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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.
Many long term disability recipients remain “employed” with their employer, perhaps listed as an “inactive employee”. But let’s say there has not been a formal separation either by resignation or termination. Can one “quit” the job while receiving long term disability (LTD) benefits? Yes, you can quit your job while on LTD benefits, but it’s …
At the Ortiz Law Firm, we recently had the privilege of helping a client who had been unfairly denied his long-term disability (LTD) benefits. Our client became disabled due to a combination of debilitating medical conditions, including long COVID syndrome with shortness of breath and dizziness, chronic fatigue syndrome, chronic migraines, dyspnea on exertion, cervical …
Many people assume that if their long-term disability (LTD) appeal is denied, they can simply take the insurance company to court and present all the evidence they didn’t get to include earlier. Unfortunately, that’s not how it works under the law that governs most group LTD policies: ERISA, which is short for the Employee Retirement …
When an insurance company approves a long-term disability (LTD) claim, many claimants assume that their benefits will continue indefinitely into the future. However, insurers are not required to approve benefits forever. Instead, they conduct periodic reviews to determine whether a claimant still meets the policy’s definition of disability. Understanding how and why these reviews occur …
If your long-term disability (LTD) claim has been denied, there’s a good chance that a “peer review report” played a role in that decision. Understanding what these reports are and how they’re used can help you make sense of the denial letter you received and decide what to do next. What Is a Peer Review …
At the Ortiz Law Firm, we fight for people who have been unfairly denied long-term disability benefits. Our recent success story highlights the importance of perseverance and strong legal advocacy when battling insurance companies like Lincoln National. Case Overview Our client, an airline operations agent, became disabled in March 2023 due to a combination of …
You’ve filed your long-term disability (LTD) appeal. You followed the instructions, submitted medical records, maybe even worked with your doctor or an attorney. Now comes the hardest part: waiting. You may be checking the mail or your inbox daily, wondering when the insurance company will respond. If it’s been several weeks, or even months, you’re …
Our client was forced to stop working due to a combination of disabling conditions, including essential tremor, chronic pain and neuropathy, and complications from right shoulder surgery. New York Life initially approved her long-term disability (LTD) claim and paid benefits during the 24-month “own occupation” period. However, after that period ended, the definition of disability …
When people think of disability, they often picture someone who can’t work at all. But when it comes to long-term disability insurance, the word “disability” can mean very different things depending entirely on how it’s defined in your policy. Understanding the exact definition of “disability” in your plan is critical. It’s the basis for whether …
I’m honored to share another story of how we helped a client recover the long-term disability (LTD) insurance benefits she desperately needed after her claim was unfairly denied. This is a testament to the power of perseverance and expertise when it comes to fighting for our clients’ rights against large insurance companies like New York …
At the Ortiz Law Firm, we fight to make sure insurance companies live up to their obligations. Recently, we helped a Charles Schwab financial manager regain the claimant’s long-term disability (LTD) benefits after Lincoln National wrongfully terminated the claimant’s disability claim. Denial of a Valid Disability Claim Our client is disabled and unable to work …
A Minnesota trial attorney diagnosed with multiple myeloma, sued Unum after the insurer wrongfully terminated his long-term disability benefits. Despite medical records and expert testimony confirming that Hardy’s cancer-related symptoms prevented him from working full-time, Unum relied on file reviews by non-examining physicians to justify the termination. The court found that Hardy remained disabled under the terms of his policy and ordered Unum to reinstate his benefits, pay back benefits, and cover attorney’s fees.
Navigating the appeals process for mental health-related long-term disability (LTD) claims can be particularly challenging. Unlike physical conditions that can be documented with imaging and lab results, mental health disorders rely on more subjective assessments that insurers often undervalue or dismiss. Insurers may also use various tactics to discredit claims, such as surveillance, relying on …
Jason Seneca, an IT Administrator from Louisiana, filed suit after MetLife terminated his LTD benefits based on a shift to the policy’s stricter “any occupation” definition of disability. Despite support from a treating neurologist, the court upheld MetLife’s decision, finding that medical records in 2019–2020 supported functional ability and that MetLife’s review process was reasonable under ERISA.
At the Ortiz Law Firm, we understand how devastating it can be when a disability insurance company unfairly denies your claim for benefits. Recently, we had the privilege of helping a brilliant lead research scientist who was struggling with Lance-Adams Syndrome. This condition caused debilitating tremors, ataxia, and startle-induced myoclonus, resulting in frequent falls and …
Some hearings require more effort than others, and today’s hearing before an Administrative Law Judge was one of them. It was a case where I really had to work as the claimant’s attorney to help him win the claim, but the effort paid off. The Challenge: A Medical Expert Who “Missed” Key Evidence The hearing …
A California physician filed an ERISA lawsuit after Sun Life denied his long-term disability claim for chronic fatigue syndrome. Despite multiple medical diagnoses supporting his condition, the insurer cited psychiatric history and lack of conclusive evidence. The court stayed the case and remanded it for further review, ordering a neuropsychiatric evaluation and a comprehensive reassessment of all medical records.
When filing a long-term disability (LTD) appeal, many people ask: “How long will it take?” Unfortunately, the answer is “it depends.” There are two main phases to the appeal timeline: We’ll break down what happens in each phase and why the entire process can take several months or more. Phase 1: Preparing the Appeal Under …
When appealing a long-term disability (LTD) claim denial with New York Life, the employee reviewing your LTD claim may not be a medical professional, but they will likely consult with one. New York Life (NYL) will often ask an independent physician to re-evaluate a claimant’s medical condition and determine if it is consistent with the …
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), refers to a range of symptoms that persist or develop long after the acute COVID-19 illness. Estimates suggest that between 5% and 30% of COVID-19 survivors develop long COVID, representing tens of millions of people worldwide. Now, clear patterns are emerging suggesting that COVID-19 …
When appealing a long-term disability (LTD) claim denial with Lincoln Financial Group, claimants often encounter an independent physician review. Lincoln, like many other insurance companies, uses these independent reviews to re-evaluate a claimant’s medical condition and determine if it is consistent with the reported functional limitations. Here, we’ll explore Lincoln’s physician reviews, including what to …
On April 1, 2024, The Standard announced the completion of its acquisition of the Life & Disability business of Elevance Health. Elevance Health is the parent company of Anthem. This move marks a significant expansion of The Standard’s presence in the employee benefits marketplace, particularly in the areas of life and disability insurance. While the …
Preparing for a psychological exam required by the Social Security Administration (SSA) can be stressful, but knowing what to expect can make a big difference in how you handle the process. Psychological consultative exams are often requested when the SSA doesn’t have enough information to determine the impact of mental health on your ability to …
In King v. Reliance Standard Life Insurance Company, the insurer failed to issue a timely decision or seek an extension within the 45-day deadline for reviewing Megan King’s appeal of her terminated long-term physical disability benefits. Under the Department of Labor’s regulations, this failure allowed King to consider her claim “exhausted” and file suit.