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Ortiz Law Firm | National Disability Law Firm
Ortiz Law Firm is dedicated to helping people recover the disability benefits they deserve. We handle group Long Term Disability (LTD) claims, individual disability insurance policy claims, ERISA disability claims, and Social Security Disability claims.
Plaintiff appealed the initial denial of benefits under the Plan, stating that her request for disability was not based solely on her thyroid surgery but rather on symptoms associated with lupus and chronic pain. On September 12, 2011, ALIC again upheld the denial of benefits to the Plaintiff. As allowed under ERISA, the Plaintiff sued to challenge that decision. Both parties moved for judgment on the administrative record.
In this case, the Court found that the Plaintiff's complaints of pain were credible there was no reason to question the Plaintiff's credibility. As such, the Defendants' motion for decision was denied and Plaintiff's motions was granted.
Case at a Glance Claimant Win Case Abrams v. Unum Life Insurance Company of America Court United States District Court for the Western District of Washington Decided December 27, 2022 Claim type Long-Term Disability (ERISA) Insurer Unum Employer Schwabe Law Firm Occupation Trial and Appellate Lawyer Conditions Long COVID, chronic fatigue syndrome (CFS) Disclaimer: This …
Long-term disability (LTD) insurance provides financial support to individuals who become disabled and cannot work for an extended period. When claimants file disability claims with a long-term disability insurer, they may also apply for Social Security Disability Insurance (SSDI) benefits. In fact, most disability insurance policies require claimants to apply for SSDI. This ensures that …
Living abroad can be an exciting adventure, but it can also be a bit nerve-wracking if you’re relying on long-term disability insurance benefits to provide you with income. Fortunately, if you have an individual or group long-term disability insurance policy, you may still be able to collect benefits while living outside of the United States. …
Social Security disability hearing offices are officially known as Offices of Hearings Operations (OHO). Previously, they were known as Offices of Disability Adjudication and Review (ODAR). Statistically, this is where most Social Security Disability claims will be approved. A Request for Hearing is the third step in the process and the second level of appeal …
Long-term disability insurance is designed to provide financial assistance to those who have become disabled and are unable to work for a long period of time. However, not all claims are approved, and many people are denied coverage. In this article, we will discuss the types of long-term disability claims that are most likely to …
One of the most commonly requested documents by disability insurance carriers is an Attending Physician Statement (APS). Attending Physician Statement forms are provided by your insurance company to be completed by your doctor(s). The medical information your doctor provides on the Attending Physician Statement could make or break your claim. If you submit an incomplete …
Long-term disability (LTD) insurance is a crucial safety net for many employees. These benefits provide financial security for a disabling illness or injury. While many employers offer LTD coverage as part of their benefits package, the claims process can often be complicated and frustrating, and many claims are denied. Why? Unlike Social Security disability adjudicators, …
The Social Security Administration (SSA) is revising criteria in the Listing of Impairments used to evaluate claims. These changes will affect Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims for adults and children involving digestive disorders and skin disorders. Why Is the SSA Revising the Listing? This is part of the SSA’s …
When it comes to long-term disability (LTD) insurance, it’s important to understand the difference between total and residual disability. These two concepts can significantly impact your insurance benefits and coverage. In this article, we’ll take a closer look at what each term means and how they affect your insurance policy. What Is Total Disability? Total …
Insurance companies often use “boilerplate” language when denying a long-term disability claim. Boilerplate language refers to a long-term disability denial letter that uses standard, pre-written language or a generic explanation rather than a detailed explanation specific to the individual’s claim. Boilerplate denials are often generic and do not provide specific information to explain why the …
This is a continuation from Long-Term Disability Policy Provisions – Part I. Long-Term Disability Insurance – The “Maximum Benefit Period” Almost all long-term disability policies stop paying benefits when you turn 65 years old, or when you reach the federal retirement age. This is often referred to as the “maximum benefit period.” Your policy should …
Your long-term disability (LTD) insurance policy probably reads like most insurance policies, meaning that it is long, confusing and full of industry-specific terms of art that you will most likely have a hard time understanding unless you are a lawyer or insurance professional. In this article, I will explain some of the most important provisions …
A question we often hear is “Can I file for disability if I have a pending Jones Act Maritime Injury Case?” The short answer is – yes, you can apply for disability benefits while your Jones Act case is ongoing. Offshore workers can apply for disability benefits while a Jones Act claim is pending. Applying …
Social Security Disability Insurance (SSDI) back pay or retroactive benefits are lump sum payments that cover the benefits you were entitled to but did not receive while waiting for your application to be approved. It can be a significant amount of money and is a welcome relief for many struggling to make ends meet while …
If you’re looking into long-term disability (LTD) insurance, you may have come across the term “elimination period.” This is an important concept to understand as it can affect when you will receive benefits if you become disabled. In this article, we will explain what the elimination period in a long-term disability claim is and how …
You should not assume that the insurance carrier will continue to pay benefits indefinitely once your long-term disability claim is approved. Your disability insurance policy may state that benefits are payable until you reach retirement age. However, it does not guarantee that you will automatically continue to be eligible to receive benefits until then. Disability …
Applying for Social Security Disability benefits can feel overwhelming. One of the most important steps in the process is your interview with the Social Security Administration (SSA). What you say during this conversation can significantly impact how your claim is evaluated. Most people focus on what they should say. But just as important is knowing …
Social Security Disability Insurance (SSDI) is a government program that provides financial support to individuals who are unable to work due to a disabling condition. However, applying for and receiving SSDI benefits can be a complicated and challenging process, which is why many individuals turn to Social Security disability advocates for help. The Role of …
If you’re unable to work due to a disabling condition, you may be eligible for long-term disability (LTD) benefits. However, obtaining these benefits is often a complex and challenging process. One of the key factors that can affect your chances of getting approved for long-term disability benefits is the medical evidence that you submit with …
In Paquin v. The Prudential Insurance Company of America, the claimant won reinstatement of his long-term disability (LTD) benefits after the United States District Court for the District of Colorado found that Prudential abused its discretion by terminating a claim it had already paid for nearly 11 years, based on a single contested neuropsychological test. …
Laverne Robinson, a former utility machine operator, sued Aetna Life Insurance Company after her benefits were terminated. Aetna argued Robinson hadn’t been approved for Social Security Disability within the Plan’s 24-month window for continued long-term disability (LTD) benefits — even though the SSA later retroactively awarded her SSDI for that same period. The court ruled …
If you’ve filed a Social Security disability claim and are headed to a hearing before an Administrative Law Judge (ALJ), it’s essential to be prepared. Knowing what to say and what not to say can make a significant difference in the outcome of your case. In this article, we’ll explore some common mistakes claimants make …