries for a bit. Going to turn that around with a recent decision in Foss v. Standard Insurance Company, Case No. 20-cv-2449, decided by the United States District Court for the District of Minnesota on August 19, 2022. Unfortunately, the Court ruled in favor of the insurance company. Plaintiff Caroline …

Read moreFoss v. Standard – “Own Occ” Is With Any Employer, Not A Specific Employer

SSA Grid Rules Explained

If your impairment does not meet or equal an impairment listing, the Social Security Administration’s medical-vocational or Grid rules come into play. SSA Grid rules may help disability applicants who are 50 years old or older get approved for Social Security disability benefits if they do not have helpful job skills or the job skills …

Read moreSSA Grid Rules Explained

Fowkes v. MetLife – Claimant Did Not Prove Disability

Ms. Fowkes does not contend the Plan’s written evidence requirement violates ERISA. Instead, she takes issue with MetLife's procedures to evaluate her LTD claim. In particular, she contends MetLife required her to present “objective evidence” supporting her LTD claim. At the hearing, she argued that MetLife did not consider the cumulative effect of her conditions in determining whether she adequately established disability. MetLife contends subjective reports of pain need not be taken at face value and argued at hearing that no disability is established even when considering Ms. Fowkes’s conditions in combination.

Read moreFowkes v. MetLife – Claimant Did Not Prove Disability

What Is A Trial Work Period? [2025 Update]

Are you ready to rejoin the workforce? A trial work period allows you to test the waters. During a trial work period, a beneficiary receiving Social Security disability benefits may test his or her ability to work and still be considered disabled. Social Security does not consider services performed during the trial work period as …

Read moreWhat Is A Trial Work Period? [2025 Update]

Can A Doctor Refuse To Fill Out Disability Forms?

When applying for disability insurance benefits, one crucial requirement is having medical evidence to support your claim. Your doctor may need to complete specific paperwork to support your claim, such as an Attending Physician’s Statement (APS) or Residual Functional Capacity (RFC) form. These forms detail your diagnoses, treatment, and any restrictions or limitations. However, some …

Read moreCan A Doctor Refuse To Fill Out Disability Forms?

Long-Term Disability Delays And Extensions

Not being able to earn an income can be scary. If you or a loved one cannot work due to an injury or medical condition, you have likely filed, or will soon be filing, an application for long-term disability insurance benefits. It is essential to know that your disability insurance company has certain obligations when …

Read moreLong-Term Disability Delays And Extensions

How Do I Ask My Doctor for Disability?

According to the CDC, about 61 million adults in the United States have a disability. That means 1 in 4 adults have some disability, whether back problems, autoimmune disorders, heart diseases, vision impairment, or one of many other disabling medical conditions. Living with a disabling condition is tough enough on its own, but one of …

Read moreHow Do I Ask My Doctor for Disability?

Top 10 Mistakes Social Security Disability Claimants Make

Filing a claim for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) disability benefits can be long and complicated. You must avoid the common mistakes that most claimants make to improve your chances of being approved for Social Security Disability.

Read moreTop 10 Mistakes Social Security Disability Claimants Make

Four Reasons Social Security Disability Claims for Mental Illness Get Denied

The top 4 reasons Social Security Disability Claims for Mental Illness get denied are: Social Security disability attorney Nick Ortiz provides more detail on these issues below. Common Reasons the SSA Denies Claims for Mental Health Your Medical Records Are Illegible or Don’t Provide Enough Information One of the biggest problems we face in a …

Read moreFour Reasons Social Security Disability Claims for Mental Illness Get Denied
Disability Insurance Benefits Denied

Long-Term Disability Denials: 12 Reasons LTD Claims Are Denied

When applying for long-term disability (LTD) insurance benefits, you must know that disability insurance companies deny many claims. Even if your disability insurance claim is initially approved, you need to know that your insurance company can terminate or cut off your benefits. If the insurance company decides you are no longer disabled, they can terminate …

Read moreLong-Term Disability Denials: 12 Reasons LTD Claims Are Denied

Long-Term Disability For School Board Employees

If you are a school board employee, you are likely covered by your county’s short-term disability (STD) and long-term disability (LTD) insurance plan. Disability insurance coverage is available to most individuals employed by public schools, such as teachers and janitorial staff, although certain requirements (such as working a certain number of hours each week) must …

Read moreLong-Term Disability For School Board Employees

Schedule For Social Security Disability Payments [2026 Update]

Social Security disability, survivor, and retirement benefits are paid in the month after they are payable. The benefit payment day is determined by the day of the month the payment recipient was born. Schedule For Social Security Disability Payments For beneficiaries born between the 1st of the month and the 10th of the month, benefits …

Read moreSchedule For Social Security Disability Payments [2026 Update]

Archer v. Hartford – Court Upholds Long-Term Disability Claim Denial

The claimant in Archer v. Hartford Life and Accident Insurance Company was an Assistant Store Manager at TJX Marshall’s Department Store. She had group long-term disability (LTD) coverage. She also had life insurance benefits. Both of these categories of group benefits were issued and administered by Hartford. Hartford had what we call “discretionary authority”. As claims administrator for …

Read moreArcher v. Hartford – Court Upholds Long-Term Disability Claim Denial

Free Social Security DisabilityWebinar: How to Win Your Claim Without Hiring a Lawyer

If you’re applying for Social Security Disability Insurance (SSDI) or preparing for a disability hearing, don’t go in blind. One of the biggest reasons claims are denied is because claimants simply don’t know how to present their case effectively. That’s why Social Security disability attorney Nick Ortiz is offering a FREE webinar that will teach …

Read moreFree Social Security DisabilityWebinar: How to Win Your Claim Without Hiring a Lawyer

Long-Term Disability For Knee Injuries

The gut-wrenching sound of a knee injury is a familiar sound for athletes. You may have witnessed a knee injury watching a professional basketball game. Knee injuries account for 50% of all injuries in athletes. But knee injuries don’t just happen under the lights in a large stadium. Knee injuries and pain are common in …

Read moreLong-Term Disability For Knee Injuries

Why Your Doctor Must Document Your Functional Limitations

Your functional limitations are the most critical evidence for your long-term disability claim. Your insurance company is interested in how your disability affects your ability to work. The insurance claim examiner (and a judge if your claim goes to court) will look for you to provide detailed doctor’s notes on activity limitations. This information is …

Read moreWhy Your Doctor Must Document Your Functional Limitations

The Do’s And Don’ts Of Traveling On Long-Term Disability

You can still have a life that involves traveling when you have a long-term disability. The disability insurance companies may not like it, but being on long-term disability doesn’t mean you are on house arrest. Traveling can be a little more complicated when receiving disability payments, but it is doable with additional planning. The Do’s of …

Read moreThe Do’s And Don’ts Of Traveling On Long-Term Disability

Do Insurance Companies Use Drones To Investigate LTD Claims?

Yes, insurance companies may use drones to gather information and decrease the costs of claim investigations. Why Do Insurance Companies Use Drones to Spy? Insurance companies have the duty of investigating disability insurance claims. Most insurance claims are legitimate claims filed by truly disabled individuals. But the disability insurance company doesn’t want to pay out …

Read moreDo Insurance Companies Use Drones To Investigate LTD Claims?
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