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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.
Cara R. Denney (“Denney”) was an employee of Wagner Equipment Company (“Wagner”) where she was a Computer and Technology Instructor. Her job duties “required extensive computer use” and “the ability to instruct employees on the use of various computer systems.” She was also required to travel up to fifty percent of the time, be able to …
Dana Krysztofiak (“Krysztofiak”) works as a registered nurse but was previously a Clinical Coordination Manager for the company HomeCare Maryland, LLC. In 2016, Krysztofiak ceased working because of problems with fibromyalgia and psoriatic arthritis. She then filed for long-term disability benefits with Boston Mutual Life Insurance Co. (“Boston Mutual”). According to the language of the policy: Further, payments only …
The Court found that Prudential abused its discretion in relying upon a vocational assessment that was based only on Prudential’s hired external medical reviewer’s opinions rather than all of the medical evidence.
In Pearson-Rhoads v. Aetna Life Insurance Company, the plaintiff sued for the payment of long-term disability insurance benefits from the insurer of her ERISA governed plan, Aetna Life Insurance Company. The plaintiff made numerous arguments. All were rejected by the court. Of particular note here is the plaintiff’s argument that Aetna abused its discretion by …
In Faciane vs. Sun Life Assurance Company of Canada, the claimant received a monthly benefit for long-term disability benefits pursuant to an ERISA-regulated group insurance policy. The group policy covered employees of Capital One Financial Corporation. He alleged that Sun Life had been underpaying him for years. The material facts of the case were not in …
Colon Carter (“Carter”) worked as an estimating analyst for Bath Iron Works (“BIW”), a subsidiary of General Dynamics. His job duties included “developing cost proposals for new Navy and commercial work; developing and maintaining proposal support documents and checklists; creating financial models; maintaining company baselines for all Programs; assisting management with department staffing plans; and …
The Court concluded that Warner’s motion must be granted because Unum abused its discretion in denying her claim without substantively explaining its rejection of her functional capacity evaluation and relying exclusively on the absence of objective tests confirming her subjective symptoms when denying her claim.
The case Meghan Christmas v. Sun Life Assurance Company of Canada was decided by the U.S. District Court for the District of Connecticut on December 13, 2018. In this case, Meghan Christmas (“Christmas”), a Manager of Global Solutions Integration for ISGN Corporation, sought long-term disability (“LTD”) benefits from Sun Life Assurance Company of Canada (“Sun Life”). Between …
Here, Chernequa Dawson (“Dawson”) worked as a Care Transition Coordination (“CTC”) Nurse Care Manager and was employed by Cigna Corporation (“Cigna”). Through her employment with Cigna, she was covered under both a short-term and long-term disability plan. For these plans, Cigna pays the short-term disability plan benefits, while Life Insurance Company of North America (“LINA”) pays for long-term …
Based upon an exhaustive review of the administrative record, the Court found that the plaintiff had established by a preponderance of the evidence that he was disabled under the terms of the Plan during the relevant period.
Case Name: Carole Cheney v. Standard Insurance Company Court: United States District Court for the Northern District of Illinois Date of Decision: August 28, 2014 Type of Claim: Long-Term Disability under the Employee Retirement Income Security Act (“ERISA”) Insurance Company: Standard Insurance Company Claimant’s Employer: Kirkland & Ellis Claimant’s Occupation / Job Position: The plaintiff was a long-time attorney at Kirkland & Ellis …
This is an update to the previous District Court Decision in Cheney v. Standard. Here, the U.S. Court of Appeals reversed the lower court decision in favor of the Plaintiff and rules in favor of the insurance company. Case Name: Cheney v. Standard Court: U.S. Court of Appeals for the Seventh Circuit Date of Decision: July 27, …
Charlie Craig Hounihan (“Hounihan”) was a technician who was employed by Proctor and Gamble (“P&G”) on the Bounty paper towel line at a plant in Cape Girardeau, Missouri. Through his employment with P&G, Hounihan was covered under both short-term and long-term disability benefit plans with Aetna. The Proctor & Gamble Disability Committee (“Disability Committee”) is …
In this case, Gary Carty (“Carty”) worked as a manager of Eastman Chemical Company’s (“Eastman”) information technology department. Gary held a policy under the Eastman Chemical Company Welfare Benefit Program which Metropolitan Life Insurance Company (“MetLife”) administered. Under the policy provisions, a claimant is considered disabled if he cannot make 80% of his pre-disability salary …
In this case, the U.S. District Court for the Northern District of California ruled in favor of Plaintiff Sarabjit Sangha and ruled against Cigna Life Insurance Company of New York. Specifically, the Plaintiff appealed Cigna’s denial of her long-term disability (“LTD”) benefits. After reviewing briefs submitted by both parties, the Judge overturned Cigna’s denial of …
Because the record establishes that LINA acted arbitrarily and capriciously in denying Calhoun long-term disability benefits, the Sixth Circuit REVERSED the district court’s judgment and REMANDED this case to the district court.
Bruce Tracia (“Tracia”) was an employee of Comcast Cable Communication Management, LLC (“Comcast”) and held the job of a business account executive. He had previously worked as a line technician and several other positions while working for Comcast. Through his employment with Comcast, Tracia was covered by a Group Disability Income Policy. Liberty Life Assurance …
In the instant case, Julissa Bradshaw (“Bradshaw”) was a medical biller for Pyramid Healthcare Solutions, Inc. (“Pyramid”). She held a policy through Reliance Standard Life Insurance Company (“Reliance Standard”) for both short-term and long-term disability coverage. Her coverage under this policy began on May 1, 2013. When Bradshaw was hired by Pyramid, she was several weeks into a pregnancy. She …
In this case, the court found that the evidence MetLife received in 2014, and in 2015 after Black appealed MetLife’s initial denial, showed that Black’s physical condition had in fact improved sufficiently to allow her to perform sedentary work
The Court found that ERISA preempts Ms. Bey’s state law claims and that Reliance is entitled to summary judgment in its favor in all respects. Given the thorough review by an independent physician, the Court did not conclude that Reliance acted arbitrarily or capriciously.
In this case, Tiffany Ausler (“Ausler”) worked as a software engineer for Boeing Corporation (“Boeing”). Because she was a Boeing employee, Ausler was covered under both short-term and long-term disability compensation plans where Aetna Life Insurance Company (“Aetna”) was the administrator of the plans. The plan brochure explains that an employee may be eligible for short-term disability benefits …
Charles Buford Arning (“Arning”) was employed full-time by ECMD, Inc. as the President of the Arndt & Herman Building Products Division. Aetna Life Insurance Company (“Aetna”) administered a Long-Term Disability Executives Plan provided to ECMD employees. The Plan’s language provides: “You will be considered disabled while covered under this . . . Plan on the …
In this case, Andrew Scott (“Scott”) was an orthopedic surgeon focusing on sports medicine. His employer had a long-term disability (LTD) plan through Union Security Insurance Company (“Union”). The LTD plan defined “disability” as follows: In October 2012, the Plaintiff had surgery for a rotator cuff injury. As a result, he stopped working as a surgeon. Union then …
Susan Usztics (“Usztics”) was employed as a program manager for MSX International, Inc. Through her employment, she held a short-term disability benefits policy which was administered by Unum Life Insurance Company of America (“Unum”). Her last day of work was February 4, 2014, following which she applied for short-term disability benefits because of fibromyalgia, anxiety, and …